Nurse II Position

5 days ago

San Angelo, Texas, United States Texas Department of Aging & Disability Services Full time
Job Title: Nurse II

At the Texas Department of Aging & Disability Services, we are seeking a highly skilled and dedicated Nurse II to join our team.

Job Summary:

The Nurse II will play a critical role in ensuring the delivery of quality, cost-effective services to Texans. This position will be responsible for reviewing and evaluating individual records, service plans, and patient assessments to determine service justification.

Key Responsibilities:
  • Conduct desk reviews of required documentation for Health and Human Services Commission (HHSC), Medicaid Long Term Care Waiver Programs, and Community Attendant Services (CAS).
  • Participate in onsite, televideo, or telephonic interviews of individuals identified in the random sample.
  • Review, evaluate, and document services provided to aged and disabled persons and persons with intellectual disability to validate service needs, service provision, determines appropriateness, quality, and cost effectiveness of services.
  • Makes service authorization decisions on difficult, complicated, and/or targeted cases.
  • 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.
  • Works collaboratively with other UR nurses through routine and ad hoc meetings to implement an effective statewide UR program and to ensure UR policies and procedures are applied consistently.
  • Develops, provides resources and technical assistance to regional staff and providers.
  • Testifies as the Subject Matter Expert (SME) in Medicaid fair hearings related to appealed service reductions or denials.
  • Produces routine and specialized data and information for program reports.
Requirements:
  • Meets the criteria for designation as a Qualified Intellectual Disability Professional (QIDP) as defined in 42 Code of Federal Regulations.
  • Knowledge of nursing health care laws, rules, standards, and regulations, medical diagnoses and procedures, community health and nursing care principles, quality management, utilization management, health care needs and services for elderly and disabled.
  • Thorough knowledge of ID and other developmental disability related conditions, HCS, TxHmL, CLASS, DBMD, CAS, and ICF/ID program rules, service array and billing guidelines, local authority functions and waiver service system.
  • Written and verbal communication skills necessary to consult, teach, and provide clear and concise directions and reports.
  • Awareness of federal and state laws relating to long term care and other Medicaid and non-Medicaid services and programs.
  • Knowledge of program planning, implementation and evaluation, and continuous quality improvement.
What We Offer:

As a Nurse II at the Texas Department of Aging & Disability Services, you will have the opportunity to work in a dynamic and collaborative environment, making a significant contribution to the delivery of quality services to Texans.

We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.

Join our team and be part of a mission-driven organization that is dedicated to improving the lives of Texans.

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