Nurse II

Position Overview Title: Nurse II Department: Medicaid CHIP Services (MCS) Location: 1460 19TH ST NW, PARIS, TX Salary: $4,801.16 – $7,761.50 per month Shift: Day, first days (primary) Telework: Eligible Travel: Up to 75% Job Summary You will serve as a Utilization Review Nurse, responsible for evaluating records, service plans, and conducting interviews to ensure that Medicaid services in 1915(c) waiver and Community Attendant Services programs are appropriate, cost‑effective, and meet legal requirements. Key Responsibilities Conduct desk reviews of documentation for Medicaid waiver programs and CAS. Participate in onsite, televideo, or telephonic interviews to assess service justification. Make service authorization decisions on difficult and targeted cases. Perform quality assurance reviews and improvement studies, evaluating compliance with program rules. Collaborate with other UR nurses and regional staff to implement statewide UR policies. Provide resources and technical assistance to regional staff and providers. Testify as Subject Matter Expert in Medicaid fair hearings concerning appealed service reductions or denials. Produce routine and specialized data for program reports. Identify innovative solutions across MCS to enhance client and staff outcomes. Required Qualifications and Skills Licensed Registered Nurse (RN) in Texas or in a state recognized by the Nurse Licensure Compact. Qualified Intellectual Disability Professional (QIDP) designation. Valid Texas Driver’s License. Minimum two years of RN experience. BSN preferred; otherwise education may substitute experience on a year‑to‑year basis. At least one year of experience working directly with persons with intellectual or developmental disabilities. Willingness to travel up to 75% of the time. Proficiency with clinical knowledge of nursing laws, medical diagnoses, community health principles, quality management, utilization management, and long‑term care regulations. Strong written and verbal communication, ability to consult, teach, and produce clear reports. Proficiency with Microsoft Office, Outlook, and use of PCs. Ability to multitask, handle stress, meet deadlines, and work collaboratively. Additional Information Position subject to E‑Verify; candidates must bring I‑9 documentation. Eligible for telework as per agency policy. Position may require 75% travel across the state of Texas. #J-18808-Ljbffr Texas Health and Human Services