Enforcement Clinical Consultant

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: Enforcement Clinical Consultant 
Job Title: Nurse III 
Agency: Health & Human Services Comm 
Department: Professional Cred Enfmnt 
Posting Number: 8041 
Closing Date: 08/26/2025 
Posting Audience: Internal and External 
Occupational Category: Healthcare Practitioners and Technical 
Salary Group: TEXAS-B-24 
Salary Range: $5,425.32 - $8,886.16 
Pay Frequency: Monthly
Shift: Day 
Additional Shift:  
Telework: Eligible for Telework 
Travel: Up to 20% 
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; Abilene; Alamo; Alice; Alpine; Alvin; Amarillo; Anahuac; Andrews; Angleton; Anson; Aransas Pass; Archer City; Arlington; Athens; Atlanta; Bacliff; Ballinger; Bandera; Bastrop; Bay City; Baytown; Beaumont; Bedford; Beeville; Bellville; Big Spring; Boerne; Bonham; Borger; Bowie; Brady; Breckenridge; Brenham; Brownfield; Brownsville; Brownwood; Bryan; Burnet; Caldwell; Cameron; Canton; Canutillo; Carlsbad; Carrizo Springs; Carrollton; Carthage; Center; Centerville; Childress; Clarksville; Cleburne; Cleveland; Coldspring; Columbus; Conroe; Copperas Cove; Corpus Christi; Corsicana; Crockett; Crosby; Crystal City; Cuero; Cypress; Daingerfield; Dallas; Decatur; Del Rio; Denton; Dickinson; Dumas; Duncanville; Eagle Pass; Eastland; Edinburg; El Paso; Elgin; Elsa; Ennis; Fabens; Falfurrias; Floresville; Fort Stockton; Fort Worth; Fredericksburg; Gainesville; Galveston; Garland; Gatesville; Georgetown; Giddings; Gilmer; Goliad; Gonzales; Graham; Granbury; Grand Prairie; Grapevine; Greenville; Hallettsville; Hamilton; Harlingen; Haskell; Hearne; Hemphill; Hempstead; Henderson; Hereford; Hillsboro; Hondo; Houston; Humble; Huntsville; Hurst; Irving; Jacksonville; Jasper; Johnson City; Jourdanton; Karnes City; Katy; Kaufman; Kerrville; Killeen; Kingsville; Kingwood; Kirbyville; La Grange; Lake Jackson; Lake Worth; Lamesa; Lampasas; Lancaster; Laredo; Levelland; Lewisville; Liberty; Linden; Littlefield; Livingston; Llano; Lockhart; Longview; Lubbock; Lufkin; Lumberton; Madisonville; Marble Falls; Marfa; Marlin; Marshall; Mcallen; Mckinney; Mercedes; Meridian; Mesquite; Mexia; Midland; Mineola; Mineral Wells; Mission; Monahans; Mount Pleasant; Mount Vernon; Nacogdoches; Navasota; New Boston; New Braunfels; Odessa; Orange; Palestine; Pampa; Paris; Pasadena; Pearland; Pearsall; Pecos; Perryton; Pharr; Pittsburg; Plainview; Plano; Pollok; Port Arthur; Port Lavaca; Presidio; Quitman; Raymondville; Refugio; Richardson; Richmond; Rio Grande City; Robstown; Rockwall; Rosenberg; Round Rock; Rowlett; Rusk; San Angelo; San Antonio; San Benito; San Juan; San Marcos; San Saba; Schertz; Seguin; Seminole; Seymour; Sherman; Silsbee; Sinton; Snyder; Socorro; Sonora; South Houston; Stephenville; Sugar Land; Sulphur Springs; Sweetwater; Taylor; Temple; Terrell; Texarkana; Texas City; The Woodlands; Tomball; Trinity; Tyler; Uvalde; Van Horn; Vernon; Victoria; Waco; Washington; Watauga; Waxahachie; Weatherford; Webster; Weslaco; Wharton; Wichita Falls; Woodville; Zapata 
MOS Codes: 290X,46AX,46FX,46NX,46PX,46SX,46YX,66B,66C,66E,66F,66G,66H,66P,66R,66S,66T,66W 
 
 
 

Brief Job Description:

Has broad knowledge of Day Activity Health Services (DAHS); Home and Community Support Services Agencies (HCSSA); Individualized Skills and Socialization (ISS); Prescribed Pediatric Extended Care Centers (PPECC); and/or Home and Community-based Services (HCS) and Texas Home Living (TxHmL) programs.

Has broad knowledge of Medicare, Medicaid programs; state licensing regulations relating to DAHS, HCSSA, ISS, and PPECC programs; federal certification regulations for HCSSAs; and/or certification rules relating to HCS and TxHmL programs.

Has broad knowledge of complex disease processes and treatments for pediatrics, adults, and geriatrics. Has broad knowledge of intellectual and developmental disabilities. 

Applies analytical and critical thinking skills using the Issue, Rule, Application and Conclusion (IRAC) method in the review of state licensing violations for DAHS, HCSSA, ISS, and PPECC to ensure accuracy pursuant to state licensing standards. 
Applies analytical and critical thinking skills using the Issue, Rule, Application and Conclusion (IRAC) method in the review of state certification violations for HCS and TxHmL to ensure accuracy pursuant to state certification principles.
Applies analytical and critical thinking skills in the review of Medicare deficiencies to ensure accuracy pursuant to Medicare Conditions of Participation rules and regulations for federally certified HCSSAs and determines appropriate sanctions.

Performs review of Opportunity to Show Compliance (OSC) packets to determine if enforcement action is supportable and warranted and prepares detailed narrative of decisions and rationales. 

Performs Informal Dispute Resolution (IDR) reviews of state licensing violations and Medicare Condition-level deficiencies and prepares detailed narrative of decisions and rationales.

Provides consultation, interpretation and or clarification of standards, principles, and rules relating to DAHS, HCSSA, ISS, PPECC HCS and TxHmL and participates in work groups and meetings representing enforcement relating to DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL programs.

Performs quality management of assignments including proofing, follow-up, tracking and monitoring, and data entry in applicable program databases including but not limited to TULIP, SharePoint, Access. 

Attends enforcement case pre-hearing conferences and hearings related to enforcement actions of DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL. 

Communicates on a complex and professional level with others, internally and externally. 

Must attend and complete all required training related to the DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL programs. 

Essential Job Functions (EJFs):

1. Performs clinical review and analysis of Day Activity Health Services (DAHS), Home and Community Support Services Agencies (HCSSA), Individualized Skills and Socialization (ISS), and Prescribed Pediatric Extended Care Centers (PPECC) state licensing violations. Performs review and analysis of Home and Community-based Services (HCS) and Texas Home Living (TxHmL) state certification principle violations. Implements the Issue, Rule, Application and Conclusion (IRAC) method to determine whether the documented evidence and packets support noncompliance and whether violations warrant enforcement action. Performs clinical review and analysis of Home and Community Support Services Agencies (HCSSA) federal deficiencies to determine noncompliance with Medicare Conditions of Participation (CoP) and Standards and whether federal sanctions and or Medicare termination is warranted. 40%
2. Performs quality management of assignments, maintains systems for follow-up and tracking of assignments, and performs data entry in applicable program databases including but not limited to TULIP, SharePoint, Access. 25%
3. Conducts Informal Dispute Resolution (IDR) reviews of state licensing violations and Medicare Condition-level deficiencies. Communicates with IDR requestors for clarifications and additional information as needed. Prepares detailed narrative of rationale and decisions. Utilizes all resources, peers, and literature for clarification. 10%
4. Reviews Opportunity to Show Compliance (OSC) packets to determine if the recommended action is warranted and supportable. Prepares detailed narrative of rationale and decision. Utilizes all resources, peers, and literature for clarification. 10%
5. Communicates with regional and state office staff to provide consultation, interpretation, guidance, and clarification relating to DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL standards, principles, and rules; and as needed, participates in work groups and meetings representing enforcement relating to DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL programs. 5%
6. Attends and completes all required trainings applicable to the DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL programs. Attends work on a regular and predictable schedule and performs other duties as assigned. 5%  
7. Attends enforcement case pre-hearing conferences and hearings related to enforcement actions of DAHS, HCSSA, ISS, PPECC, HCS, and TxHmL. 5%

Knowledge, Skills and Abilities (KSAs):

Knowledge of Medicare, Medicaid, and/or state licensing rules relating to DAHS, HCSSA, ISS, and PPECC, or other long-term care programs; and/or certification rules relating to HCS and TxHmL programs; and/or federal regulations relating to certified HCSSAs

Knowledge of administration of and/or skill in the provision of clinical care to patients under Day Activity Health Services (DAHS); Home and Community Support Services Agencies (HCSSA); Individualized Skills and Socialization (ISS); Prescribed Pediatric Extended Care Centers (PPECC); and/or Home and Community-based Services (HCS) and Texas Home Living (TxHmL) programs or other long-term care programs.

Knowledge of regulatory activities including inspections/surveys, investigations and/or enforcement.

Ability to gather, organize, analyze facts; compile and prepare professional reports; effectively enter and track data, develop and evaluate policies and procedures to initiate modifications as needed.

Ability to perform work independently and operate effectively within established guidelines and timeframes.

Ability to establish and maintain effective working relationships with managers, team members, internal and external stakeholders.

Registrations, Licensure Requirements or Certifications:

Active, unencumbered licensed to practice as a registered nurse (RN) in the State of Texas, or in a state that recognizes reciprocity through the Nurse Licensure Compact is required.

Initial Screening Criteria:

Experience working as a practicing registered nurse in a clinical setting is required.

Experience working as a practicing registered nurse with DAHS, HCSSA, ISS, PPECC, HCS and/or TxHmL programs preferred.

Experience in long-term care regulatory services in surveys, investigations, and/or enforcement of DAHS, HCSSA, ISS, PPECC, HCS and/or TxHmLprograms preferred.

Graduation from a Nursing Program accredited by the Texas Board of Nurse Examiners preferred.

Additional Information:

Work schedule is Monday - Friday, 8:00 a.m. - 5:00 p.m.

This position may telework according to the agency policy.

The position may be located in any LTCR region within the State of Texas.

An in-basket exercise using the Issue, Rule, Application and Conclusion (IRAC) process is required.

Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.

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.