Nurse II

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more.

Explore more details on the Benefits of Working at HHS webpage.

Functional

Title:

Nurse II

Job Title:

Nurse II

Agency:
Health & Human Services Comm

Department: UR Wav & Comm Srvs Ran Mmt St

Posting Number: 18926

Closing Date: 01/12/2027

Posting Audience:
Internal and External

Occupational Category:
Healthcare Practitioners and Technical

Salary Range: $4,801.16 - $7,761.50

Pay Frequency:
Monthly

Salary Group: TEXAS-B-22

Shift: Day

Additional

Shift: Days (First)

Telework:
Eligible for Telework

Travel:
Up to 75%

Regular/Temporary:
Regular

Full Time/Part Time:
Full time

FLSA Exempt/Non-Exempt:
Exempt

Facility

Location:

Job Location City: PARIS

Job Location Address: 1460 19TH ST NW

Other Locations:
Arlington;
Bedford;
Carrollton;
Dallas;
Decatur;
Denton;
Fort Worth;
Granbury;
Grand Prairie;
Grapevine;
Hurst;
Kaufman;
Lake Worth;
Lewisville;
Mckinney;
Mesquite;
Paris;
Plano;
Rockwall;
Weatherford

MOS Codes: 290X,46AX,46FX,46NX,46PX,46SX,46YX,66B,66C,66E,66F,66G,66H,66N,66P,66R,66S,66T,66W

Nurse II

The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Nurse II. MCS is driven by its mission to deliver quality, cost-effective services to Texans. This position makes a significant contribution to MCS's mission by ensuring individuals served in our 1915(c) waiver programs and Community Attendant Services (CAS) receive the appropriate type and amount of service.

The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, upholds excellence through high professional standards and personal accountability, fosters curiosity to grow and learn continuously, employs critical thinking for effective execution, and upholds integrity to do things right, even when what is right is not easy.

Under the direct supervision of the Utilization Review Nurse Manager, the utilization review (UR) nurse: reviews and evaluates individual's records, individual service plans (ISPs), patient assessments, documentation related to Title XIX and Title XX, and state plan Medicaid community services for aged and disabled persons and individuals with intellectual and developmental disabilities (IDD); and conducts face to face interviews with individuals enrolled in the Community Attendant Services (CAS), Community Living Assistance and Support Services (CLASS), Deaf Blind with Multiple Disabilities (DBMD), Home and Community-based Services (HCS), and Texas Home Living (TxHmL) programs to determine service justification.

Based on the in-person, teleconference, or telephone interview assessment, desk review, and evaluation of services, the UR nurse uses program knowledge and nursing expertise to determine appropriateness and quality of services, cost effectiveness of the service plan, validate determinations of health service needs, and make service authorization decisions.

The UR nurse conducts a variety of quality assurance reviews and quality improvement studies. The UR nurse evaluates assigned Level of Need (LON) determinations in the IDD waiver programs when assigned to do so. This position works collaboratively with other UR nurses and regional staff to implement an effective statewide UR program and to ensure UR policies and procedures are applied consistently.

This position works under the general supervision of the UR Nurse Manager, with moderate latitude for the use of initiative and independent judgment.

Essential Job Functions:

Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.

Conducts desk reviews of required documentation for Health and Human Services Commission (HHSC), Medicaid Long Term Care Waiver Programs, and Community Attendant Services (CAS). Participates in onsite, televideo, or telephonic interviews of the individuals identified in the random sample. Reviews, evaluates, and documents services provided to aged and disabled persons and persons with intellectual disability to validate service needs, service provision, and determine appropriateness, quality, and cost effectiveness of services.

(35%)

Makes service authorization decisions on difficult, complicated, and/or targeted cases. (20%)

Conducts a variety of quality assurance reviews and quality improvement studies and evaluates compliance with Medicaid program service requirements, state rules, regulations, policies, and procedures. (10%)

Works collaboratively with other UR nurses through routine and ad hoc meetings to implement an…