Behavioral Health Residential Care Navigator

Preferra Insurance; West Virginia; On-site; USD 44,000 - 102,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

Retirement options

Job summary

CVS Health is hiring a Behavioral Health Residential Coordinator to manage admissions and referrals for out-of-home residential treatment, collaborating with care teams and providers to ensure timely access and optimal outcomes.

The role requires strong clinical knowledge, organization, and the ability to coordinate with multiple stakeholders across residential facilities and care management partners.

Qualifications

• 2+ years of experience with Arizona behavioral health system, behavioral health network operations, and community-based treatment resources.
• Proficiency in Microsoft Office applications (Excel) and electronic documentation systems.
• Willingness to travel up to 10% 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 clinically appropriate participating residential treatment providers to support members' treatment goals based on their needs.
• Manage referral process, distribute referrals, track responses, and maintain accurate documentation.
• Collaborate with behavioral health homes, treating providers, and community partners to ensure timely submission of clinical information for facility reviews.
• Monitor referral status and facility timelines to promote timely access to care and minimize delays.
• Serve as primary contact for residential treatment providers and internal stakeholders regarding coordination needs.
• Respond urgently to facility disruptions, denials, or changes by coordinating alternative treatment options.
• Participate in utilization management rounds and case reviews; present cases and support team discussions.
• Facilitate meetings with residential providers to improve collaboration and facility outcomes.
• Partner with Care Management, Utilization Management, Quality Management to support continuity of care.
• Identify and address concerns with leadership; maintain compliance with policies and regulations.
• Maintain accurate case documentation and tracking tools per organizational standards.

Skills

Microsoft Excel

Electronic health records

Communication skills

Travel willingness

Education

Bachelor's degree in Behavioral Health

Tools

MS Office

Job description

CVS Health is hiring a Behavioral Health Residential Coordinator to manage admissions and referrals for out-of-home residential treatment, collaborating with care teams and providers to ensure timely access and optimal outcomes.

The role requires strong clinical knowledge, organization, and the ability to coordinate with multiple stakeholders across residential facilities and care management partners.