Director, Virtual Utilization Review

This is a fully remote position, open to applicants in North America.

📋 Description

• Establish strong, trustworthy relationships with clients and act as a strategic collaborator.

• Gain a thorough understanding of client KPIs and SLAs within the initial 60 days.

• Recognize and implement proactive measures to enhance performance, satisfaction, and outcomes.

• Supervise complex multi-client utilization review and management operations.

• Propel measurable advancements in performance, productivity, and SLA achievement.

• Lead decision-making based on data utilizing dashboards and analytical tools.

• Advocate for the adoption of innovative technologies and investment capabilities.

• Spearhead large-scale transformation initiatives across personnel, processes, and technology.

• Collaborate across functions to implement improvements in processes and systems.

• Guide, develop, and mentor a sizable, multi-tiered team (125–175 employees globally).

• Oversee and empower direct reports (at least 3 leaders).

• Cultivate a high-performing culture that aligns with organizational values.

⛳️ Requirements

• Valid Registered Nurse (RN) license.

• Demonstrated experience in leading complex, multi-client utilization review/utilization management operations (RPM environment is preferred).

• Strong foundation in Revenue Cycle Management (RCM) or equivalent healthcare leadership experience.

• Experience managing teams across multiple geographies.

• Proven success in client relationship management and developing partnerships.

• Strategic thinker with a background in driving organizational change.

• Data-driven leadership style, equipped with robust analytical skills.

• Proficient in Power BI (dashboard navigation and insights).

• Familiarity with EMR systems (Cerner, Epic, or Meditech preferred), with both front-end and back-end understanding.

• Skilled in Microsoft Office Suite.

• Experience in leading change management initiatives across personnel, processes, and technology.

🏝️ Benefits

• Extensive benefits package tailored to support physical, emotional, and financial well-being.

• Healthcare coverage.

• Paid time off.

• Retirement plans.

• Programs focused on well-being.

• Opportunities for professional development.

• Reimbursement for professional certifications.

• Tuition assistance.

• Incentive programs offered quarterly and annually.