Licensed Behavioral Health Utilization Management Professional 2 (Behavioral Health UM)

Location: Remote, with residence required in Louisiana. Training is Monday through Friday, 8:00 AM–5:00 PM Central Time; the regular schedule is Sunday through Thursday, 8:00 AM–5:00 PM Central Time, with flexibility for Eastern Time, occasional weekends, and holidays. Less than 5% travel may be required for office meetings, training, or business needs.

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 Medicare, Medicaid, families, individuals, military personnel, and communities.

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.
• Perform utilization management activities and communicate with providers, members, and other parties.
• Apply independent critical thinking to ambiguous cases while following established guidelines.
• Make decisions regarding work methods and resolve technical issues across multiple systems in a remote environment.

Requirements

• Must reside in Louisiana.
• Must hold either a Multi-State Compact Registered Nurse license or a Louisiana professional license with a master’s degree in social work, counseling, psychology, or another behavioral health-related field.
• Eligible licenses include LCSW, LMSW, LPC, LMFT, LAC, and Licensed Psychologist.
• At least 3 years of post-degree clinical experience in direct patient care and at least 3 years of behavioral health experience.
• Proficiency with Microsoft Office, multiple systems and platforms, and general technical troubleshooting in a remote environment.
• Must protect member PHI and HIPAA information by working from a dedicated space without ongoing interruptions.

Nice to have

• Behavioral health utilization management experience with MCG, ASAM, or InterQual criteria.
• Managed care or Medicaid experience.
• Health plan experience.
• An independent Kentucky license.

Culture & Benefits

• Remote work with occasional travel to hirify.global offices for training or meetings.
• Dedicated home workspace and internet service with at least 25 Mbps download and 10 Mbps upload speeds.
• Medical, dental, and vision coverage.
• 401(k) retirement savings plan, paid time off, company and personal holidays, and paid parental and caregiver leave.
• Short- and long-term disability coverage, life insurance, and wellness-focused benefits.