Vp, Utilization Management

Ensemble Health Partners

Remote
Fully remote
Virtual utilization review (vur)
Bedded insurance authorization (bia)
Strategic direction for utilization management
Reporting to the Chief Clinical Officer, this position is responsible for providing leadership for all activities related to the management of Virtual Utilization Review (VUR) and Bedded Insurance Authorization (BIA) functions

Job Summary

  • Reporting to the Chief Clinical Officer, this position is responsible for providing leadership for all activities related to the management of Virtual Utilization Review (VUR) and Bedded Insurance Authorization (BIA) functions.
  • The VP of Utilization Management helps set the strategic direction for all Ensemble clients for the Utilization Management scope.
  • Ensemble offers 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.

Matching Summary

Reporting to the Chief Clinical Officer, this position is responsible for providing leadership for all activities related to the management of Virtual Utilization Review (VUR) and Bedded Insurance Authorization (BIA) functions.

Skills & Requirements

Must-have

  • Virtual Utilization Review (VUR)
  • Bedded Insurance Authorization (BIA)
  • strategic direction for utilization management
  • operational quality and cost management
  • regulatory compliance guidelines
  • client SOWs and SLAs

Nice-to-have

  • human touch and meaningful experiences
  • embracing emerging technology
  • fostering a culture of creativity
  • empowering associates to thrive
  • collaboration and innovation

Key Requirements

  • Certified Healthcare Access Manager (CHAM) certification
  • Certified Revenue Cycle Representative (CRCR) certification within 90 days of hire
  • Bachelors Degree or Equivalent Experience

Work Rights

Not specified

Tailored Resume

Cover Letter