Behavioral Health Residential Admissions Lead

CVS Health Corporation; Arizona; Hybrid; USD 44,000 - 102,000; Full time

Job summary

CVS Health Corporation is seeking a Behavioral Health Residential Coordinator to manage referrals and admissions for out-of-home residential treatment within our utilization management framework. You will partner with behavioral health homes, providers, and care teams to ensure timely access to appropriate facilities and high-quality care.

This role requires strong clinical knowledge, excellent organization, and the ability to coordinate across multiple stakeholders, while maintaining compliant

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.
• Identify the most 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.

Education

Bachelor's degree in Behavioral Health

Tools

Microsoft Office

Excel

Job description

CVS Health Corporation is seeking a Behavioral Health Residential Coordinator to manage referrals and admissions for out-of-home residential treatment within our utilization management framework. You will partner with behavioral health homes, providers, and care teams to ensure timely access to appropriate facilities and high-quality care.

This role requires strong clinical knowledge, excellent organization, and the ability to coordinate across multiple stakeholders, while maintaining compliant