Virtual Utilization Review Specialist - Weekend - Full Time

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners 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

The Opportunity:

***This position is Full Time, Friday - Sunday or Saturday - Monday, 12 hours/day, 36 hours/week with option to work 4 additional hours***

The Virtual Utilization Review (VUR) is a key contributor to the overall financial, quality, and clinical performance of the organization. The VUR supports an outcomes-oriented, patient care delivery system, which places the patient at the center of all activities.

The VUR facilitates the improvement of overall quality and completeness of medical record documentation. The VUR provides a positive financial impact to the institution through extensive interaction with physicians, nurses, other patient care givers, and coding professionals to ensure that medical record documentation accurately reflects the level of services rendered to patients and the clinical information utilized in profiling and reporting outcomes is complete. Monitors and evaluates care to ensure costs are medically necessary, provided in the appropriate setting, and are generated according to governmental and regulatory agency standards.

Essential Job Functions:

Employment Qualifications:

Required Minimum Educations: 4 year/Bachelor's Degree; Specialty/Major: Nursing

Licensure/Certification Required: Current unrestricted LPN or RN license to practice nursing in Ohio, or a compact license. Baccalaureate degree preferred.

Minimum Years and Type of Experience: Five years nursing experience in an acute care environment required. Utilization review/discharge planning experience preferred. Recent and working knowledge of medical necessity review criteria experience preferred. Current working knowledge of quality improvement process preferred. Ability to receive high speed internet at home.

Other Knowledge, Skills, and Abilities Required: Excellent interpersonal, communication and negotiation skills in interactions with physicians, payors, and health care team colleagues. Remain focused on customer service at all times. Communicate ideas and thoughts effectively verbally and in written form. Able to participate collaboratively with all members of care team. Strong clinical assessment, organization and problem solving skills. Ability to assess and identify appropriate resources, internal and community, on assigned caseload and to work collaboratively with health care team, providers, and payors to achieve the desired patient, quality, and financial outcomes. Ability to organize information quickly and effectively; prioritize and complete multiple tasks effectively. Ability to work independently.

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Join an award-winning company

Three-time winner of “Best in KLAS” 2020-2022

2022 Top Workplaces Healthcare Industry Award

2022 Top Workplaces USA Award

2022 Top Workplaces Culture Excellence Awards

Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:

Ensemble Health Partners 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 Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.

Ensemble Health Partners 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 .