Put your nursing expertise to work in a fully remote utilization review role that supports hospitals, patients, and payors. This position offers competitive pay, career growth, and the chance to join an award-winning healthcare organization.
About Ensemble Health Partners
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, hospitals, and physician groups nationwide. Recognized as a five-time Best in KLAS winner and multiple-time Top Workplace USA, Ensemble is committed to innovation, excellence, and putting people first. The organization empowers associates to challenge the status quo and deliver meaningful results in healthcare finance.
Schedule
- Remote/work-from-home (nationwide)
- Full-time roles available (PRN and part-time weekend shifts also offered)
- Standard weekday schedule with flexibility based on assignment
What You’ll Do
- Conduct medical necessity reviews for admissions and continued stays using approved criteria
- Identify over/under utilization of services and collaborate with physician advisors
- Support denial management by coordinating appeals, tracking updates, and monitoring trends
- Collaborate with care teams, financial counselors, and business offices regarding billing and payer issues
- Accurately document reviews, decisions, and communications in required systems
- Prioritize patient reviews, ensuring compliance with clinical standards and payer guidelines
- Educate staff and providers on utilization review processes
- Participate in quality improvement initiatives and departmental process improvement teams
What You Need
- Bachelor’s degree in Nursing or related field preferred
- Current, unrestricted RN or LPN license (compact license preferred)
- At least 3 years of acute care nursing experience required
- Utilization review or discharge planning experience strongly preferred
- Knowledge of medical necessity criteria, quality improvement processes, and revenue cycle operations
- Strong clinical assessment, organizational, and communication skills
- Ability to work independently in a fast-paced, remote environment
Benefits
- Pay range: $28.90–$35.45/hour (based on experience)
- Bonus incentives and recognition programs
- Paid certifications and tuition reimbursement
- Comprehensive healthcare, retirement, and well-being benefits
- Professional development opportunities with growth-focused culture
- Award-winning workplace environment that values flexibility and innovation
Join a healthcare leader where your clinical expertise ensures better patient outcomes and stronger hospitals.
Empower patients. Elevate care.
Happy Hunting,
~Two Chicks…