Utilization Management Specialist

Join BasePoint as a Utilization Management Specialist!

Are you passionate about ensuring adolescents and young adults receive the right care at the right time? BasePoint is seeking a Utilization Review Specialist to help patients and families access life-changing behavioral health services while partnering closely with our clinical teams to support quality outcomes.

Why work for BasePoint?

At BasePoint, we believe every teen and young adult deserves hope, healing, and a future filled with possibilities. Our mission is to empower individuals and families through compassionate, evidence-based care that is grounded in both clinical excellence and human connection.

When you join our team, you become part of a culture built on resilience, servant leadership, and a deep commitment to those we serve.

What You’ll Do:

The UM Specialist is responsible for performing admission approvals, initial and concurrent insurance reviews, and ensures proper utilization of benefits. This position is also responsible for determining appropriate levels of care and ensuring the daily census is accurate. Participates in performance improvement and continuous quality improvement (CQI) activities.

Key Responsibilities:

• Determine the appropriate level of care for patients based on clinical/medical interview and/or record review, and via consultation with the interdisciplinary clinical and medical teams using American Society of Addiction Medicine Criteria.
• Identify from insurance company/managed care organizations pre-certification procedures, treatment and discharge plan procedures and transfer procedures.
• Obtain admission certifications from insurance companies and continue to do concurrent reviews while the patient is admitted.
• Work with other members of the treatment team to assist in discharge and treatment planning. Communicate with the interdisciplinary team regarding current or future level of care transitions. Report any potential patient safety issues to the interdisciplinary treatment team.
• On an ongoing basis identify potential certification problems and discuss them with the interdisciplinary team.
• Communicate with the facility Case Managers regarding EAP referrals, legal entities, disability applications, family and medical leaves, and discharge planning.
• Communicate with patients and/or their families regarding insurance certification and benefit issues.
• Review charts for quality of clinical and medical documentation. These concerns have to be communicated to the appropriate team members.
• Documentation meets standards and policies, and established timeframes.
• Maintains a good working professional relationship within the department and with other departments.

Minimum Qualifications:

Education: Bachelor’s or master’s degree in relevant field, or equivalent professional training and qualifications (Bachelor’s in Nursing, Master’s in Social Work/ Counseling/ Psychology)

Experience: At least one year of utilization review experience in healthcare required; behavioral health experience strongly preferred.

Knowledge of PHP/IOP operations or similar levels of care behavioral health treatment programs.

License: Strongly preferred active Texas licensure in one or more of the following: LCSW, LPC, LMFT, RN, LMSW, LVN or LCDC considered with direct behavioral health experience.

What We Offer:

• Medical, Dental & Vision Insurance
• 401(k)
• Life Insurance + AD&D
• Short-Term & Long-Term Disability
• Accident Insurance, Critical Illness Insurance & Hospital Indemnity Insurance
• Employee Assistance Program
• Paid Time Off (PTO) plus 7 Paid Holidays + 2 Floating Holidays
• A culture of growth, recognition, and celebration

The BasePoint Difference – Our Core Values

Courage to Solve – We face challenges head-on, taking responsibility for solutions and acting with integrity.

Spirit of Grit – We bring perseverance, endurance, and passion to everything we do even when it isn’t easy.

WWIWFMF (“What Would I Want for My Family”) – We deliver the kind of care we’d want for our own loved ones, ensuring the highest standard of excellence.

Tend to Your Roses – We practice servant leadership, caring deeply for our people so they can flourish and thrive.

Why Join Us?

At BasePoint, you won’t just have a job—you’ll have a mission. You’ll be part of a team that cares deeply for one another, that shows up every day with grit and compassion, and that never loses sight of the fact that the work we do changes lives.

Apply today and become a vital part of a team where courage, grit, family, and care for one another make the difference.

This position requires valid U.S. work authorization. The company does not provide visa sponsorship now or in the future.