Nurse III 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 III Policy Analyst
Job Title: Nurse III
Agency: Health & Human Services Comm
Department: Med Benefits Clinical Policy75
Posting Number: 15609
Closing Date: 05/13/2026
Posting Audience: Internal and External
Occupational Category: Healthcare Practitioners and Technical
Salary Range: $5,425.33 - $8,886.16
Pay Frequency: Monthly
Salary Group: TEXAS-B-24
Shift: Day
Additional Shift: Days (First)
Telework: Eligible for Telework
Travel: Up to 10%
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 III) position reports to a Medical and Dental Benefits Policy Manager in the Office of Policy, Medicaid and CHIP Services Department. The Nurse Policy Analyst performs complex medical benefits policy analysis, development, and consultation. The Nurse Policy Analyst in this position will serve as the subject matter expert for a variety of medical topics, with a focus primarily on hearing device and audiology services.

This 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 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 program's requirements for application and development of Medicaid’s medical benefits.

The Nurse Policy Analyst in this position will be asked to participate in internal and external stakeholder workgroups, 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, evaluates, and synthesizes peer-reviewed literature and evidence-based practices for application to Medicaid medical, dental, and mental health benefit policy. Synthesizes complex technical medical information verbally or in writing for clinical and 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 staff in Medical Benefits, HHSC, other State agencies, and the claims system administrators 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.

(20%) Quality Assurance - Participates in quality assurance activities through the development and review of program medical, dental, and mental health benefits, including: reviewing documentation, reviewing and approving medical benefits language for internal and forward-facing publications, documenting and tracking research, reviewing policy development, discussions, and draft program benefit policy changes. Researches provider or manufacturer questions or concerns. Maintains organized electronic files of activities and shares with staff and partners, as appropriate. Assists in the review and referral of complaints concerning medical and other providers and services.

(15%) 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. 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.

(5%) Regulation review - 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 agency's obligations.

Registrations, Licensure Requirements or Certifications:

Must have a current license to practice as a Registered Nurse in Texas or a state that recognizes reciprocity through the Nurse Licensure Compact. Clinical coding certificate preferred.

Knowledge, Skills, and Abilities

Knowledge of:

• Health and Human Services agencies and programs, including Medicaid/CHIP;
• Computer use, including but not limited to the use of Microsoft Office suite;
• General clinical coding resources such as Current Procedural Terminology (CPT) and International Classification of Diseases (ICD); and
• Quality assurance principals.

Skill in:

• Evaluating the quality and levels of evidence presented in the literature;
• Synthesizing findings for clinical and non-clinical audiences;
• Clinical practice guideline evaluation or development; clinical quality assessment, assurance, or improvement; clinical research or health care delivery;
• Written, verbal, and interpersonal communication and presentation skills;
• Project planning, evaluation, and implementation; and
• 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;
• 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;
• Manage several projects concurrently in a fast-paced environment and juggle competing priorities. Detail and task oriented;
• Effectively facilitate meetings and establish and advance agenda goals; and
• Stay organized

Initial Screening Criteria

• Bachelor’s degree from an accredited 4-year college or university. 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 experience. Master’s degree in nursing preferred;
• Experience analyzing clinical research and applying findings to work; and
• Experience or familiarity with literature reviews of medical research topics.

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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 Auditor's 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.