Support hospitals, patients, and communities by ensuring the right care is delivered at the right time. Ensemble Health Partners is hiring Virtual Utilization Review Specialists to join our award-winning revenue cycle team. Full-time and PRN opportunities available.
About Ensemble Health Partners
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for hospitals and physician groups. Our mission is simple: keep communities healthy by keeping hospitals healthy. Recognized nationally as a multi-time “Best in KLAS” winner, Top Workplace, and Great Place to Work® certified, we empower our people to challenge the status quo and deliver meaningful impact.
Schedule
- Remote, nationwide (US only)
- Full-time or PRN roles available
- Must have reliable high-speed internet and be available for meetings/trainings as scheduled
Responsibilities
- Conduct medical necessity reviews for admissions, patient status, and continued stay using approved clinical criteria
- Collaborate with physicians, advisors, and care teams to ensure appropriate level of care
- Identify barriers to patient progress and assist with utilization of healthcare resources
- Document reviews, decisions, and communications in clinical and revenue cycle systems
- Support denial management, peer-to-peer processes, and appeals as needed
- Partner with financial clearance, billing, and patient access teams on payer-related issues
- Monitor readmissions, denial trends, and report outcomes to leadership
- Actively participate in departmental process improvement and quality initiatives
- Maintain positive communication with physicians, nurses, and hospital staff
Requirements
- Bachelor’s degree in Nursing or related field (or equivalent experience)
- Current unrestricted RN or LPN license (RN compact license preferred)
- Minimum 3 years of acute care nursing experience required
- Prior utilization review or discharge planning experience preferred
- Working knowledge of medical necessity review criteria and quality improvement processes
- Strong organizational, clinical assessment, and problem-solving skills
- Excellent communication and negotiation abilities
Benefits & Growth
- Competitive pay: $28.90 – $35.45/hr (based on experience)
- Bonus incentives and recognition programs
- Paid certifications and tuition reimbursement
- Comprehensive benefits package (healthcare, retirement, PTO, well-being programs)
- Career advancement with structured training and professional development
- Collaborative, innovative, and people-first culture
Join Ensemble Health Partners and make a difference by blending clinical expertise with operational excellence to improve healthcare delivery nationwide.
Happy Hunting,
~Two Chicks…