Utilization Review Clinician - Behavioral Health

Location: Remote in Texas, United States; preferred schedule is Monday through Friday, 8:00 AM to 5:00 PM CST, with holiday rotation participation required.

Salary: $27.02–$48.55 per hour.

Company

hirify.global provides healthcare services focused on improving access to care and supporting healthier communities.

What you will do

• Review mental health and substance abuse treatment before, during, and after services to assess medical appropriateness.
• Conduct prior authorization and concurrent reviews for behavioral health inpatient care.
• Evaluate treatment needs, levels of care, discharge planning, and service utilization.
• Analyze behavioral health member data to improve care quality and appropriate utilization.
• Educate providers, members, and families about the behavioral health utilization process.
• Present cases in staffing and integrated rounds and collaborate with providers, medical directors, and leadership.

Requirements

• Must be based in Texas for this remote role.
• Graduate of an accredited nursing school or bachelor's degree, plus 2–4 years of related experience.
• Master’s degree required for behavioral health clinicians.
• Independent practice licensure required under applicable state requirements.
• One of the following licenses required: LCSW, LMHC, LPC, LMFT, LMHP, or RN state/compact-state licensure.
• Clinical knowledge of mental health and substance abuse treatment planning and utilization review is preferred; hospital-based behavioral health or inpatient psychiatric experience is strongly preferred.

Culture & Benefits

• Health insurance, 401(k), stock purchase plans, tuition reimbursement, and paid time off.
• Paid holidays and participation in a holiday rotation for the role.
• Flexible work approaches, including remote, hybrid, field, and office schedules across the organization.
• Equal opportunity workplace committed to diversity and consideration of qualified applicants.