Supervisor, Behavioral Health Utilization Management

Location: Remote - Texas, United States

Salary: $75,300–$135,400 per year

Company

hirify.global provides healthcare services and programs designed to improve access to care for individuals, families, and communities.

What you will do

• Supervise behavioral health utilization review clinicians and manage daily team activities.
• Monitor utilization management resources, performance, quality, efficiency, and compliance with applicable guidelines.
• Resolve complex behavioral health member-care issues and serve as the primary contact for escalated cases.
• Develop and implement utilization management policies, procedures, and clinical guidelines with senior management.
• Coach, evaluate, onboard, hire, and train team members, including providing performance feedback and corrective action when needed.
• Lead process improvements and change initiatives in a matrixed, cross-functional environment.

Requirements

• Graduate of an accredited nursing school or bachelor's degree with 4+ years of related experience.
• Active Texas clinical license required.
• One of the following credentials required: LCSW, LMHC, LPC, LMFT, LMHP, RN with state or compact-state licensure, or BCBA; BCBA applicants must also hold one of the listed licenses for ABA.
• Independent practice licensure or the applicable state-required license is required.
• Knowledge of behavioral health utilization management principles and medical necessity criteria across a broad range of behavioral health services.
• Prior supervisory or leadership experience is preferred.

Nice to have

• Knowledge of Texas Administrative Code and Local Mental Health Authorities guidelines.
• Experience with retrospective audits, Medicaid, community mental health, foster care, or the Texas Department of Family and Protective Services or Child Protective Services.

Culture & Benefits

• Remote work arrangement with flexible remote, hybrid, field, or office scheduling approaches across the organization.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Work focused on improving healthcare access and outcomes for individuals, families, and communities.
• Equal opportunity employment and consideration under applicable fair-chance employment laws.