Health Coordinator

• 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 based on members’ treatment needs
• Manage residential referrals by distributing referrals, tracking provider responses, and maintaining accurate facility activity 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 treatment delays
• Serve as a primary contact for residential treatment providers, behavioral health homes, and internal stakeholders regarding facility-related questions and coordination needs
• Respond to facility disruptions, denials, or changes in member circumstances by coordinating alternative treatment options
• Participate in utilization management rounds and interdisciplinary case reviews; present member cases and provide operational support
• 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 departments to support continuity of care
• Identify and elevate concerns and assist leadership with addressing them
• Maintain accurate case documentation, referral records, and tracking tools according to organizational, regulatory, and departmental requirements
• Support departmental projects, process improvements, reporting activities, and operational initiatives related to residential treatment coordination and utilization management
• Apply care coordination principles, clinical judgment, and established policies to promote quality outcomes and appropriate resource utilization
• Perform other duties as assigned

Behavioral Health Residential Coordinator

• Support the full implementation lifecycle for new group implementations from kickoff through go-live
• Create and own detailed project plans for each new piece of business
• Coordinate with internal departments to set accurate and realistic deadlines
• Track deliverables across cross-functional teams and follow up on missed milestones
• Escalate timeline risks to leadership
• Lead internal implementation meetings to surface blockers and align stakeholders
• Identify and manage implementation risks and develop action plans
• Audit new client account configurations across internal systems before go-live

Implementation Coordinator – Health Plans, TPA

• Serve as the initial point of contact for potential home health patients
• Manage new home health referrals and ongoing follow-ups
• Work closely with Home Health nurses
• Act as a liaison between patients, families, and referral sources
• Manage centralized intake for home health locations
• Perform occasional on-site work for training or other purposes if within driving distance to the center

Authorization Coordinator III, Home Health

• Provides medical administration support to providers by obtaining referral or prior authorizations for patients to see specialty providers
• Completes referrals and/or authorizations accurately and consistently with minimal supervision
• Processes authorization and referral requests for members in coordination with health plans and contracted providers in Managed Care
• Provides support to Case Management staff
• Serves as a resource to providers regarding the authorization process