Director, Virtual Utilization Review
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Job Description
Director of Virtual Utilization Review at Ensemble guiding client partnerships and transformational change in healthcare revenue cycle management. Leading strategic initiatives with a global team for improved performance.
Responsibilities:
- 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
- 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
- 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
- Lead, develop, and mentor a large, multi-layered team (125–175 employees globally)
- Manage and empower direct reports (minimum of 3 leaders)
- Foster a high-performing culture aligned with organizational values
Requirements:
- Active Registered Nurse (RN) license
- Proven experience leading complex, multi-client utilization review / utilization management operations (RPM environment preferred)
- Strong background in Revenue Cycle Management (RCM) (or equivalent healthcare leadership experience)
- Experience managing multi-geography teams
- Demonstrated success in client relationship management and partnership development
- Strategic mindset with experience driving organizational transformation
- Data-driven leadership approach, with strong analytical skills
- Proficiency in Power BI (dashboard navigation and insights)
- Working knowledge of EMR systems (Cerner, Epic, or Meditech preferred) with both front- and back-end understanding
- Proficiency in Microsoft Office Suite
- Experience leading change management initiatives across people, process, and technology
Benefits:
- Comprehensive benefits package designed to support physical, emotional, and financial health
- Healthcare
- Time off
- Retirement
- Well-being programs
- Professional development
- Professional certification reimbursement
- Tuition reimbursement
- Quarterly and annual incentive programs
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