Senior Financial Clearance SME Operator

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!

O.N.E Purpose:

• Customer Obsession:Consistently provide exceptional experiences for our clients patients and colleagues by understanding their needs and exceeding their expectations.

• Embracing New Ideas:Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

• Striving for Excellence:Execute at a high level by demonstrating our Best in KLAS Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity:

Job Summary

The Senior Financial Clearance SME Operator is a senior-level individual contributor focused on redesigning eligibility and authorization workflows translating payer and clearance judgment into decision models and validating AI/automation approaches that reduce preventable denials.

Role Overview

Operators serve as subject matter experts in specific revenue cycle domains while maintaining literacy across the end-to-end revenue cycle. They redesign workflows identify upstream root causes build knowledge graphs participate in design sessions and validate emerging automation and AI-driven models.

Essential Duties & Responsibilities

Core Responsibilities:

• Act as the domain SME while maintaining literacy across the full revenue cycle.
• Identify structural root causes that drive downstream rework friction and leakage.
• Design future-state workflows and operating models with measurable impact.
• Build and maintain domain-specific knowledge graphs capturing inputs rules actions and outcomes.
• Participate in design sessions and rapid innovation sprints with product engineering and analytics teams.
• Test and validate automation ML AI and agentic models using real operational scenarios.
• Translate SME judgment into rules decision trees training data and guardrails.
• Support pilots and controlled rollouts with clear success criteria and measurement.
• Document operational logic and findings for reuse and scale.

Role-Specific Responsibilities:

• Identify causes of eligibility errors authorization failures and preventable denials.
• Build decision trees for clearance pathways across payer and service types.
• Translate payer rules into deterministic and probabilistic models.
• Test predictive and agentic clearance models for prioritization and exception handling.

Qualifications

Required Qualifications:

• 5 years of hands-on experience in the revenue cycle domain aligned to this role.
• Strong end-to-end revenue cycle literacy.
• Exceptional process mapping and process improvement capability.
• Data-driven problem solving and comfort with variance analysis.
• Ability to operate effectively in ambiguity; self-motivated and proactive.
• Strong communication skills for both technical and non-technical audiences.
• Curiosity and aptitude for automation ML/AI and agentic technologies.
• This is a hybrid role based in Austin Texas. Candidates must be able to commute to the Austin on-site location as required.

Senior-Level Individual Contributor Expectations:

• Demonstrated ability to lead problem-solving and redesign efforts independently (without formal authority).
• Proven ability to challenge existing processes constructively and propose more efficient methods.
• Comfort partnering closely with engineering/product teams to define test and iterate solutions.
• Ability to translate complex operational judgment into structured logic suitable for automation or AI.

Core Competencies

• Innovative thinking and solutioning mindset
• Creative problem solving and systems thinking
• Comfort challenging existing processes to identify better more efficient methods
• Interest in and practical familiarity with AI-enabled workflows and automation
• Strong stakeholder communication and collaboration

Work Style & Environment

This role operates in a rapid-iteration environment and requires comfort with ambiguity experimentation and cross-functional collaboration. The Senior Operator is expected to challenge existing processes respectfully propose improvements and help validate automation and AI-driven solutions using real operational scenarios.

Equal Opportunity Statement

Ensemble Health Partners is an Equal Opportunity / Affirmative Action Employer. We welcome and encourage diversity in our workplace.

Join an award-winning company

Five-time winner of Best in KLAS

Black Book Researchs Top Revenue Cycle Management Outsourcing Solution 2021-2024

22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024

Leader in Everest Groups RCM Operations PEAK Matrix Assessment 2024

Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance-2023

Energage Top Workplaces USA 2022-2024

Fortune Media Best Workplaces in Healthcare 2024

Monster Top Workplace for Remote Work 2024

Great Place to Work certified 2023-2024

• 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 .

This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the roles range.

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