Virtual Utilization Review Supervisor (Fully Remote)

Ensemble; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Ensemble delivers technology-enabled revenue cycle management solutions for health systems, hospitals, and affiliated groups. The nurse will ensure medical necessity and appropriate care levels, supporting quality and financial outcomes.

In this role, you will conduct daily admission reviews, coordinate appeals, monitor denials, and collaborate with liaisons, physicians, and revenue cycle teams to optimize care facilitation across the care continuum.

Qualifications

• Active RN license.
• 5+ years acute care nursing experience.
• 2+ years utilization review (UR) experience.

Responsibilities

• Perform daily admission and continued stay reviews using approved clinical criteria.
• Coordinate appeals, monitor denials, and support care facilitation.
• Collaborate with liaisons, physicians, and revenue cycle teams.

Skills

RN license

Acute care nursing

Utilization review

Leadership

Clinical assessment

Job description

• You will ensure medical necessity and appropriate levels of care to support quality and financial outcomes.
• You will collaborate with liaisons, physicians, and revenue cycle teams.

Responsibilities:

• Conduct daily admission and continued stay reviews using approved clinical criteria.
• Coordinate appeals, monitor denials, and support care facilitation.

Qualifications:

• Active RN license, 5+ years acute care nursing, and 2+ years UR experience.
• Leadership/coaching experience and strong clinical assessment skills.

Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They empower associates to challenge the status quo and put people first, fostering a collaborative and innovative culture.