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CategoryHealthcare
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No of Jobs1
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Apply Before09/19/2025
Description
Nurse III
Texas Health and Human Services - Austin, TX
Job Title: Nurse III
Position: Nurse III
Job Type: Full Time
Pay: $5,833.34 - $6,103.03
Shift: Day
Work Type: Hybrid
Location
Address:
City: Austin
State: TX
ZIP Code:
Job Responsibilities
- Conducts retrospective utilization reviews and other consultative nursing work supporting the OIG SUR division and other divisions across the OIG.
- Collaborates, reviews medical records/documents, tracks post-review activities, researches cases/providers, runs queries, and completes other ad-hoc assignments.
- Participates in medical record review and analysis process, summarizing feedback and findings for fraud, waste, and abuse identification.
- Responds to inquiries from OIG staff, leadership, providers, and legislative entities on the reviews and appeals process.
- Consults with internal and external stakeholders for policy and inquiries as needed.
- Monitors work products for accuracy and timeliness.
- Works under limited supervision with considerable latitude in professional judgment.
- Reviews internal policies for compliance with federal and state regulations and recommends updates.
- Collaborates with others within the OIG/SUR division on projects and assists with data analysis and interpretation.
- Represents the OIG in both internal and external meetings and forums.
- Coordinates responses for external stakeholders and audits, providing written or verbal feedback.
- Prepares and delivers reporting/status updates to management.
- Identifies and implements process improvements.
- Performs related work as assigned and keeps the manager informed as required.
Required Skills
Core Skills
- Knowledge of federal and state laws governing Medicaid policies and procedures
- Experience in managed care, healthcare, and/or healthcare billing environment
- Knowledge of nursing practices and procedures
- Ability to interpret and apply policies, procedures, regulations, and other healthcare criteria
- Ability to develop, revise, and apply policies and procedures
- Ability to use personal computers and related software for reporting
- Ability to manage multiple program activities and priorities
- Skill in communicating effectively in both written and oral formats
Preferred Skills
- Experience using Microsoft Word and Excel
- Experience in hospital, nursing facility, acute care, and/or managed care
Requirements
Experience: Minimum of 2 years in a program or service area related to hospital, nursing facility, acute care, and/or managed care.
Education: Graduate of a college, university, or school of nursing.
License & Certification:
- Licensed to practice as a Registered Nurse in the State of Texas or in a state recognized under the Compact Licensure Agreement
Schedule:
- Eligible for telework with a potential of 15% travel
COVID-19 Requirements: Not Specified
Benefits
- 100% paid employee health insurance for full-time eligible employees
- Defined benefit pension plan
- Generous time off benefits
- Numerous opportunities for career advancement
Supplemental Pay
- Not specified
Special Notes
- Selected applicants must complete a national fingerprint-based criminal background check.
- Potential OIG employees are subject to criminal background checks.
- All HHS positions are subject to state and agency telework policies.
- ADA accommodations available for qualified individuals with disabilities.
Facility Details
Name: Texas Health and Human Services
Description: The HHSC is committed to creating a positive impact in the lives of fellow Texans.
Specialties:
- Healthcare
- Medicaid
Mission: Not Specified
Job Info
Discipline:
Department:
Status:
Sourcing
Duration:
Experience:
Career Level:
No of Jobs:
1
Apply Before:
09/19/2025
Posted:
06/19/2025
