Licensed Behavioral Health UM (RN, SW, Counseling, Psychology)

Location: Remote; must reside in Louisiana. Monday–Friday, 8:00 AM–5:00 PM Central Time, with flexibility for Eastern Time hours and occasional weekends and holidays. Occasional travel to hirify.global offices for training or meetings may be required.

Salary: $65,000–$88,600 per year, plus eligibility for a bonus incentive plan.

Company

hirify.global is a U.S. healthcare and health insurance company serving members through hirify.global insurance services and CenterWell healthcare services.

What you will do

• Coordinate, document, and communicate behavioral health medical services and benefit administration determinations.
• Interpret clinical criteria, policies, and procedures to support appropriate treatment and care decisions.
• Conduct independent reviews and determine appropriate courses of action in varied and sometimes ambiguous situations.
• Coordinate with providers, members, and other parties to facilitate optimal care and treatment.
• Navigate multiple systems and platforms while resolving technical issues in a remote work environment.

Requirements

• Must reside in Louisiana.
• Meet one licensure pathway: a Multi-State Compact Registered Nurse license, or a master’s degree in social work, counseling, psychology, or another behavioral health-related field with a professional Louisiana license; an additional independent Kentucky license is required for the behavioral health licensure pathway.
• Eligible licenses include RN, LCSW, LMSW, LPC, LMFT, LAC, or Licensed Psychologist, with no history of disciplinary action.
• 3+ years of post-degree clinical experience in direct patient care and 3+ years of behavioral health experience.
• Proficiency with Microsoft Office, multiple systems and platforms, and general technical troubleshooting in a remote environment.
• Work schedule requires Central Time availability, flexibility for Eastern Time, and occasional weekends or holidays.

Nice to have

• Behavioral health utilization management experience, including medical necessity reviews using MCG, ASAM, or InterQual criteria.
• Managed care or Medicaid experience.
• Health plan experience.

Culture & Benefits

• Remote work with a dedicated workspace required to protect member PHI and HIPAA information.
• Self-provided internet service with at least 25 Mbps download and 10 Mbps upload speeds.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan, paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short-term and long-term disability coverage, life insurance, and additional well-being benefits.