Utilization Review Clinician - Behavioral Health

Location: Remote within Washington State; Monday–Friday, 8:00 AM–5:00 PM PST, with weekend and holiday rotation

Salary: $27.02–$48.55 per hour

Company

hirify.global provides healthcare services and works to improve access to effective 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.
• Conduct prior authorization and concurrent reviews for behavioral health services, including inpatient care.
• Assess treatment needs, level of care, member health status, and discharge planning requirements.
• Analyze behavioral health member data to improve quality and appropriate utilization of services.
• 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

• Graduate of an accredited nursing school or a bachelor's degree, with 2–4 years of related experience.
• Active Washington RN license or active Compact RN license required.
• One of the following licenses required: LCSW, LMHC, LPC, LMFT, LMHP, or RN state/Compact licensure.
• Master’s degree required for behavioral health clinicians.
• Knowledge of mental health and substance abuse treatment plans and utilization review processes.
• Experience working with providers and healthcare teams to review behavioral health services.

Culture & Benefits

• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Flexible work approaches, including remote, hybrid, field, and office schedules.
• Equal opportunity workplace committed to diversity and inclusion.