Nurse II Position
3 weeks ago
Job Summary:
We are seeking a highly qualified Nurse II to join our team at the Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department. As a Nurse II, you will play a critical role in ensuring individuals served in our (c) waiver programs and Community Attendant Services (CAS) receive the appropriate type and amount of service.
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.
* Make service authorization decisions on difficult, complicated, and/or targeted cases.
* Conduct a variety of quality assurance reviews and quality improvement studies and evaluates compliance with Medicaid program service requirements, state rules, regulations, policies, and procedures.
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.
* Ability to communicate effectively, both orally and in writing.
* Ability to interpret statistical information.
* Ability to multi-task, handle stress and meet deadlines.
* Ability to work collaboratively across MCS to accomplish objectives.
Working Conditions:
* Works under the general supervision of the UR Nurse Manager, with moderate latitude for use of initiative and independent judgment.
* Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
What We Offer:
* Competitive salary and benefits package.
* Opportunities for professional growth and development.
* Collaborative and dynamic work environment.
How to Apply:
If you are a motivated and detail-oriented individual with a passion for healthcare and Medicaid services, we encourage you to apply for this exciting opportunity.
Equal Employment Opportunity:
The Texas Health and Human Services Commission is an equal employment opportunity employer and welcomes applications from diverse candidates.
Contact Information:
For more information about this position, please contact the HR department at [insert contact information].
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