Case Manager Behavioral Health (Remote)

Location: Remote within the United States; Work At Home - Pennsylvania. Travel requirement: 0%–25%. The position is office-based and requires a physical work site.

Company

hirify.global provides health insurance and healthcare services focused on quality, cost-effective member outcomes.

What you will do

• Manage a caseload of members with moderate-complexity behavioral health needs.
• Assess member health status, needs, resources, and barriers to care.
• Develop, implement, coordinate, and adjust individualized care plans.
• Coordinate with members, physicians, providers, and healthcare teams in complex clinical situations.
• Monitor intervention effectiveness, identify quality and cost improvements, and support appropriate benefit utilization.
• Document activities in compliance with company policies, regulatory requirements, and accreditation standards.

Requirements

• Master’s degree for licensed Behavioral Health Professionals, or an associate degree with an RN license.
• At least 3 years of experience in clinical care, case or utilization management, disease condition management, provider operations, or health insurance.
• Current state RN license or enhanced Nurse Licensure Compact multi-state license, or an accepted behavioral health license such as LSW, LCSW, LMSW, LPC, LMHC, or LMFT.
• Strong assessment and care planning skills with the ability to work independently and collaboratively.
• Proficiency with Microsoft Office, case management software, and electronic health records.
• Understanding of healthcare systems and case management principles.

Nice to have

• Bachelor’s or master’s degree in nursing for licensed RNs.
• Certified Case Manager credential.
• Experience serving diverse populations and applying cultural competency.

Culture & Benefits

• Remote work arrangement within the United States.
• Collaboration with physicians, providers, and multidisciplinary healthcare teams.
• Work focused on improving quality outcomes and controlling healthcare costs.
• Confidential information must be handled in accordance with HIPAA and company information security policies.