RN Full-time

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 III 
Job Title: Nurse III 
Agency: Health & Human Services Comm 
Department: Adm AcuteCarePsych Nursing 
Posting Number: 13363 
Closing Date: 04/29/2026 
Posting Audience: Internal and External 
Occupational Category: Healthcare Practitioners and Technical 
Salary Group: TEXAS-B-24 
Salary Range: $7,532.75 - $8,886.16 
Pay Frequency: Monthly
Shift: Regular Weekend Day 
Additional Shift: Days (First); Evenings (Second); Nights (Third); Weekends 
Telework: Not Eligible for Telework 
Travel: Up to 10% 
Regular/Temporary: Regular 
Full Time/Part Time: Full time 
FLSA Exempt/Non-Exempt: Exempt 
Facility Location: Big Spring State Hospital 
Job Location City: BIG SPRING 
Job Location Address: 1901 N HIGHWAY 87 
Other Locations: Big Spring 
MOS Codes: 290X,46AX,46FX,46NX,46PX,46SX,46YX,66B,66C,66E,66F,66G,66H,66N,66P,66R,66S,66T,66W 
 
 
 




Brief Job Description:

 

Would you thrive in an environment where you learn and grow personally and professionally all while helping make a positive impact on people’s lives? Do you appreciate being around others like yourself who are dependable, trustworthy, hard workers who believe in the value of teamwork? HSCS is dedicated to building an atmosphere where employees feel valued and supported while providing specialized care for Texans in need. HSCS is comprised of nine psychiatric hospitals, one youth residential treatment facility, and thirteen state supported living centers. The psychiatric hospitals are a hub of excellence for forensic mental health and complex psychiatric care, with all facilities accredited by The Joint Commission. They provide state-of-the-art treatment that is recovery-oriented and science-based. If providing hope and healing through compassionate, innovative, and individualized care interests you, we welcome your application for the position below.

 

Under the direct supervision of the Chief Nurse Executive/Nurse Administrator/Assistant Chief Nurse Executive, observes, assesses, plans, intervenes and evaluates outcomes and documents all aspects of patient care. Possesses a unique knowledge regarding the patient population to be served. Coordinates scheduling within assigned areas. Provides primary management for service area during assigned shift with a supportive but clear supervisory manner. May supervise, counsel, and evaluate other nursing staff. Collaborates with Nurse Coordinator, other charge nurses, and Mental Health Supervisor/Specialist to ensure 24-hour continuity of care. May assume duties of the Nurse Coordinator/Nurse Manager during absence. Flexible in work schedule. Has broad latitude for initiative and independent judgment. Provides direct nursing care to individual patients as needed. Duties, location of work and shift/pattern are subject to change as determined by administration to meet the needs of the hospital. Duties may include exposure to blood or other potentially infectious materials.

 

Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.

 

This position may be eligible to earn additional pay for work performed on evenings, nights and/or weekends.

 

Essential Job Functions (EJFs):

 

Attends work on a regular basis and may be asked to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned.

 

1. Assess the health/mental status of the patient upon admission and/or transfer and on an ongoing basis and documents assessment, planning, intervention, and evaluation in patient record to determine priorities and plan therapeutic nursing care. Performs CPR/Heimlich techniques correctly and safely according to the specifications of the American Heart Association. (30%)

 

2. Provides direction and coordination of staffing and patient care activities on assigned units in a consultative manner with nurse administrators and staff nurses by addressing performance problems promptly and keeping accurate documentation of interventions. Coordinates and administers the effective utilization of nursing service personnel on assigned units. (30%)

 

3. Facilitates a smooth admission and/or transfer process during working hours to achieve the hospital mission by communicating with admissions staff, unit staff reviewing written documentation to ensure appropriate status and triage patients when needed. (15%)

 

4. Carries out medical staff practitioners’ orders and implements nursing interventions according to acceptable nursing care standards and hospital policies and procedures. Assist in the client abuse and neglect investigation process. (5%)

 

5. Implements special precautions as ordered and explain and document rights restrictions and implements restraint/seclusion procedures according to departmental policy and established nursing standards to maintain patient safety. Protect the patient from causing harm to self and/or others and uphold patient rights. (5%)

 

6. Attends mandatory training to ensure staff competence and development. Attends and participates in on-going in-service and other education and training programs appropriate to the population/age group to meet the physical, psychosocial, and cultural needs of patients. Monitors the use of treatment, intervention, and protection strategies (TIPS) to ensure the well-being of patients and staff and that TIPS program requirements are adhered to during an episode of patient restraint (5%)

 

7. Communicates openly with Chief Nurse Executive/Asst. Chief Nurse Executive/Nurse Administrator/Nurse Manager to obtain current information to inform and disseminate to staff on assigned units. (5%)

 

8. Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. (5%)

 

Knowledge, Skills and Abilities (KSAs):

 

1.Knowledge of recognized American Nurses Association Nursing Standards.

2.Knowledge of departmental policies and procedures.

3.Knowledge of the Nurse Practice Act.

 

4.Skills in supervisory and management techniques.

5.Skills and ability to perform CPR, agency approved aggression management and restraint techniques, and emergency care in a medical or psychiatric emergency.

6.Skills for positive interaction with patients, staff, families, and the public.

7.Ability to handle crisis situations calmly.

8.Ability to communicate effectively, verbally, and in writing.

9.Ability to use sound judgement and critical thinking skills.

 

Registrations, Licensure Requirements or Certifications:

 

Licensed to practice as a registered nurse (RN) in the State of Texas (or state that recognizes reciprocity through the Nurse Licensure Compact).

 

If transporting patients, must possess a valid Texas driver license or obtain it no later than 90 days after hire date to drive a state vehicle. Applicants with an out-of-state driver license must provide an original certified driving record from the state of driving licensure. Eligible driving record required based on HHSC Fleet Management policy.

 

Initial Screening Criteria:

 

Three (3) years of work experience as a RN in a recognized health agency, hospital, or health care facility.

 

Graduation from a Nursing Program accredited by the Texas Board of Nurse Examiners preferred.

 

Additional Information:

 

Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aid, Medication Aide and Employee Misconduct, List of Excluded Individuals/Entities (LEIE). Males between the ages of 18-25 must be registered with the Selective Service.

 

All applicants must be at least 18 years of age to be considered for employment at a state-operated facility. Waco Center for Youth applicants must be 21 years of age.

 

Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours.

 

Compliance with HHSC immunization policy and state hospital operating procedures related to immunizations is required. According to the Centers for Disease Control and Prevention, healthcare workers are considered to be at significant risk for acquiring or transmitting hepatitis B, measles, mumps, rubella, varicella (chicken pox), tetanus, diphtheria, pertussis (whooping cough), and influenza. All these diseases are vaccine preventable. As a result, state hospital policy requires employees be vaccinated according to their level of contact with individuals. In the event you choose to not be immunized for the influenza virus, you may be required to wear a mask and take other protective measures.

Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.

 

Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.

 

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS 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.

 

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

 

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework.  Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.

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Develops and presents information for inservice training or staff development, as assigned. Communicates with others, such as direct care staff, physicians, primary care practitioners (PCPs), administration, and other nursing staff to ensure optimal care as part of the interdisciplinary team. Notifies the Nurse Manager, Nurse Operations Officer (NOO) or other designated supervisor, of trends and concerns to ensure that communication is in place to provide consistent, high quality care for all persons served. Maintains a professional, harmonious working relationship with facility employees as well as outside agency employees. Keeps informed of and follows all agency, and facility policies and procedures. Completes other assignments as instructed. Works under general supervision of the Nurse Manager, NOO or other designated supervisor, with moderate latitude for the use of initiative and independent judgment. This position may be eligible to earn additional pay for work performed on evenings, nights and/or weekends. Essential Job Functions (EJFs): Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned. May serve in an on-call status on a rotating schedule as required to meet operational needs of the facility. During the shift, is assigned to either a home, group of homes or the SSLC as a whole, depending on SSLC size. Ensures appropriate nursing staff coverage is maintained for the assigned area during the assigned shift by collaborating with person(s) responsible for nursing schedule and other appropriate staff. Makes adjustment to nursing assignments based upon call-ins and the immediate needs of individuals served. Delegates work assignments to nursing staff within the assigned area and reports significant nursing coverage issues to the appropriate administrator. Serves as the point-of-contact for other interdisciplinary staff for coordination of nursing services for the assigned areas, or the SSLC as a whole, specific to SSLC needs. For the assigned area, receives calls for assistance from staff members such as direct care nurses, the campus coordinator, home supervisor, on-duty supervisor, incident and risk management staff and other department heads. Responds to these calls by assessing nursing services being providing and the need for additional or different services. Coordinates with other nursing staff, medical staff or administrative staff to ensure the needed services are received in the assigned area. Needs might include a specific nursing assessment, treatment, or consultation with medical staff for consideration for transfer offsite to a hospital to receive assessment or treatment. Performs complex nursing work including comprehensive physical health assessments, health screenings, and treatments campus wide. Performs technical nursing procedures according to facility and state regulations after demonstration for competency, i.e., tracheostomy care, gastrostomy/jejunostomy care, wound care, breathing treatments. Maintains competency in use of all medical equipment as ordered by physician/PCP. Administers medications, immunizations, and treatment and observes patients for unusual symptoms and reactions. Demonstrates knowledge of medications administered in order to identify desired effects or adverse reactions. Evaluates and documents healthcare needs and/or issues and reports health care needs and/or issues to the appropriate person(s). Communicates health status/needs to other disciplines, and to families as needed. Provides teaching and training to staff and individuals. Assists with on-the-job nursing instruction and training of other nurses, such as LVNs and Nurse Is during the assigned shift by observing them perform their essential job duties and providing feedback to them in their performance of nursing protocols and treatments. Develops and presents information for Inservice training or staff development, as assigned. Serves as a resource for other nurses by answering their questions about nursing protocols and providing information about where to seek additional information for in their professional development such as the use of online learning platforms. Models appropriate interaction with individuals with intellectual and developmental disabilities, their family members, and with staff members. Provides input to nurse manager and other supervisors to assist in the evaluation of employee performance. Responds to emergency situations to ensure safety of individuals. Performs CPR, suctioning, and other emergency procedures as directed by physician/PCP/protocol. Administers emergency medications as prescribed. Demonstrates a working knowledge of emergency procedures and emergency equipment. Recognizes and coaches appropriate Safe Use of Restraint (SUR) procedures. Provides treatment to HHS employees injured in course and scope of employment. Performs related work as assigned. Serves as resource/mentor to other nurses. Cross-trains other registered nurse(s) to back–up as RN Shift Supervisor, as needed. Provides back-up coverage for nursing activities on an as-needed basis. For example, as needed, assists in lab to draw blood samples as per scheduled time periods, etc. Collects specimens for laboratory examination and conducts appropriate screening tests (after competency is documented) as requested by lab personnel. Actively participates in, and prepares for in advance, essential meetings related to care of persons served in order to manage and coordinate health care to achieve optimal health. Updates necessary items in the automated system(s) and other tracking documents and takes the necessary action to communicate information to other disciplines. Participates in competency-based training and continuing education activities and meetings to maintain competence in nursing best practice. Demonstrates knowledge of safety and infection control practices to ensure a safe working environment. Complies with state mandated continuing education to maintain licensure as a registered nurse. Follows information security protocols in order to maintain the accuracy and confidentiality of consumer records. Complies with all State/Federal/Local standards; Facility Policy, ICF Standards, and Texas Nurse Practice Act. by following standard precautions to minimize cross contamination. Provide treatment to HHS employees injured in course and scope of employment. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. Knowledge, Skills and Abilities (KSAs): Knowledge of nursing techniques, standards, and procedures; of health care laws and regulations; of medical diagnoses and procedures; of accepted medical treatment patterns; of community health and nursing care principles, practices, and procedures; of program regulations and procedures; and of utilization review and control measures. Knowledge of state and federal laws and Intermediate Care Facility for individuals with intellectual disabilities (ICF-IID) rules, regulations, policy and procedures related to State Supported Living Center or ability to quickly gain that knowledge. Knowledge of nursing care standards, the Settlement Agreement and the Healthcare Guidelines or ability to quickly gain the knowledge. Knowledge of infectious diseases and infection prevention and control principles and practices in the healthcare setting. Knowledge of standards and Infection Prevention Control standards related to infection control and utilization management. Skills in the use of computer/software and an electronic health record system Skill in the care and treatment of patients. Exceptional physical assessment skills. Exceptional organizational skills. Excellent verbal and written communication skills and the ability to present ideas clearly and concisely in both written and oral communications, and via telemedicine equipment. Ability to provide patient care; to prepare and maintain records; to organize, coordinate, and evaluate nursing activities and delivery of health services; to interpret policies and procedures; to interpret health care regulations; to recognize patterns of medical necessity treatment; and to plan, assign, and/or supervise the work of others. Ability to interpret regulations and communicate them effectively both orally and in writing. Ability to appropriately interact with individuals with intellectual/developmental disabilities, with their family members, and with staff members. Ability to work independently and productively with all levels of staff. Ability to train all levels of staff and coordinate shift assignments. Ability to make decisions and recommendations to SSLC leadership including on-call administrators. Must maintain current CPR certification. Must have strength and flexibility to safely perform Cardiopulmonary Resuscitation (CPR). Knowledge of emergency procedures and emergency equipment, i.e., CPR., and ability to assess and care for residents and/or staff members in emergency situations. Registrations, Licensure Requirements or Certifications: Licensed to practice as a registered nurse in the State of Texas or a state that recognizes reciprocity through the Nurse Licensure Compact. Initial Screening Criteria: At least one (1) year experience as a practicing registered nurse is required. At least two (2) years of experience as a practicing registered nurse in a health agency, hospital, or health-care facility is preferred. Bachelor's Degree is preferred. Previous experience working with Individuals with Intellectual or Developmental Disabilities (IDD) is preferred. Nursing supervisory experience is preferred. Additional Information: Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aide, Medication Aide and Employee Misconduct and HHS List of Excluded Individuals/Entities (LEIE). Males between the ages of 18 – 25 must be registered with the Selective Service. All State Supported Living Center Employees are subject to Random Drug Testing. Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours. Must be willing to work weekends and holidays. All applicants must be at least 18 years of age to be considered for employment at a state-operated facility. Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC . Active Duty, Military, Reservists, Guardsmen, and Veterans : Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions . ADA Accommodations: In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS 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. Pre-Employment Checks and Work Eligibility: Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks. HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form Telework Disclaimer: This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.
Texas Health and Human Services

Quality Monitor Nurse III

$5,425.33 - $8,886.16 / month
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: Quality Monitor Nurse III Job Title: Nurse III Agency: Health & Human Services Comm Department: QMP Nurses and Pharm RMS FTE Posting Number: 15158 Closing Date: 04/08/2026 Posting Audience: Internal and External Occupational Category: Healthcare Practitioners and Technical Salary Range: $5,425.33 - $8,886.16 Pay Frequency: Monthly Salary Group: TEXAS-B-24 Shift: Day Additional Shift: Telework: Travel: Up to 80% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Exempt Facility Location: Job Location City: CROSBY Job Location Address: 6500 FM 2100 RD STE 300 Other Locations: Wichita Falls; Abilene; Amarillo; Archer City; Atlanta; Ballinger; Big Spring; Bowie; Brady; Breckenridge; Brownwood; Carlsbad; Childress; Clarksville; Daingerfield; Gainesville; Haskell; Mineral Wells; San Angelo; Seymour; Snyder; Sweetwater MOS Codes: 290X,46AX,46FX,46NX,46PX,46SX,46YX,66B,66C,66E,66F,66G,66H,66N,66P,66R,66S,66T,66W Job Description The Nurse Quality Monitor III reports to the Quality Monitoring Nurse Manager. This position makes a significant contribution to MCS’s mission by conducting monitoring visits in Texas nursing facilities. The Nurse Quality Monitor III utilizes expertise in the area of nursing to assess conditions that could place facility residents’ health, safety, and welfare at risk and assists providers in improving systems. This position must be able to apply the complex knowledge of nursing practice as well as the rules outlined in the Texas Nursing Practice Act. The Nurse III will be familiar with local, state, and federal laws and regulations relevant to long-term care. The Quality Monitor Nurse (QMN) III works under limited supervision, with considerable latitude for the use of initiative and independent judgment. Performs highly complex (senior-level) nursing work. The Quality Monitor Nurse utilizes expertise in the area of nursing to assess conditions that could place facility residents’ health, safety, and welfare at risk and assist providers in improving systems. Work may include serving as a resource on nursing practices and education programs by performing consultative and administrative work. May serve as a mentor providing direction to others. Essential Job Functions Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned. Works collaboratively across MCS to identify innovative and effective solutions. Maintains cooperative and collaborative relationships with colleagues and facility staff. Performs other work as assigned by Nurse Manager III or Nurse Program Manager V. Coordinates and/or conducts various types of visits to nursing facilities; including quality monitoring visits, rapid response team visits, mentoring visits and in-service visits. Acts as a team coordinator on Rapid Response Team visits offering leadership and direction to team members. Monitors and evaluates facility systems through observations, interviews, and record reviews identifying facility strengths and weakness making recommendations on opportunities for improvement. Instructs, counsels, and assists nursing facilities to achieve best practice. Reviews facilities policy/procedures and performance reports to determine if the facility's systems are consistent with evidence-based best practice. (50%) Documents accurate and complete reports of monitoring visits. Communicates accurate information, findings, recommendations, and technical assistance to the facility administrator and staff as well as quality monitoring leadership. Disseminates and teaches from appropriate education tools and materials. (20%) Communicates with various audiences (internally or externally) to provide clinical information, answer inquiries, address issues, and/or resolve problems. Maintains current knowledge in assigned areas by attending unit meetings, seminars, or other training and by continually reviewing program policies, procedures, and any changes. May conduct literature reviews and analyze complex information to update nursing-related evidence-based best practices technical assistance material. (10%) Develops and provides in-service education and other training to facility-licensed and non-licensed staff regarding evidence-based best practices. (10%) May train and mentor others in the context of a quality monitoring team visit, and orientation to peers as needed. May assists with the development and updating of program policy/procedures, evidence-based best practice standards, and educational programs. (10%) REGISTRATION, CERTIFICATION, OR LICENSURE Must be licensed as a Registered Nurse in the State of Texas or a state that recognizes reciprocity through the Nurse Licensure Compact and a current Texas driver’s license. KNOWLEDGE, SKILLS, AND ABILITIES Knowledge of nursing principles and acceptable professional standard of patient care. Knowledge of local, state, and federal laws and regulations relevant to long-term care as well as an understating of long-term care facility operations. Knowledge of modern office management practices and procedures and technology tools such as Microsoft Office, SharePoint, and Teams productivity tools. Skill in researching, creating, analyzing, monitoring, and evaluating complex clinical issues. Skills in communication and public speaking. Skill in managing multiple and competing priorities. Skill in promoting data-driven decision-making. By identifying trends, concerns, evaluating alternatives, and negotiating and implementing solutions. Skills in working with diverse groups and interests, resolving conflicts, building consensus and problem solving. Ability to gather, evaluate, analyze facts by observation, interviews, and record reviews. Ability to interpret policies, procedures, and regulations as they relate to long term care facility. Ability to organize and present information effectively, both orally and in writing. Ability to serve as a mentor to others. Ability to work collaboratively across HHS/MCS/QMP to accomplish objectives. Ability to balance team and individual responsibilities. Ability to exercise judgment and work independently with moderate direction. Ability to lift twenty-five pounds. Must be able to travel up to 80% including overnight travel and hours other than 8am-5pm and days other than Monday-Friday. Initial Screening Criteria Graduation with a bachelor's degree from an accredited four-year college or university with major coursework in nursing preferred. An associate in nursing with a four-year degree in an applicable healthcare-related field will be considered. Experience may be substituted for education on a year-for-year basis with a maximum of four years. A minimum of 3 years of nursing experience is required. Experience in mentoring peers is required. Experience with or knowledge of Long-Term Care Nursing Facilities with knowledge of CMS requirements or a SMQT (surveyor minimum qualifications test) is preferred. Must be able to travel up to 80% including overnight travel and hours other than 8am-5pm and days other than Monday-Friday. Must have reliable transportation Additional Information : Applicants will be required to complete a written exercise (in-basket) to demonstrate knowledge, skills, and abilities. The successful candidate must desire to dedicate their skills, talents, and abilities to serve and protect the most vulnerable Texans. This position requires the selected candidate to be excited to be a part of a team of highly skilled, capable, and motivated individuals. This position will work in accordance with the agency leave policy and perform other duties as assigned and required to maintain unit operations. All applicants must pass a fingerprint criminal background check. The position may be filled statewide. HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work. 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 online 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. Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC . Active Duty, Military, Reservists, Guardsmen, and Veterans : Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions . ADA Accommodations: In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS 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. Pre-Employment Checks and Work Eligibility: Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks. HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form Telework Disclaimer: This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.
Texas Health and Human Services

Utilization Review Nurse

$4,801.16 - $7,761.50 / month
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: Utilization Review Nurse Job Title: Nurse II Agency: Health & Human Services Comm Department: UR Wav & Comm Srvs Ran Mmt St Posting Number: 15113 Closing Date: 09/23/2026 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: Travel: Up to 75% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Exempt Facility Location: Job Location City: SAN ANTONIO Job Location Address: 1067 BANDERA RD Other Locations: Weslaco 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, 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. 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, validates determinations of health service needs, and makes 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 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, determines 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 effective statewide UR program and to ensure UR policies and procedures are applied consistently. (10%) Develops, provides resources and technical assistance to regional staff and providers. (10%) Testifies as the Subject Matter Expert (SME) in Medicaid fair hearings related to appealed service reductions or denials. (5%) Produces routine and specialized data and information for program reports. (5%) Works collaboratively across MCS to identify innovative and effective solutions for clients and staff (5%) Registrations, Licensure Requirements or Certifications: Must be licensed as a professional Registered Nurse (RN) in the state of Texas or a state that recognizes reciprocity through the Nurse Licensure Compact. Qualification as a Qualified Intellectual Disability Professional (QIDP) as defined in 42 Code of Federal Regulations 483.430(a) required. Must have a valid Texas Driver License. Knowledge Skills Abilities: Meets the criteria for designation as a Qualified Intellectual Disability Professional (QIDP) as defined in 42 Code of Federal Regulations 483.430(a) required. 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. 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. A keen attention to detail and the ability to implement creative solutions to problems. Able to balance team and individual responsibilities. Written and verbal communication skills necessary to consult, teach, and provide clear and concise directions and reports. Ability to: explain and interpret applicable health laws, rules, standards, and regulations; recognize patterns of medical necessity treatment, fraud, abuse, and neglect; use a personal computer, copier, Microsoft Office suite and Outlook e-mail; travel throughout the state as necessary. Initial Screening Criteria: Two-year experience working as a Registered Nurse (RN). Graduation from an accredited four-year college or university with major course work in nursing preferred, or from an accredited nursing program. BSN preferred, experience and education may be substituted for one another. Must meet the federal definition of a Qualified Intellectual and Developmental Disability Professional as defined in 42 Code of Federal Regulations 483.430(a). Must have at least one year of experience working directly with persons with intellectual disability or other developmental disabilities. Must be able to travel 75% of the time. Experience in utilization review, or quality assurance activities in long term services and supports for the aged and disabled preferred. Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC . Active Duty, Military, Reservists, Guardsmen, and Veterans : Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions . ADA Accommodations: In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS 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. Pre-Employment Checks and Work Eligibility: Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks. HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form Telework Disclaimer: This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.