Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference
The Opportunity:
I. Job Summary
Render compliant Status determinations for hospitalized patients.
Perform peer to peers with payors’ medical directors.
Serve as subject matter expert for all issues pertaining to Physician Advisory.
II. Job Competencies
Leadership Decision Making - Makes day-to-day leadership decisions by securing and comparing information from multiple sources to identify issues; commits to an action after weighing alternative solutions against important criteria; effectively communicates decisions to the appropriate people and teams and holds them accountable. Drives results.
Coaching & Building Talent - Achieves results through other leaders by empowering them and providing feedback, instruction and development (coaching the coach) to develop their own associates; plans and supports the growth of individual skills and abilities in preparation for their next role (building bench); focuses on retention of high performers.
Delegation - Successfully shares authority and responsibilities with others to move decision making and accountability downward through the organization while accomplishing strategic priorities; maintains personal ownership of outcomes without excessive involvement.
Leading Teams - Inspires and sustains team unity and engagement by developing, motivating, and guiding the team to achieve results together through productive relationships and work.
Executive Communication - Clearly and succinctly conveys information and ideas; communicates in a focused and compelling way that captures and holds others’ attention (appropriate, impactful, and clear).
Program/Project Management - Demonstrates high accountability and responsibility for projects and programs from inception through completion/implementation; manages budget and resource planning and awareness to ensure maximized output, reduced waste and exceptional results.
III. Essential Job Functions
Status determinations for hospitalized patients
Perform peer to peers with payors’ medical directors
Short inpatient stay reviews
Review observation patients daily
Build relationship with medical staff and leadership to get their buy-in with UM issues
Attend UM Committees as subject matter expert
Assist with denials and appeals as appropriate
Educate medical staff on UM topics
Partner with UR nurses, IA staff, and Case Management to maintain and improve upon the UM process
Track denial trends to assist the team evolve to meet new payor challenges
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.
IV. Employment Qualifications
Legally Required License / Certification (Ex: MD, RN, LPN, etc.) ONE CERTIFICATION PER FIELD
Hold and maintain an unrestricted medical license in the state of the facility / client
Ensemble Required License / Certification (Ex: CRCR) ONE CERTIFICATION PER FIELD
Member of the American College of Physician Advisors (ACPA) ## Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, inc. (ABQAURP) ## Physician Advisor Sub-specialty Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQAURP)
Or other approved job relevant certification.
Desired Work Experience
Job ExperiencePeople Leadership Experience
Desired Education
Education Level Preferred Area Of Study
Post Graduate Degree or Equivalent Experience
Other Preferred Knowledge, Skills And Abilities
Graduate Degree (Masters)Post Graduate Degree (Ph.D)
Minimum Years and Type of Experience: Previous managed care medical doctor experience
Possess or acquires a solid foundation, knowledge, and/or experience in the areas of utilization management, quality improvement, and patient safety
Possess a working knowledge of (Hospital) organization & Case Management operations and administrative standards and policies
Strong computer skills and working knowledge of the EMR
Familiarity with MCG/Interqual placement status criteria is preferred
Ability to build rapport with medical staff and hospital leadership to obtain in buy-in and collaboration necessary to achieve desired outcomes
Possess excellent time management and organizational skills
Demonstrated critical thinking, creativity, problem solving and decision-making skills
Strong data skills, including relational database management, proficiency with MS Excel and MS Access, and SQL programming are required
Join An Award-winning Company
Three-time winner of “Best in KLAS” 2020-2022
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards
- Innovation
- Work-Life Flexibility
- Leadership
- Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
- Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
- Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
- Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
- Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.
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