UM Behavioral Health Professional

Location: Remote work from home in the United States; the posting specifies Illinois and requires an active professional license without disciplinary action or restrictions. Schedule is typically Monday–Friday, 8:00 AM–5:00 PM Eastern Time. Occasional travel to hirify.global offices for training or meetings may be required.

Salary: $65,000–$88,600 per year, plus eligibility for a performance-based bonus incentive plan.

Company

hirify.global is a U.S. healthcare and insurance company providing insurance and healthcare services to members, families, and communities.

What you will do

• Support behavioral health utilization management, medical service coordination, and benefit administration determinations.
• Interpret clinical criteria, policies, and procedures to determine appropriate treatment, care, and services.
• Coordinate and communicate with providers, members, and other parties to facilitate optimal care.
• Document clinical reviews and communicate medical service and benefit determinations.
• Make independent decisions in varied and occasionally ambiguous situations while following established guidelines.

Requirements

• Active, applicable professional license without disciplinary action or restrictions, such as LCSW, LMSW-ACP, LPC, psychologist license, or another relevant professional license.
• At least three years of post-degree clinical experience in private practice or patient care.
• At least one year of managed care or health plan experience.
• Ability to work remotely from the United States and maintain a dedicated workspace protecting member PHI and HIPAA information.
• Reliable home internet with at least 25 Mbps download and 10 Mbps upload speeds.

Nice to have

• Experience with pre-authorization and utilization review processes.
• Experience in behavioral change, health promotion, coaching, or wellness.
• Experience supporting patients from pediatric through older-adult populations.
• Knowledge of community health, social service agencies, and community resources.
• Bilingual English/Spanish communication skills, including reading, writing, interpreting, and explaining Spanish documents.

Culture & Benefits

• Full-time schedule of 40 hours per week in a remote work-at-home arrangement.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and additional wellness benefits.