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Lead Utilization Review, RN at Ensemble - ApplyBlast

Lead Utilization Review, RN

Ensemble

16 days ago

4.0 on Glassdoor

Remote

Full Time

Senior

0 applicants

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About this role

The Lead Utilization Review RN plays a key role in ensuring the financial, quality, and clinical performance of the organization by supporting patient-centered care delivery. This position involves monitoring and evaluating care to ensure medical necessity, appropriate resource utilization, and compliance with regulatory standards. The role requires collaboration with physicians, nurses, and other healthcare professionals to optimize patient outcomes and revenue cycle integrity.

Responsibilities

Conduct medical necessity reviews and determine appropriate patient status
Coordinate denial management and appeal processes with payers
Evaluate patient care needs and facilitate timely discharge planning

Skills

Qualifications

Unrestricted RN licenseAssociates degree Nursing

About Ensemble

ensemblehp.com

Headquarters

Cincinnati, Ohio, United States

Company Size

10001+ employees

Founded

2014

View Profile

Ensemble Health Partners is a revenue cycle management company that partners with hospitals, health systems and physician practices to optimize financial performance. They deliver end-to-end RCM services—patient access, coding and clinical documentation improvement, billing and collections, denials management and revenue integrity—backed by analytics and consulting. Ensemble combines operational teams and technology-enabled insights to accelerate cash flow, reduce write-offs, and improve patient financial engagement.