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Role Overview:
- You will ensure medical necessity and appropriate levels of care to support quality and financial outcomes.
- You will collaborate with liaisons, physicians, and revenue cycle teams.
Responsibilities:
- Conduct daily admission and continued stay reviews using approved clinical criteria.
- Coordinate appeals, monitor denials, and support care facilitation.
Qualifications:
- Active RN license, 5+ years acute care nursing, and 2+ years UR experience.
- Leadership/coaching experience and strong clinical assessment skills.
Ensemble
Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They empower associates to challenge the status quo and put people first, fostering a collaborative and innovative culture.