Nurse Policy Analyst

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.

Functional Title: Nurse Policy Analyst

Job Title: Nurse IV

Agency: Health & Human Services Comm

Department: Med Benefits Clinical Policy75

Posting Number: 18394

Closing Date: 07/22/2026

Posting Audience: Internal and External

Occupational Category: Healthcare Practitioners and Technical

Salary Range: $6,377.50 - $10,785.83

Pay Frequency: Monthly

Salary Group: TEXAS-B-26

Shift: Day

Additional Shift: Days (First)

Telework:

Travel: Up to 5%

Regular/Temporary: Regular

Full Time/Part Time: Full time

FLSA Exempt/Non-Exempt: Exempt

Facility Location:

Job Location City: AUSTIN

Job Location Address: 701 W 51ST ST

Other Locations: Austin

MOS Codes: 290X,46AX,46FX,46NX,46PX,46SX,46YX,66B,66C,66E,66F,66G,66H,66N,66P,66R,66S,66T,66W

Brief Job Description

The Nurse Policy Analyst (Nurse IV) position reports to the Medical Benefits Policy Manager in the Office of Program and Policy, Medicaid and CHIP Services Department. The Nurse Policy Analyst (Nurse IV) will lead internal workgroups and projects, and mentor other staff. This position performs complex analysis of medical benefits for the Medicaid/CHIP Policy Development Division. 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; and must be able to synthesize findings for clinical and non-clinical audiences, and apply findings to medical benefits for policy development in the Medicaid program. These findings must be interpreted correctly in accordance with the Texas Medicaid programs requirements for application to and development of Medicaid's medical benefits. The Nurse Policy Analyst in this position must be proactive in seeking input from other staff in the Medicaid/CHIP Division and demonstrate the ability to work as an effective team member with peers, other divisions within HHSC, and other HHS agencies.

Essential Job Functions

(30%) Clinical Review of the Literature - Researches, analyzes, and synthesizes peer reviewed literature and evidence-based practices and applies it to program medical, dental, and mental health benefit policy. Provides complex technical medical information verbally or in writing to nonclinical audiences. Consults with stakeholders to address Medicaid program benefit policy issues.

(30%) Develops policies- Reviews and updates current benefits and develops new benefits for Medicaid 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 materials intended for use by vendors, providers, managed care organizations, and other partners, as well as stakeholders.

(25%) Special Projects and Workgroups - 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, and synthesizing medical and dental benefit policy langauge, including during legislative session where this position may be expected to serve in a lead role. 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.

(15%) Quality Assurance and Process Improvement - 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. Other duties, as assigned, include but are not limited to actively participating in or serving in a supporting role to meet the agencys obligations.

Registrations, Licensure Requirements or Certifications

Requires current license to practice as a Registered Nurse (RN) in Texas or a state that recognizes reciprocity through the Nurse Licensure Compact.

Knowledge, Skills, and Abilities

• Strong research skills including experience conducting 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.
• Experience evaluating the quality and levels of evidence presented in the literature. Must be able to synthesize findings for clinical and non-clinical audiences. Experience with clinical practice guideline evaluation or development; clinical quality assessment, assurance, or improvement; clinical research or health care delivery.
• Ability to mentor and work well with others.
• Ability to work collaboratively and adapt quickly to changing circumstances and team dynamics, and take on a lead role as needed.
• Knowledge of Health and Human Services agencies and programs, including Medicaid/CHIP. Excellent computer skills, including Microsoft Office suite.
• Demonstrated ability to work independently and function effectively as a member of a team, and under tight deadlines with high volume workloads.
• Highly organized and the ability to manage several projects concurrently in a fast-paced environment and juggle competing priorities.
• Detail and task oriented.
• Excellent written, verbal, and interpersonal communication and presentation skills.
• Ability to effectively facilitate meetings, and establish and advance agenda goals.
• 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.
• Knowledge of quality assurance principals.
• Familiarity with medical vocabularies such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD), version 10 is a plus.
• Skills in effective interpersonal communication and ability to collaborate across a variety of business areas and with staff at multiple levels of experience and expertise.
• Skills in active listening, asking questions, providing constructive/collaborative feedback, building trust, and setting SMART goals.
• Skills in identifying problems, evaluating alternatives, and proposing effective solutions.
• Ability to effectively plan and work cooperatively in a rapid-paced, deadline-oriented environment.
• Healthy work-relationship building is a must.

Initial Screening Criteria

Required:

• Bachelor of Nursing degree preferred, but other bachelor degrees will be considered for 4 years experience such as public health, health policy, biology or other social/behavioral health field.
• Experience in researching clinical, scholarly, academic, and peer reviewed literature.
• Demonstrated experience in leading and managing projects, as well as analyzing, utilizing, and applying evidenced-based research.

Preferred:

• Experience completing policy analysis or developing health-related policy preferred.
• Master's degree in Nursing preferred, but master's degree in other areas such as public health, health policy, biology or other social/behavioral health field considered.
• Clinical coding (CPT, HCPCS, ICD, NCCI) experience preferred, but not required.

Additional Information

Applicants selected for an interview will be required to submit a resume, a professional or academic writing sample, and may be asked to complete an in-basket exercise.

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Active Duty, Military, Reservists, Guardsmen, and Veterans:

Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor's Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditors Office - Job Descriptions.

ADA Accommodations:

In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Pre-Employment Checks and Work Eligibility:

Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.

HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form

Telework Disclaimer:

This position may be eligible for telework. Please note, all HHS positions are subject to state and agency telework policies in addition to the discretion of the direct supervisor and business needs.