Nurse IV Women's Health Nurse Policy Analyst

Texas Health & Human Services Commission•Austin, TX

4d•$6,378 - $10,786•Hybrid

About The Position

The Women's Health Nurse Policy Analyst - Nurse IV position reports to one of the Medical and Dental Benefits Policy Managers in the Medicaid and CHIP Services division of the Health and Human Services Commission. The position performs highly advanced and/or supervisory (senior-level) medical benefit policy analysis for the Medicaid benefit program. Work involves planning, developing, coordinating, and evaluating Medicaid women's health related medical benefit policy updates. The position requires excellent writing skills and strong research skills, including experience conducting comprehensive literature reviews using PubMed/Medline, Hayes, and other health literature electronic databases; must be able to synthesize findings for clinical and political audiences, and apply findings to women's health medical benefits for policy development in the Medicaid program. These findings must be interpreted correctly in accordance with the Medicaid program requirements for application to and development of Medicaid women's health medical benefits. The Nurse Policy Analyst in this position must be proactive in seeking input from other staff in the Medicaid and CHIP Services Division and demonstrate the ability to work independently, and as an effective team member with peers, other divisions within HHSC, and other HHS agencies. This position works under minimal supervision, with extensive latitude for the use of initiative and independent judgment.

Requirements

Current license to practice as a Registered Nurse (RN) in Texas or a state that recognizes reciprocity through the Nurse Licensure Compact.
Bachelor’s degree from an accredited 4-year college or university.
Experience working as a nurse in an obstetric and/or gynecology clinical setting.
Experience analyzing clinical research and applying findings to work.
Experience or familiarity with literature reviews of medical research topics.
Knowledge of Health and Human Services agencies and programs, including Medicaid/CHIP and other women's health programs.
Knowledge of Computer use, including but not limited to the use of Microsoft Office suite.
Knowledge of General clinical coding resources such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD).
Knowledge of Quality assurance principals.
Skill in Evaluating the quality and levels of evidence presented in the literature.
Skill in Synthesizing findings for clinical and non-clinical audiences.
Skill in Clinical practice guideline evaluation or development; clinical quality assessment, assurance, or improvement; clinical research or health care delivery.
Skill in Written, verbal, and interpersonal communication and presentations.
Skill in Project planning, evaluation, and implementation.
Skill in Establishing and maintaining effective working relationships with managers, co-workers, and other staff or program stakeholders.
Ability to Work independently and function effectively as a member of a team, and under tight deadlines with high volume workloads.
Ability to Conduct 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.
Ability to Manage several projects concurrently in a fast-paced environment and juggle competing priorities.
Ability to Effectively facilitate meetings and establish and advance agenda goals.
Ability to Consistently remain organized and detail- and task-oriented.

Nice To Haves

Bachelor’s of Nursing degree preferred.
Master’s degree in public health, health policy, biology, or other social/behavioral health field or 4 years' experience in an area that provided equivalent women's healthcare or clinical experience.
Master’s degree in nursing preferred.

Responsibilities

Researches, analyzes, and synthesizes peer reviewed literature and evidence-based practices and applies it to program medical and behavioral health benefit policy.
Provides complex technical medical information verbally or in writing to nonclinical audiences.
Consults with stakeholders to address Medicaid program women's health benefit policy issues.
Reviews and updates current benefits and develops new benefits for Medicaid women's health medical policy.
Identifies eligibility standards and authorization requirements for benefit policy.
Collaborates, as needed, with Medical Benefits staff as well as HHSC staff in other programs and other State agencies for program benefit policy development, planning, and implementation.
Serves as clinical subject matter expert in the development and review of program benefit policy.
Develops, reviews, and provides comments on Medicaid program materials intended for use by vendors, providers, managed care organizations, and other partners.
Leads or participates in workgroups and public meetings engaged in research, analysis, and evaluation of policy issues or initiatives.
Leads or participates in special projects as requested by management.
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.
Identifies the need to, and communicates and consults with external stakeholders, as necessary.
Identifies methods for effectively managing benefit changes that have varying effective dates.
Researches provider or manufacturer questions or concerns.
Maintains organized electronic files of activities and shares with staff and partners, as appropriate.
Reviews, analyzes, and comments on regulations affecting program benefit policy.
Actively participating in or serving in a supporting role to meet the agency's obligations.