Job/Position DescriptionNurse IVPerforms advanced (senior-level) nursing work in implementation, oversight and management of Utilization Review for Intellectual and Developmental Disability (100) 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 programsby performing consultative and administrative work. Supervising a team of 10-13 RNs, support staff and evaluating the work of others. Worksunder minimal 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 FunctionsAttends 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.Pr https://jobshrportal.hhsc.state.tx.us/ENG/CareerPortal/job_profile.cfm?szOrderID=572648 Copy the URL in the preceding sentence to an Internet Explorer browser to apply to the job directly through the Texas Health and Human Services Career Portal.