Utilization Management Behavioral Health Professional

Location: Remote within Louisiana; must reside in Louisiana and perform work within the state. Occasional travel to hirify.global offices for training or meetings may be required. Schedule: Monday–Friday, 8:00 AM–5:00 PM CST, with potential overtime and weekend/on-call rotation coverage.

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

• Apply behavioral health knowledge, clinical judgment, and independent critical thinking to interpret criteria, policies, and procedures.
• Coordinate and communicate with providers, members, and other parties to facilitate appropriate care and treatment.
• Support documentation and communication of medical service and benefit administration determinations.
• Follow established guidelines and procedures while aligning work with department and organizational objectives.
• Provide clear narrative documentation and collaborate with internal partners through electronic information systems and Microsoft Office.

Requirements

• Master’s-level clinician with independent Louisiana licensure, such as LCSW, LPC, LMFT, or LAC.
• At least 1 year of managed care experience.
• Experience using MCG and American Society of Addiction Medicine criteria.
• Proficiency with electronic information systems and Microsoft Word, Outlook, and Excel.
• Strong keyboard, web navigation, documentation, communication, and interpersonal skills.
• Must reside in Louisiana and work within the state; availability for a 40-hour work week and weekend/on-call rotation is required.

Nice to have

• Two years of direct care experience in acute or outpatient behavioral health.
• Experience with utilization management or prior authorization.
• Experience with behavioral change, health promotion, coaching, and wellness.
• Experience serving Medicare, Medicaid, TANF, or CHIP populations.
• Bilingual English/Spanish communication skills and knowledge of community health and social service resources.

Culture & Benefits

• Remote work from a dedicated space that protects member PHI and HIPAA information.
• Self-provided internet service must provide 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- and long-term disability, life insurance, and additional well-being benefits.