[Hiring] Director of Virtual Utilization Review @Ensemble Health Partners

Role Description

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 125–175 employees globally
  • Manage and empower direct reports including a minimum of 3 leaders
  • Foster a high-performing culture aligned with organizational values

Qualifications

• Bachelor’s 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 initiatives across 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)

Benefits

• 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.
• Professional development opportunities, including earning a professional certification relevant to your field and tuition reimbursement.
• Quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

Company Description

• Five-time winner of “Best in KLAS” 2020-2022, 2024-2025
• Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
• 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
• Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
• Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
• Energage Top Workplaces USA 2022-2024
• Fortune Media Best Workplaces in Healthcare 2024
• Monster Top Workplace for Remote Work 2024
• Great Place to Work certified 2023-2024