Utilization Review Clinician - Behavioral Health

Location: Remote, Georgia; applicants must hold an active Georgia clinician license or Compact Nursing License

Salary: $27.02–$48.55 per hour

Company

hirify.global provides healthcare services focused on improving access to care for individuals, families, and communities.

What you will do

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

Requirements

• Graduate of an accredited nursing school or a bachelor's degree with 2–4 years of related experience.
• Master's degree required for behavioral health clinicians.
• Active Georgia clinician license or Compact Nursing License required.
• One of the following credentials required: LCSW, LMHC, LPC, LMFT, LMHP, or RN state/compact licensure.
• Experience in behavioral health and the ability to practice independently.
• Provider-facing experience, strong communication and customer service skills, organization, computer proficiency, and adaptability.

Nice to have

• Clinical knowledge of mental health and substance abuse treatment plans.
• Knowledge of behavioral health utilization review processes.
• Experience reviewing care services with providers and healthcare teams.

Culture & Benefits

• Remote work schedule from Monday through Friday, 8:00 AM to 5:00 PM.
• Rotating holiday and weekend coverage is required.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Compensation is adjusted based on skills, experience, education, and other job-related factors.