Registered Nurse (RN) - Infusion
Austin State Hospital
Austin, TX

Nurse IV

Texas Health and Human Services Commission (HHSC) seeks a highly qualified candidate to fill the position of Health Texas Women (HTW) Nurse Policy Analyst (Nurse IV). HHSC is driven by its mission to deliver quality, cost-effective services to Texans. This position makes a significant contribution to HHSC's mission by performing complex medical benefits policy analysis, development, and consultation. The position requires excellent writing skills and strong research skills, including experience conducting comprehensive literature reviews using a variety of resources such as PubMed/Medline, Hayes, and other health literature electronic databases; must be able to synthesize findings for clinical and lay audiences, and apply findings to medical benefit policy development in the HTW program. These findings must be interpreted correctly in accordance with the HTW program's requirements. 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 HTW Nurse Policy Analyst (Nurse IV) position reports to the Medical and Dental Benefits Policy (MDBP) Manager in the Office of Policy, Medicaid and CHIP Services Department. The Nurse Policy Analyst in this position must be proactive in seeking input from other staff in the Medicaid and CHIP Services and Family Health Services (FHS) departments and demonstrate the ability to work as an effective team member with other divisions within HHSC and other HHS agencies. The Nurse Policy Analyst in this position will be asked to participate in internal workgroups and must work well with peers. Essential Job Functions: (30%) Clinical Review of the Literature - Researches, analyzes, evaluates, and synthesizes peer-reviewed literature and evidence-based practices for application to HTW medical and mental health benefit policy. Synthesizes complex technical medical information verbally or in writing to nonclinical audiences. Consults with stakeholders to address HTW program benefit policy issues. (30%) Develops policies - Reviews and updates current benefits and develops new benefits for HTW medical policy. Identifies eligibility standards and authorization requirements for benefit policy. Collaborates, as needed, with MDBP staff as well as HHSC staff in other programs and other State agencies, and the claims system administrators for program benefit policy development, planning, and implementation. Develops, reviews, and provides comments on HTW materials intended for use by vendors, providers, managed care organizations, and other partners. (20%) Quality Assurance - Participates in quality assurance activities through the development and review of HTW program medical and mental health benefits, including: reviewing documentation, reviewing and approving medical benefits language for internal and forward-facing publications, documenting and tracking research, reviewing policy development, discussions, and draft program benefit policy changes. Assists in the review and referral of complaints concerning medical and other providers and services. (15%) Special Projects and Workgroups - Leads or participates in workgroups and public meetings engaged in research, analysis, and evaluation of policy issues or initiatives. 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. (5%) Regulation review - Reviews, analyzes, and comments on regulations affecting HTW 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. Works collaboratively across MCS and FHS to identify innovative and effective solutions for clients and staff. 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 evaluating the quality and levels of evidence presented in the literature * Must be able to synthesize findings for clinical, non-clinical, and political audiences * Experience with clinical practice guideline evaluation or development; clinical quality assessment, assurance, or improvement; clinical research or health care delivery * Knowledge of Health and Human Services agencies and programs, including HTW and 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 * Ability to work collaboratively across MCS to accomplish objectives * A keen attention to detail and the ability to implement creative solutions to problems * Highly organized and the ability to manage several projects concurrently in a fast-paced environment and juggle competing priorities * 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 * Skilled in project planning, evaluation, and implementation * Knowledge of quality assurance principles * 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: Must have a current license to practice as a Registered Nurse in Texas or a state that recognizes reciprocity through the Nurse Licensure Compact. Clinical coding certificate preferred but not required. Initial Selection Criteria: Must be a registered nurse. Bachelor of Science in Nursing degree preferred, but other Bachelor's degrees may 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 may also be considered. Experience completing policy analysis or developing health-related policy preferred. Experience in analyzing clinical research and applying findings to work; experience in performing comprehensive literature reviews of medical research topics. A nurse applying for this position must have a clinical background in women's healthcare, and demonstrate experience in leading and managing projects, as well as analyzing, utilizing, and applying evidenced-based research. Preference may be given to those with a coding certificate such as AAPC. Additional Information: 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. Top 10 Tips for Success when Applying to Jobs at HHSC and DSHS