Behavioral Health Residential Coordinator; Arizona)

Available in 49 locations

Job : R1052532

Category:
Category:
Clinical

Sub Category:
Sub Category:
Clinical Support

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
The Behavioral Health Residential Coordinator supports the Behavioral Health Child/Adolescent Utilization Management Department by coordinating residential treatment admissions for members requiring out-of-home behavioral health residential services. This person serves as a key liaison between utilization management teams, behavioral health homes, residential treatment providers, care management staff, and other external stakeholders to ensure timely access to appropriate, quality treatment settings.

The Behavioral Health Residential Coordinator manages the referral process for approved prior authorized residential treatment levels of care, monitors treatment facility referral progress, facilitates communication among stakeholders, and assists with complex facility challenges, including urgent facility disruptions. The position requires strong clinical knowledge, exceptional organizational skills, and the ability to build collaborative relationships across provider networks and multidisciplinary teams.

Primary Duties and 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, Residential Coordinators 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…