Behavioral Health Residential Admissions Coordinator

Preferra Insurance; Washington (District of Columbia); Hybrid; USD 29,000 - 68,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Behavioral Health Residential Coordinator to support the utilization management team by coordinating residential treatment admissions and referrals for out-of-home services. You will collaborate with behavioral health homes, residential providers, care management, and other stakeholders to ensure timely access to appropriate treatment settings.

A Bachelor’s degree in Behavioral Health or related field is required, with 2+ years of Arizona behavioral health experience.

Qualifications

• 2+ years of experience with Arizona behavioral health system, behavioral health network operations, and community-based treatment resources.
• Proficiency in Microsoft Office applications (particularly Excel) and electronic documentation systems.
• Willingness to travel up to 10% of the time within Arizona.

Responsibilities

• Coordinate residential treatment facility referrals and admissions for members approved for out-of-home behavioral health residential treatment across multiple levels of care.
• Based on members' treatment needs, identify clinically appropriate participating residential treatment providers to support the member's treatment goals.
• Manage the residential referral process, including the distribution of referrals, tracking provider responses, and maintaining accurate documentation of facility activities.
• Collaborate with behavioral health homes, treating providers, and community partners to ensure timely submission of clinical information required for facility reviews.
• Monitor referral status and facility timelines to promote timely access to care and minimize delays in treatment facility.
• Serve as a primary point of contact for residential treatment providers, behavioral health homes, and internal stakeholders regarding facility-related questions, concerns, and coordination needs.
• Respond with urgency to facility disruptions, denials, or changes in member circumstances by identifying and coordinating alternative treatment options.
• Participate in behavioral health utilization management rounds and interdisciplinary case reviews; present member cases and provide operational support to team discussions.
• Facilitate and participate in meetings with behavioral health residential providers to support collaboration, resolve barriers, and improve facility outcomes.
• Partner with Care Management, Utilization Management, Quality Management, and other internal departments to support continuity of care and coordinated service delivery.
• Identify, elevate, and assist in addressing concerns and collaborate with leadership.
• Maintain accurate case documentation, referral records, and tracking tools in accordance with organizational policies, regulatory requirements, and departmental standards.
• Support departmental projects, process improvements, reporting activities, and other operational initiatives related to residential treatment coordination and utilization management.
• Apply care coordination principles, clinical judgment, and established policies and procedures to promote quality outcomes and appropriate resource utilization.
• Perform other duties as assigned.

Job description

CVS Health is seeking a Behavioral Health Residential Coordinator to support the utilization management team by coordinating residential treatment admissions and referrals for out-of-home services. You will collaborate with behavioral health homes, residential providers, care management, and other stakeholders to ensure timely access to appropriate treatment settings.

A Bachelor’s degree in Behavioral Health or related field is required, with 2+ years of Arizona behavioral health experience.