Care Manager, BH - Remote PA

Location: Remote in Pennsylvania, United States

Salary: $64,285–$102,855 per year

Company

hirify.global provides behavioral health and healthcare management services, including clinical care coordination and utilization management.

What you will do

• Authorize and review the medical necessity and effectiveness of inpatient and outpatient mental health and substance abuse services.
• Perform concurrent clinical reviews, telephone triage, crisis intervention, and emergency authorizations within the scope of practice.
• Coordinate with providers and facilities to develop and oversee discharge plans and alternative treatment options.
• Educate members and providers about behavioral health benefits, community resources, managed care programs, and applicable criteria.
• Collect, track, and analyze utilization data and participate in quality improvement projects.
• Collaborate with physician advisors, community agencies, and provider networks while advocating for members' treatment needs.

Requirements

• Current state, Commonwealth, or customer-specific professional licensure is required.
• One or more of the following credentials with the necessary degree: CEAP, LMSW, LCSW, LMFT, LSW, LPC, or RN with state or compact-state licensure.
• At least 2 years of post-degree experience in healthcare, behavioral health, psychiatric, or substance abuse care.
• Experience with inpatient and/or outpatient care settings, utilization management procedures, community resources, and providers.
• Knowledge of the DSM-5 or the most current diagnostic edition.
• Strong organization, time management, communication, analytical, and problem-solving skills.

Culture & Benefits

• Remote work arrangement based in Pennsylvania.
• Potential eligibility for short-term incentives.
• Comprehensive health, life, voluntary, and other benefits.
• Tobacco-free workplace and equal employment opportunity environment.
• Security, regulatory, contractual, and internal policy compliance responsibilities apply to the role.