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:

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.

• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

• Striving for Excellence: Execute at a high level by demonstrating our "Best in KLAS" Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity:

We are seeking a Director of Virtual Utilization Review to join our growing leadership team. This is a newly created, strategic leadership role within our Virtual Utilization Review (VUR) organization, focused on driving client partnerships, performance outcomes, and transformational change across people, process, and technology.

Unlike traditional operational roles, 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.

What You'll Do

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 (125-175 employees globally)
• Manage and empower direct reports (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

What You Bring

Required Qualifications

• 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

Preferred Qualifications

• Experience with project management tools (AHA, Loop, Microsoft Project, or similar)

Join an award-winning company

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

• 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.

Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.

Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role's range.

Employment Disclaimers - Ensemble