Utilization Review Clinician (Behavioral Health)

Location: Fully remote within the United States, supporting the California market; applicants in other states may be considered if they can work Pacific Time hours.

Salary: $27.02–$48.55 per hour

Company

hirify.global provides healthcare services focused on connecting people with accessible and effective care.

What you will do

• Evaluate mental health and substance abuse treatment before, during, and after services.
• Perform prior authorization and concurrent inpatient behavioral health reviews using regulatory guidelines and clinical criteria.
• Assess treatment needs, level of care, medical appropriateness, and discharge planning.
• Analyze behavioral health member data to improve care quality and service utilization.
• Educate providers, members, and families about the behavioral health utilization process.
• Present cases in staffing and integrated rounds while collaborating with providers, medical directors, and leadership.

Requirements

• Graduate of an accredited nursing school or a bachelor's degree, plus 2–4 years of related experience.
• Independent practice licensure or the applicable state-required license.
• Master's degree required for behavioral health clinicians.
• One of the following licenses is required: LCSW, LMHC, LPC, LMFT, LMHP, or RN state/compact state licensure.
• Ability to work Monday through Friday during Pacific Time hours, 9:00 AM–6:00 PM or 9:30 AM–6:00 PM, with rotating holidays and occasional overtime.

Nice to have

• Behavioral health and utilization management or utilization review experience.
• Clinical knowledge of mental health and substance abuse treatment plans.
• Experience working with providers and healthcare teams to review behavioral health services.

Culture & Benefits

• Remote work with a flexible approach to work arrangements.
• Health insurance, 401(k), stock purchase plans, and paid time off including holidays.
• Tuition reimbursement and opportunities to build healthcare expertise.
• Competitive pay adjusted for skills, experience, education, and other job-related factors.