Nurse IV

    Texas Health & Human Services Commission
    4900 N LAMAR BLVD, AUSTIN, TX
    Full-time
    Similar jobs pay $24.69 - $32.24

    Job Description


    The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Nurse Policy Analyst (Nurse IV). 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 performing complex analysis of medical benefits for the Medicaid/CHIP Policy Development Division.

    The ideal candidate thrives in an environment that emphasizes: teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy. The position requires excellent writing skills and strong research skills, including experience conducting comprehensive literature reviews using PubMed/Medline, Hayes, and other health literature electronic databases; must be able to synthesize findings for clinical and political audiences, and apply findings to medical benefits for policy development in the Medicaid program. These findings must be interpreted correctly in accordance with the Texas Medicaid program's requirements for application to and development of Medicaid's medical benefits. The Nurse Policy Analyst in this position must be proactive in seeking input from other staff in the Medicaid/CHIP Division and demonstrate the ability to work as an effective team member with peers, other divisions within HHSC, and other HHS agencies.

    The Nurse Policy Analyst (Nurse IV) position reports to one of the Medical Benefits Policy Managers in the Office of Program and Policy, Medicaid and CHIP Services Department. Nurse Policy Analysts in this position will be asked to lead internal workgroups and mentor other staff, and at times take on the role as a team lead for projects.

    Essential Job Functions:
    (30%) Clinical Review of the Literature - Researches, analyzes, and synthesizes peer reviewed literature and evidence-based practices and applies it to program medical, dental, and mental health benefit policy. Provides complex technical medical information verbally or in writing to nonclinical audiences. Consults with stakeholders to address Medicaid program benefit policy issues. (30%) Develops policies- Reviews and updates current benefits and develops new benefits for Medicaid medical policy. Identifies eligibility standards and authorization requirements for benefit policy. Collaborates, as needed, with Medical Benefits staff as well as HHSC staff in other programs and other State agencies for program benefit policy development, planning, and implementation. Serves as clinical subject matter expert in the development and review of program benefit policy. Develops, reviews, and provides comments on Medicaid materials intended for use by vendors, providers, managed care organizations, and other partners. (25%) Special Projects and Workgroups - Leads or participates in workgroups and public meetings engaged in research, analysis, and evaluation of policy issues or initiatives. Leads or participates in special projects as requested by management. Positively represents department, agency, and State in conferences and meetings, including public presentation delivery, and, as an ongoing representative on various committees and teams, as directed. Prepares project updates, summaries, reports, or other documents and keeps management informed on pertinent issues. Functions as a resource to other State staff providing guidance, advice, or direction. Responds to internal and external communications and requests for information in a timely manner. Identifies the need to, and communicates and consults with external stakeholders, as necessary. (15%) Quality Assurance and Process Improvement - Identifies methods for effectively managing benefit changes that have varying effective dates. Researches provider or manufacturer questions or concerns. Maintains organized electronic files of activities and shares with staff and partners, as appropriate. Reviews, analyzes, and comments on regulations affecting program benefit policy. Other duties, as assigned, include but are not limited to actively participating in or serving in a supporting role to meet the agency's obligations.

    Knowledge Skills Abilities:
    Strong research skills including experience conducting comprehensive literature reviews using electronic databases such as PubMed/Medline, Hayes, or other similar electronic sources such as UpToDate, and reviewing professional organization's recommendations for best practices

    Experience with clinical practice guideline evaluation or development; clinical quality assessment, assurance, or improvement; clinical research or health care delivery

    Ability to work collaboratively across MCS to accomplish objectives and adapt quickly to changing circumstances and team dynamics, and take on a lead role as needed

    Knowledge of Health and Human Services agencies and programs, including Medicaid/CHIP

    Excellent computer skills, including Microsoft Office suite

    Demonstrated ability to work independently and function effectively as a member of a team, and under tight deadlines with high volume workloads

    Highly organized and the ability to manage several projects concurrently in a fast-paced environment and juggle competing priorities

    A keen attention to detail and the ability to implement creative solutions to problems

    Highly proficient in the English language with excellent written, verbal, and interpersonal communication and presentation skills

    Ability to effectively facilitate meetings, establish and advance agenda goals

    Skill in project planning, evaluation, and implementation

    Skilled in establishing and maintaining effective working relationships with managers, co-workers, and other staff or program stakeholders

    Able to balance team and individual responsibilities

    Familiarity with medical vocabularies such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD), version 10 is a plus

    Registration or Licensure Requirements:
    Requires current license to practice as a Registered Nurse (RN) in Texas or a state that recognizes reciprocity through the Nurse Licensure Compact. Clinical coding certificate preferred.

    Initial Selection Criteria:
    Must be a registered nurse. Graduation from an accredited four-year college or university required. Bachelor of Nursing degree preferred, but other bachelor's degrees will be considered. Master's degree in Nursing preferred, but master's degree in other areas such as public health, health policy, biology or other social/behavioral health field or 4 years' experience in an area that provided equivalent experience will also be considered. Experience completing policy analysis or developing health-related policy preferred. Strong skills in analyzing clinical research and applying findings to work or to policy development and implementation; strong skills in performing comprehensive literature reviews of medical research topics. A nurse applying for this position must demonstrate experience in leading and managing projects, as well as analyzing, utilizing, and applying evidenced-based research.

    Additional Information:
    Requisition # 451851
    Applicants selected for an interview will be required to submit a resume, a professional or academic writing sample, and complete an in-basket exercise.

    Salary Note: The salary offered will follow HHS HR Policy and Procedures. The offered salary will be determined in accordance with budgetary limits and the requirements of HHSC Human Resources Manual. For internal applicants, there can be limitations in consideration of applicant's current classification and salary, and is also dependent upon available budget.

    Only complete applications will be considered.

    Note: Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to: 68C, 66N/P/W, 290X, 46FX, 46NX, 46SX. All active duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information see the Texas State Auditor's Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx. In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

    MOS Code:
    68C, 66N/P/W, 290X, 46FX, 46NX, 46SX
    HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.

    I-9 Form - Click here to download the I-9 form.

    In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

    HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.

    I-9 Form - Click here to download the I-9 form.

    In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

    Posting ID: 556640552Posted: 2020-05-21