Utilization Review Clinician - Behavioral Health

Location: Remote-LA

Salary: $27.02–$48.55 per hour

Company

hirify.global connects people with healthcare services and works to improve access, quality, and care outcomes.

What you will do

• Review mental health and substance abuse treatment before, during, and after services to assess medical appropriateness and level of care.
• Perform behavioral health prior authorization and concurrent inpatient reviews in accordance with regulatory guidelines and clinical criteria.
• Assess treatment needs, overall member health, 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.
• Discuss care levels and services with providers, medical directors, leadership, and integrated clinical teams.

Requirements

• Graduate of an accredited nursing school or a bachelor's degree with 2–4 years of related experience.
• Master's degree required for behavioral health clinicians.
• Independent clinical practice license or applicable state-required licensure.
• One of the following licenses required: LCSW, LMHC, LPC, LMFT, LMHP, or RN state/compact-state licensure.
• Clinical knowledge of mental health and substance abuse treatment plans and utilization review processes.

Culture & Benefits

• Remote, hybrid, field, and office work schedules may be available depending on the role and eligibility.
• Health insurance, 401K, and stock purchase plans.
• Tuition reimbursement, paid time off, and holidays.
• Compensation is adjusted based on skills, experience, education, and other job-related factors.