Ensemble Health Partners

Director, Virtual Utilization Review

Ensemble Health Partners$101K — $145K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Active Registered Nurse (RN) license
  • Experience in leading multi-client utilization review/management operations (RPM environment preferred)
  • Background in Revenue Cycle Management (RCM) or equivalent healthcare leadership
  • Experience managing teams across multiple geographies
  • Proven success in client relationship management and partnership development
  • Strategic mindset with organizational transformation experience
  • Data-driven leadership approach with strong analytical skills
  • Proficiency in Power BI and understanding of EMR systems (Cerner, Epic, Meditech preferred)

Responsibilities

  • Build strong relationships with clients as a strategic partner
  • Understand client KPIs and SLAs within first 60 days
  • Identify opportunities to improve performance and satisfaction
  • Oversee multi-client utilization review and management operations
  • Drive improvements in performance, productivity, and SLAs
  • Champion new technology adoption and change initiatives
  • Lead, develop, and mentor a large global team

Benefits

  • Comprehensive benefits package for physical, emotional, and financial health
  • Collaborative and innovative culture that encourages personal growth
  • Professional development investment, including certification and tuition reimbursement
  • Recognition programs for outstanding employee contributions
Full Job Description

The Opportunity:

By embodying our core purpose of customer obsession, driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare. The Director of Virtual Utilization Review will serve as a strategic leader focused on driving client partnerships, performance outcomes, and transformational change across people, process, and technology. This position emphasizes strategic oversight, data-driven decision-making, and relationship management rather than day-to-day workflow execution. You will lead complex, multi-client utilization review and utilization management operations while shaping the future of how we deliver value to our partners. This role will include travel, up to 25%.

Job Responsibilities include, but are not limited to:

Strategic Leadership & Client Partnership

  • Build strong, trusted relationships with clients and serve as a strategic partner
  • Develop a deep understanding of client KPIs and SLAs within the first 60 days
  • Identify and execute proactive opportunities to improve performance, satisfaction, and outcomes

Operational & Performance Excellence

  • Oversee complex multi-client utilization review and utilization management operations
  • Drive measurable improvements in performance, productivity, and SLA attainment
  • Lead data-driven decision-making using dashboards and analytics tools

Transformation & Change Management

  • Champion adoption of new technologies and investment capabilities
  • Lead large-scale change initiatives across people, process, and technology
  • Partner cross-functionally to implement process and system improvements

Team Leadership

  • Lead, develop, and mentor a large, multi-layered team of 125175 employees globally
  • Manage and empower direct reports including a minimum of 3 leaders
  • Foster a high-performing culture aligned with organizational values

Who You9ll Work With

  • Direct reports and broader VUR organization
  • Clients and external partners
  • Cross-functional teams, including Clinical Documentation Improvement (CDI)
  • Peer Directors and AVP-level leadership

What Makes This Role Exciting

  • Director-level strategic role with significant visibility and impact
  • Opportunity to lead a large, global team across multiple geographies
  • Exposure to complex healthcare operations in utilization review and management
  • Key role in driving technology transformation and innovation
  • Strong focus on analytics, performance improvement, and client experience

Experience:

  • Bachelor9s degree or equivalent combination of education and experience
  • Current RN license
  • 2+ years of leadership experience in multi-client utilization review / utilization management operations
  • Experience in Revenue Cycle Management (or equivalent healthcare leadership experience)
  • Experience managing geographically dispersed teams across the US and international locations
  • Demonstrated success in client relationship management and partnership development
  • Strategic mindset with experience driving organizational transformation and leading change management initiativesacross people, process, and technology
  • Data-driven leadership approach, with strong analytical skills; proficiency in Power BI(for dashboard navigation and insights) preferred
  • Effective communication skills with the ability to organize and present information clearly and concisely
  • Strong technical skills including database and spreadsheet analysis and working knowledge of EMR(s) with front- and back-end understanding
  • Experience with project management tools preferred (AHA, Loop, Microsoft Project, or similar)

**This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needsdictate**

**This position pays between $101,600 - $145,000 based on experience, and is eligible for annual incentives.**

Join an award-winning company

22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle [redacted]

Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024

Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, [redacted]

Fortune Media Best Workplaces in Healthcare 2024

Monster Top Workplace for Remote Work 2024

Great Place to Work certified 2023-2024

  • Innovation

  • Work-Life Flexibility

  • Leadership

  • Purpose + Values

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

  • Associate Benefits We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.

  • Our Culture Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.

  • Growth We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.

  • Recognition We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

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