Utilization Review Specialist (Behavioral Health)

Location: Remote within the United States; not available in Alaska, Maine, Washington DC, New Jersey, California, New York, Massachusetts, Connecticut, Colorado, Washington State, Oregon, or Minnesota.

Base compensation: $62,000–$70,000 per year, plus a potential performance bonus of $0–$900 per month.

Company

hirify.global provides personalized virtual behavioral healthcare for people facing mental health conditions, substance use disorders, and eating disorders.

What you will do

• Oversee utilization review functions for a virtual intensive outpatient program caseload.
• Complete pre-certifications, authorizations, follow-ups, and peer-to-peer reviews with insurance medical directors.
• Participate in denial management, appeals, and treatment advocacy after initial denials.
• Collaborate with Revenue Cycle, Admissions, managers, and directors to resolve complex cases and improve workflows.
• Train clinical teams on high-quality documentation standards.

Requirements

• Active, unrestricted, unencumbered U.S. professional license allowing independent practice; accepted credentials include MD, DO, PsyD, PhD, LCSW, LMFT, LPC, or LCPC.
• At least 2 years of behavioral health utilization experience.
• Knowledge of utilization review processes, medical necessity criteria, healthcare regulations, HIPAA, and patient confidentiality.
• Familiarity with InterQual, MCG, or similar clinical guidelines.
• Proficiency with Google tools, electronic medical records, and utilization management systems.
• Strong analytical, communication, documentation, interpersonal, and project management skills.

Culture & Benefits

• Mission-driven work focused on expanding access to life-saving behavioral healthcare.
• Remote work supporting virtual care delivery.
• Comprehensive benefits for full-time, exempt employees.
• Potential stock options and other company-sponsored benefits depending on the position.
• Values centered on connection, evidence-based practice, curiosity, urgency, and persistence.