Director, Virtual Utilization Review

About the role

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.

Responsibilities

• 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

Requirements

• 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

Benefits

Additional Information

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.

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