Behavioral Health Navigator

Behavioral Health Navigator – Onsite (California)
Location: Onsite (California — exact site provided during interview)
Schedule: Monday–Friday, 8:00 AM–5:00 PM
Pay: $43.50
Job Type: Full Time 

We’re hiring a Behavioral Health Navigator to support Utilization Management (UM) and care coordination for members with complex behavioral health needs. This Behavioral Health Navigator role is heavy on prior authorizations, documentation accuracy, queue management, and professional communication with providers, members, and internal clinical teams. If you’ve worked in managed care, behavioral health administration, UM/prior auth, referrals, or care coordination, this is a great opportunity to step into a structured, guideline-driven environment.

Responsibilities (Behavioral Health Navigator):

• Process and monitor behavioral health authorizations and supporting documentation (urgent, routine pre-service, concurrent, and retrospective)
• Manage authorization queues; continuously track aging and turnaround time (TAT) to meet service standards and state guidelines
• Apply established UM pathways/guidelines to screen, authorize, and finalize inpatient/outpatient/retro requests
• Coordinate member access to timely, appropriate behavioral health and ABA services; partner with Member Services and clinical staff
• Communicate with providers, hospitals, vendors, and delegated groups to facilitate care coordination and resolve inquiries
• Accurately interpret and communicate eligibility/benefits information; support resolution of eligibility issues as needed
• Document all actions clearly and consistently; complete high-volume data entry across multiple systems/portals
• Support behavioral health clinicians/nurses with administrative components of UM and basic case management (authorizations, care coordination outreach)
• Investigate and respond to care coordination cases; conduct member outreach to confirm services and identify barriers
• Prepare reports for internal, regulatory, contractual, and accreditation requirements; support non-clinical audits and compliance reporting
• Participate in department meetings, process improvements, and special projects

Qualifications:

• Bachelor’s degree (health services or related preferred) or equivalent related experience
• 1+ year experience in a healthcare/managed care setting preferred (UM, prior authorization, referrals, eligibility, care coordination)
• Strong verbal/written communication and professional phone etiquette
• Ability to follow protocols, exercise good judgment, and prioritize multiple deadlines
• Comfortable working with behavioral health populations and complex care coordination needs
• Proficiency with Microsoft Office (Word, Excel, Outlook) and working in multiple systems/queues
• Knowledge of California Children’s Services (CCS) is a plus