Director, Virtual Utilization Review

This is a fully remote position, open to applicants in United States.

📋 Description

• Establish robust, trusted relationships with clients while acting as a strategic partner.

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

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

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

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

• Lead data-driven decision-making through the use of dashboards and analytics tools.

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

• Direct large-scale change initiatives affecting people, processes, and technology.

• Collaborate cross-functionally to execute process and system enhancements.

• Guide, develop, and mentor a sizable, multi-layered team of 125–175 employees globally.

• Oversee and empower direct reports, including at least 3 leaders.

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

⛳️ Requirements

• Bachelor’s degree or an equivalent combination of education and experience.

• Valid RN license.

• Over 2 years of leadership experience in multi-client utilization review or utilization management operations.

• Background in Revenue Cycle Management or equivalent healthcare leadership experience.

• Experience managing teams that are geographically dispersed across the US and internationally.

• Proven record of success in client relationship management and partnership development.

• Strategic mindset with experience in driving organizational transformation and managing change initiatives across people, processes, and technology.

• Data-driven leadership style, possessing strong analytical skills; proficiency in Power BI for dashboard navigation and insights is preferred.

• Excellent communication abilities with the capacity to organize and convey information clearly and succinctly.

• Strong technical expertise including database and spreadsheet analysis and a working knowledge of EMR(s) with both front-end and back-end understanding.

• Familiarity with project management tools is preferred (such as AHA, Loop, Microsoft Project, or similar).

🏝️ Benefits

• Healthcare.

• Time off.

• Retirement.

• Well-being programs.

• Professional development.

• Quarterly and annual incentive programs.