RN II Direct Care

Texas Health and Human Services; Harlingen (TX); On-site; USD 73,000 - 87,000; Full time

Benefits offered by this job

100% paid employee health insurance (h

Defined benefit pension

Generous time off benefits

Career advancement opportunities

Job summary

Texas Health and Human Services Commission (HHSC) is seeking a Direct Care RN II at the Rio Grande State Supported Living Center in Harlingen, TX. The role involvesProviding nursing care across multiple homes, including mornings, evenings, and nights, with potential extra pay for evenings/nights.

The RN conducts assessments, documents care, administers medications, and coordinates with LVNs, CMA staff, and the interdisciplinary team.

Qualifications

• Licensed to practice as a registered nurse in Texas.
• At least six months of RN experience preferred in health settings.
• Bachelor's degree is preferred but not required.

Responsibilities

• Attend regular shifts as scheduled, including mornings, evenings, or nights.
• Administer medications, immunizations, and treatments; monitor patients.
• Document care and assessments in the medical record (EHR).
• Collaborate with LVNs, CMAs, and other staff to provide coordinated care.
• Participate in QA/QI initiatives and safety programs.
• Respond to emergencies to ensure patient and staff safety.

Skills

Nursing care

Vital signs

Documentation

Emergency response

Interdisciplinary teamwork

Education

Registered Nurse license (TX)

Bachelor's degree preferred

Tools

Electronic Health Record system

Job description

Date: Aug 28, 2026
Location:
HARLINGEN, TX
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.
RN II Direct Care Job Title: Nurse II Agency: Health & Human Services Comm Department: Nursing A Posting Number: 20726 Closing Date: 11/26/2026 Posting Audience: Internal and External Occupational Category: Healthcare Support Salary Range: $6,579.41 - $7,761.50 Pay Frequency: Monthly Salary Group: TEXAS-B-22 Shift: Day Additional Shift Telework: Not Eligible for Telework Travel: Up to 5% Regular/Temporary: Regular Full Time/Part Time: Full time FLSA Exempt/Non-Exempt: Exempt Facility Location: Rio Grande State Supported Living Center Job Location City: HARLINGEN Job Location Address: 1401 S RANGERVILLE RD MOS Codes: 290X,46AX,46FX,46NX,46PX,46SX,46YX,66B,66C,66E,66F,66G,66H,66N,66P,66R,66S,66T,66W

Brief Job Description

This position is available for Morning, Evening and Night shifts on multiple homes.

This position may be eligible to earn additional pay for work performed on evenings, and nights.

Come work in an environment where we truly value and respect those we serve and believe in the mission that all people can achieve a higher level of wellness and independence. The state supported living centers serve people with intellectual and developmental disabilities who are medically fragile or who have behavioral problems. The centers provide campus-based direct services and supports at 13 centers located throughout the state. Learn About Our State Supported Living Centers. If you are looking for a place to work where you can establish a career that is filled with purpose, this is the job for you! Free CEUs and updated resources through Lippincott access for all nurses.

The Direct Care RN performs routine level nursing work providing for the assessment, care and treatment of individuals who reside in a State Supported Living Center (SSLC) setting. Evaluates, treats and documents healthcare needs and/or issues and reports needs and/or issues to the appropriate person(s). Communicates with others, such as direct care staff, physicians/PCP, administration, and other nursing staff to ensure optimal care as part of the interdisciplinary team. Notifies the supervisor and PCP of trends and concerns to ensure that communication is in place to provide consistent, high quality care for all persons served. Completes data entry, required documentation and reports and maintains records.

Assists with services provided by LVNs and Certified Medication Aides (CMA), as needed, and makes recommendations for improvements. Participates in facility quality assurance/quality improvement (QA/QI) initiatives, as required. Provides treatment to HHS employees injured in course and scope of employment. Responds to emergency situations to ensure safety and care of individuals and staff. Works under moderate supervision of the Nurse Manager or Nursing Operations Officer, with limited latitude for the use of initiative and independent judgment.

Essential Job Functions (EJFs)

Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned.

May serve in an on-call status on a rotating schedule as required to meet operational needs of the facility.

Performs routine nursing tasks and procedures in accordance with HHSC, SSLC and state regulations, such as tracheostomy care, gastrostomy/jejunostomy care, wound care, breathing treatments. Collects specimens for laboratory examination and conducts appropriate screening tests when requested by lab personnel.

Administers medications, immunizations, and treatments and observes patients for unusual symptoms and reactions. Makes rounds and/or home visits as needed and works in other locations at the SSLC as needed. Monitors individuals’ weight, diet, feedings, and vital signs. Monitors for signs and symptoms of illness and uses appropriate nursing judgement to provide adequate care for the individual, including initiating acute care plans.

Assists in evaluating nursing intervention outcomes and provides input to other members of the healthcare team including recommendations for improvements. Instructs direct support professionals on how to monitor individuals after a treatment or procedure using instruction sheets such as that used for post-sedation monitoring of signs and symptoms.

Timely and accurately documents and reports pertinent treatments and observations in the individual’s medical record (electronic health record or paper chart) in accordance with SSLC procedures and protocols. Prepares reports as required.

Assists with services provided by LVNs and/or Certified Medication Aides (CMA), as needed, and makes recommendations for improvements, including acclimating them to the individuals, their needs and preferences.

Assists LVNs with implementation of protocols, procedures and programs to improve overall health and safety of staff and individuals. Provides assistance with completing follow up assessments, guidelines, acute care plan (ACP) interventions, injury reports, restraints, and med variances.

Provides support to Nurse Manager’s including reviews and follow up on controlled drug counts, medication counts, emergency checklist logs, refrigerator temp logs, and glucose controls.

Assists the Infection Control nurse by implementing measures that prevent the spread of disease, assists the Quality Assurance Nurse in the implementation of therapeutic nursing programs. Participates in facility Quality Assurance/Quality Improvement initiatives.

Responds to emergency situations to ensure safety of individuals. Follows safety and infection control procedures of the SSLC. Provides educational and safety training to SSLC staff upon request. Provides treatment to HHS employees injured in course and scope of employment.

Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.

Knowledge, Skills And Abilities (KSAs)

Knowledge of nursing techniques and procedures; of health care laws and regulations; of medical diagnoses and procedures; of accepted medical treatment programs; and of community health and nursing care principles, practices, and procedures.

Knowledge of state and federal laws and Intermediate Care Facility for individuals with intellectual disabilities (ICF-IID) rules, regulations, policy and procedures related to State Supported Living Center or ability to quickly gain that knowledge.

Knowledge of nursing care standards, the Settlement Agreement and the Healthcare Guidelines or ability to quickly gain the knowledge.

Skill in the care and treatment of patients.

Skills in the use of computer/software and an electronic health record system.

Excellent verbal and written communication skills and the ability to present ideas clearly and concisely in both written and oral communications.

Ability to provide patient care; to prepare and maintain records; to interpret policies and procedures; to interpret health care regulations; and to recognize patterns of medical necessity treatment.

Ability to demonstrate a working knowledge of emergency procedures and emergency equipment.

Ability to appropriately interact with individuals with intellectual/developmental disabilities, with their family members, and with staff members.

Ability to work independently and productively with all levels of staff.

Ability to provide support and coaching to LVNs, CMAs and DSPs.

Ability to make decisions and recommendations to SSLC leadership including on-call administrators.

Registrations, Licensure Requirements Or Certifications

Licensed to practice as a registered nurse in the State of Texas (or a state that recognizes reciprocity through the Nurse Licensure Compact).

Initial Screening Criteria

Work experience as a practicing registered nurse is required.

At least six (6) months of experience as a practicing registered nurse in a health agency, hospital, or health-care facility is preferred.

Bachelor's Degree is preferred.

Additional Information

Applicants must pass a fingerprint criminal background check, pre-employment drug screen, and registry checks including the Client Abuse/Neglect Reporting System (CANRS), Nurse Aide, Medication Aide and Employee Misconduct and HHS List of Excluded Individuals/Entities (LEIE).

Males between the ages of 18 – 25 must be registered with the Selective Service.

All State Supported Living Center Employees are subject to Random Drug Testing.

Flexibility in work hours may be required for this position. The position may be required to work overtime and/or extended hours. Must be willing to work weekends and holidays.

All applicants must be at least 18 years of age to be considered for employment at a state-operated facility.

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‑dut y 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.

Nearest Major Market: Brownsville