Nurse III Managed Care Nurse Analyst

Nurse III Managed Care Nurse Analyst
Texas Health and Human Services

Date:
Jan 9, 2026

Location:

Austin, TX – 701 W 51ST ST

Agency: Health & Human Services Comm

Department: UR Acute Care FTE 75

Posting Number: 12694

Closing Date: 02/08/2026

Posting Audience: Internal and External

Occupational Category: Healthcare Practitioners and Technical

Salary Group: TEXAS-B-24

Salary Range: $5,425.33 - $8,886.16 Monthly

Shift: Day (First)

Telework: Eligible

Travel: Up to 25%

Full Time/Part Time: Full time

FLSA Exempt/Non-Exempt: Exempt

Job Title: Nurse III

The Nurse III, Managed Care Nurse Analyst is a senior-level position that reports to an Acute Care Utilization Review Unit’s (ACUR) Managed Care Clinical Review Manager. The role involves complex assessments and analyses of Medicaid MCO utilization management policies pillows, policies and procedures to ensure compliance with Texas Medicaid contracts, state and federal regulations, and to provide effective team collaboration within HHSC.

• Reviews clinical documentation, Medicaid MCO policies and procedures, and authorization criteria (25%)
• Participates in discussions of case, policy, andarthritis reviews with MCO leadership and staff, and conducts interviews during onsite reviews (15%)
• Provides effective post-review follow‑up by compiling findings and monitoring MCO activities related to non‑compliance (15%)
• Demonstrates competency in internal processes and usage of ACUR clinical and utilization management review tools for accurate findings (15%)
• Provides clinical review of complaints and inquiries, prepares written reports (10%)
• Accurately interprets complex state and federal laws related to Texas Medicaid Managed Care (10%)
• Provides consultation as a utilization management subject matter expert for contract procurement, training, and guidance to internal/external staff (10%)

tens of knowledge of Texas Medicaid policy related to clinical services, utilization review, and managed care principles; familiarity with ICD‑10 and HCPC/CPT codes;
Microsoft Office skills; strong interpersonal, written, and oral communication; ability to prioritize multiple projects and work under tight deadlines.

Must possess a current, unencumbered Texas Registered Nurse License (or a state that recognizes reciprocity through the Nurse Licensure Compact) in good standing.

Bachelor’s degree in nursing preferred; minimum three years of nursing experience in a clinical setting required; preferred experience with Texas Medicaid, managed care, or utilization review; ability to travel up to 25%.

Telework opportunities are available following successful לא orientation and per business needs.

In compliance with the ADA, HHSC will provide reasonable accommodations during hiring and selection for qualified individuals with a disability. Contact the HHS Employee nkar Service Center at 1‑888‑894‑4747 وع if assistance is needed with the online application or interview process.

Selected candidates may be required to pass background checks. HHSC uses E‑Verify and requires I‑ условиях when starting employment.

Telework is subject to state and agency policies and the discretion of the direct supervisor.