Behavioral Health Residential Admissions Specialist

Preferra Insurance; North Olmsted (OH); Hybrid; USD 29,000 - 68,000; Full time

Job summary

CVS Health is hiring a Behavioral Health Residential Coordinator to manage residential treatment referrals, coordinate admissions, and ensure timely access to care for members with out-of-home behavioral health needs.

You will partner with utilization management, care management, and residential providers to streamline referrals, document outcomes, and support continuity of care while navigating regulatory requirements.

Qualifications

• 2+ years of experience in behavioral health systems, utilization management or related field.
• Strong organizational skills and ability to manage multiple referrals and deadlines.
• Experience coordinating services with residential providers and community partners.

Responsibilities

• Coordinate residential treatment referrals and admissions for out-of-home behavioral health services across multiple levels of care.
• Identify clinically appropriate residential providers based on member needs and treatment goals.
• Manage referral distribution, provider responses, and documentation of facility activities.
• Collaborate with behavioral health homes, providers, and community partners to ensure timely submission of required clinical information.
• Monitor referral status and facility timelines to minimize delays in care and maintain continuity of services.
• Serve as primary contact for residential providers and internal stakeholders; address questions and coordination needs.
• Respond promptly to facility disruptions, denials, or changes in member circumstances with alternative options.
• Participate in utilization management rounds and case reviews to support team discussions.
• Facilitate meetings with residential providers to improve collaboration and outcomes.
• Partner with Care Management, Utilization Management and Quality Management to support coordinated service delivery.
• Identify concerns and escalate collaboratively with leadership.
• Maintain accurate case documentation and tracking in line with policies and regulatory requirements.
• Support projects, reporting, and other initiatives related to residential treatment coordination.

Skills

Behavioral health experience

Utilization management

Care coordination

Microsoft Excel

Education

Bachelor's degree in Behavioral Health/ related field

Tools

Electronic documentation systems

Job description

CVS Health is hiring a Behavioral Health Residential Coordinator to manage residential treatment referrals, coordinate admissions, and ensure timely access to care for members with out-of-home behavioral health needs.

You will partner with utilization management, care management, and residential providers to streamline referrals, document outcomes, and support continuity of care while navigating regulatory requirements.