Utilization Review Clinician - Behavioral Health

Location: Remote-FL; must be available to work second shift

Company

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

What you will do

• Conduct clinical reviews of mental health and substance abuse treatment before, during, and after services.
• Perform prior authorization and concurrent reviews to determine medically appropriate levels of care in accordance with regulatory guidelines.
• Review behavioral health inpatient cases, treatment needs, member health status, and discharge planning.
• Analyze behavioral health member data to improve care quality and appropriate service utilization.
• Educate providers, members, and families about the behavioral health utilization process.
• Discuss care levels and services with providers, medical directors, and leadership, and present cases in staffing and integrated rounds.

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 practice license and applicable state-required licensure.
• One of the following required credentials: LCSW, LMHC, LPC, LMFT, LMHP, or RN with state or compact-state licensure.
• Clinical knowledge of mental health and substance abuse treatment plans and utilization review processes.

Culture & Benefits

• Health insurance, 401(k), and stock purchase plans.
• Tuition reimbursement, paid time off, and holidays.
• Flexible work approaches, including remote, hybrid, field, and office schedules.
• Competitive pay adjusted for skills, experience, education, and other job-related factors.