What are the responsibilities and job description for the Nurse IV position at Health & Human Services Comm?
Nurse IV
Performs advanced (senior-level) nursing work in implementation, oversight and management of Utilization Review for Intellectual and Developmental Disability (IDD) waiver programs. Work involves planning, developing,
coordinating, and evaluating nursing activities and providing for the care and treatment of
patients. Work may include serving as a resource on nursing practices and education programs
by performing consultative and administrative work. Supervising a team of 10-13 RNs, support staff and evaluating the work of others. Works
under moderate supervision, with latitude for the use of initiative and independent
judgement.
Oversees and/or conducts reviews to determine compliance with state and federal laws,
regulations, and rules.
Oversees and/or evaluates nursing services and activities and makes recommendations for
improvements.
Oversees and/or evaluates quality assurance programs and processes.
Ensures service delivery is cost-effective and appropriate for the individual.
Monitors the production of assessments to determine eligibility and appropriateness for
health services.
Develops and evaluates in-service training and educational programs.
Develops, reviews, revises, and explains health care program policies and procedures.
Provides consultation, training, and technical assistance to agency staff, care recipients,
provider agencies, and the medical community.
Serves as a resource on nursing practices and education programs by performing consultative
and administrative work.
Assists in developing guidelines to promote compliance with health-related laws, rules, and
regulations.
May visit settings for clinical learning experiences.
Manages, plans and supervises the work of others.
Performs other and additional related work as assigned.
Performs advanced (senior-level) nursing work in implementation, oversight and management of Utilization Review for Intellectual and Developmental Disability (IDD) waiver programs. Work involves planning, developing,
coordinating, and evaluating nursing activities and providing for the care and treatment of
patients. Work may include serving as a resource on nursing practices and education programs
by performing consultative and administrative work. Supervising a team of 10-13 RNs, support staff and evaluating the work of others. Works
under moderate supervision, with latitude for the use of initiative and independent
judgement.
Oversees and/or conducts reviews to determine compliance with state and federal laws,
regulations, and rules.
Oversees and/or evaluates nursing services and activities and makes recommendations for
improvements.
Oversees and/or evaluates quality assurance programs and processes.
Ensures service delivery is cost-effective and appropriate for the individual.
Monitors the production of assessments to determine eligibility and appropriateness for
health services.
Develops and evaluates in-service training and educational programs.
Develops, reviews, revises, and explains health care program policies and procedures.
Provides consultation, training, and technical assistance to agency staff, care recipients,
provider agencies, and the medical community.
Serves as a resource on nursing practices and education programs by performing consultative
and administrative work.
Assists in developing guidelines to promote compliance with health-related laws, rules, and
regulations.
May visit settings for clinical learning experiences.
Manages, plans and supervises the work of others.
Performs other and additional related work as assigned.
Essential Job Functions:
Attends work on a regular and predictable schedule in accordance with the agency leave policy and performs other duties as assigned.
Identifies changes needed to policies and procedures and makes recommendations for changes to the Unit Manager.
Maintains and updates internal resources and tools as needed in conjunction with changes to program policy and rule changes.
Assists in the coordination of legislative analysis, legislative assignments and inquiries by reviewing legislative bills, prepares responses to legislative inquiries and analyzes the impact of the legislation on program rules and processes. Implementation of any changes due to legislative inquiries.
Develop, implement and monitor unit-wide quality assurance, quality improvement and performance measures systems to ensure production, consistency and staff performance meet unit mission and goals.
Plans, develops, assigns, coordinates, and evaluates nursing review quality assurance activities related to plans of care for persons receiving Medicaid services.
Oversees monthly and as assigned data reports and database functionality and operations related to UR, QA and data analysis.
Provides consultation, training, and direction to Waiver and Community Services staff as needed or directed.
Participates in and/or leads workgroups and meetings to plan, develop, implement, and monitor utilization review program operations and make recommendations for improvement.
Ensures UR activities and services provided are in compliance with policies and procedures and applicable standards, rules, laws, and statutes.
Provides consultation, training, and technical assistance to agency staff, care recipients, and provider agencies.
Produces accurate and timely reports and conducts periodic assessments of data accuracy.
Innovate policy and protocols for the unit designed to streamline processes, increase cost-containment and maximum utilization of existing and available resources.
Effectively plans, monitors and manages caseload and work activities for all staff assigned.
Other duties as assigned by Unit Manager
Attends work on a regular and predictable schedule in accordance with the agency leave policy and performs other duties as assigned.
Identifies changes needed to policies and procedures and makes recommendations for changes to the Unit Manager.
Maintains and updates internal resources and tools as needed in conjunction with changes to program policy and rule changes.
Assists in the coordination of legislative analysis, legislative assignments and inquiries by reviewing legislative bills, prepares responses to legislative inquiries and analyzes the impact of the legislation on program rules and processes. Implementation of any changes due to legislative inquiries.
Develop, implement and monitor unit-wide quality assurance, quality improvement and performance measures systems to ensure production, consistency and staff performance meet unit mission and goals.
Plans, develops, assigns, coordinates, and evaluates nursing review quality assurance activities related to plans of care for persons receiving Medicaid services.
Oversees monthly and as assigned data reports and database functionality and operations related to UR, QA and data analysis.
Provides consultation, training, and direction to Waiver and Community Services staff as needed or directed.
Participates in and/or leads workgroups and meetings to plan, develop, implement, and monitor utilization review program operations and make recommendations for improvement.
Ensures UR activities and services provided are in compliance with policies and procedures and applicable standards, rules, laws, and statutes.
Provides consultation, training, and technical assistance to agency staff, care recipients, and provider agencies.
Produces accurate and timely reports and conducts periodic assessments of data accuracy.
Innovate policy and protocols for the unit designed to streamline processes, increase cost-containment and maximum utilization of existing and available resources.
Effectively plans, monitors and manages caseload and work activities for all staff assigned.
Other duties as assigned by Unit Manager
Knowledge Skills Abilities:
Knowledge of: Individuals with Intellectual and Developmental disabilities; Medicaid programs and policies; accepted nursing techniques and procedures; community health and nursing care principles, practices and procedures; quality management and utilization management; health care needs and services for individuals with disabilities.
Skills in: the use of computers, preferably in a PC, Windows-based operating environment and virtual technology.
Ability to: write in a clear and concise manner, using correct grammar and punctuation; develop and make oral presentations; prepare, maintain, and present reports; explain and interpret applicable health laws, rules, standards, and regulations.
Must have at least 7 years management experience.
Must have at least 5 years experience in IDD waiver program implementation.
Knowledge of: Individuals with Intellectual and Developmental disabilities; Medicaid programs and policies; accepted nursing techniques and procedures; community health and nursing care principles, practices and procedures; quality management and utilization management; health care needs and services for individuals with disabilities.
Skills in: the use of computers, preferably in a PC, Windows-based operating environment and virtual technology.
Ability to: write in a clear and concise manner, using correct grammar and punctuation; develop and make oral presentations; prepare, maintain, and present reports; explain and interpret applicable health laws, rules, standards, and regulations.
Must have at least 7 years management experience.
Must have at least 5 years experience in IDD waiver program implementation.
Registration or Licensure Requirements:
Must be licensed as a professional nurse (RN) in the state of Texas or a state that recognizes reciprocity through the Nurse Licensure Compact in good standing.
Must be licensed as a professional nurse (RN) in the state of Texas or a state that recognizes reciprocity through the Nurse Licensure Compact in good standing.
Initial Selection Criteria:
Valid RN license
7 years management experience
5 years IDD program experience
Valid RN license
7 years management experience
5 years IDD program experience
Additional Information:
MOS Code:
Note: There may be no military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position. 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.
Note: There may be no military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position. 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.
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