Director, Virtual Utilization Review
Thank you for considering a career at Ensemble!
Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!
O.N.E Purpose:
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Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
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Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
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Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
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 125–175 employees globally
- Manage and empower direct reports including a minimum of 3 leaders
- Foster a high-performing culture aligned with organizational values
Who You’ll 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:
- 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 Manage