Registered Nurse T3C

Now Hiring: Registered Nurse (RN) – Make Healing Possible for Children Who Need It Most

Location:   Pathways Youth and Family Services in San Antonio, TX with local travel to Mountain Home, TX

Schedule:  Full-time, flexible hours with ability to work some evenings, weekends and holidays, position is on-call 24/7

At Pathways, we believe every child deserves care that heals both the body and the heart.

Job Summary

The Registered Nurse (RN) will provide essential medical and therapeutic support for children and youth with Mental and/or Behavioral Health needs and Intellectual and Developmental Disabilities (IDD) in a General Residential Operation (GRO). This role ensures compliance with Texas Child-Centered Care (T3C) Blueprint standards and fosters a trauma-informed, nurturing environment that prioritizes safety, well-being, and individualized care.

Essential Duties:

Health Care Coordination

• Assesses, monitors, and documents the health status and medical needs of children and youth.
• Develops and implements Custom Care Plans in collaboration with the multidisciplinary team, including Service Plan goals aligned with CANS 3.0 recommendations.
• Coordinates routine and emergency medical care, including scheduling appointments and ensuring follow-ups.
• Directs and oversees the administration of psychotropic and other medications.
• Trains and oversees staff on medication administration, universal precautions, and other health protocols, including the use of medically necessary equipment and interventions.
• Available via phone or video conference 24 hours a day/7 days a week to respond to crises and provide consultation.

Treatment Planning

• Collaborates with the Service Planning team to support positive health outcomes and continuity of care.
• Provides medical insight into the development and monitoring of Treatment Models for program services.
• Supports the transition process, including organizing care for youth entering and exiting the facility.

Direct Care Services

• Delivers direct nursing care, including assessments, treatments, and interventions for youth with complex medical and behavioral needs.
• Provides therapeutic support for youth with sensory integration, communication barriers, and social interaction difficulties.
• Monitors and responds to emergency health situations, maintaining a calm and effective response.

Documentation and Compliance

• Maintains meticulous records of medical histories, treatments, and ongoing health needs.
• Ensures compliance with all DFPS, HHSC, and T3C regulations, including the Minimum Standards for GRO facilities.
• Participates in audits, inspections, and quality assurance processes as required.

Training and Education

• Educates GRO staff on trauma-informed care and best practices for supporting children with Mental and Behavioral Health needs and IDD.
• Conducts ongoing training on recognizing signs of medical distress, managing medical equipment, and handling behavioral escalations linked to health conditions.
• Engages with youth to provide age-appropriate health education and promote self-advocacy.

Supervisor:  Program Director or Treatment Director.

Supervises:  Programmatic staff as assigned.

Work Environment:  Primarily work within a residential setting, with occasional travel to external medical facilities and community events. Position requires adaptability to fast-paced, dynamic environments and engagement with children experiencing medical and behavioral challenges.

Work Hours: This is a full-time, minimum 40 hours per week position. Work hours must be flexible to include some weekend, holiday, and evening hours.

Classification:  Exempt.

Your Care Can Change a Life.

If you’re a nurse who believes healing is about more than medicine – it’s about compassion, connection, and courage – we’d love to meet you.

Apply today and become part of a team that’s transforming care for children and families across Texas.

Education & Experience

• Valid Texas Registered Nurse (RN) license required.
• Bachelor of Science in Nursing (BSN) or experience working in pediatric, developmental, or behavioral health settings preferred.
• Negotiable but prefer experience working with children and youth in a child welfare setting.

Knowledge, Skills, & Abilities

• Expertise in IDD-specific medical and behavioral care, including sensory processing and communication strategies.
• Strong organizational skills with attention to detail and accuracy in recordkeeping.
• Proficiency in electronic medical record (EMR) systems and data management.
• Ability to build positive, therapeutic relationships with youth, families, and staff.
• Understanding of trauma-informed and evidence-informed care practices.
• Ability to work collaboratively in a multidisciplinary team environment.

• Strong interpersonal and communication skills.

• Ability to support the agency's culture, growth, and success through communication, accountability, and positivity.
• Ability to be clear headed and decisive based on the scope of the position.
• Ability to appropriately accept feedback through the supervision process thus displaying the willingness to learn, grow, and improve.
• Competent in using Microsoft Word, Excel, the Internet, and other software applications.

Additional Requirements

• Availability to work flexible shifts, including weekends and holidays.
• Proof of valid Texas Driver's License (Type C) and at least three years of driving experience.
• Access to reliable transportation.
• Proof of valid/current auto insurance.
• Cleared motor vehicle driving record.
• Three employment references and two personal references.
• Cleared criminal background check.
• Cleared pre-employment drug screen.
• Working cellular telephone.

Physical and Mental Demands

With or without reasonable accommodation, the physical and mental requirements of this job may include the following: seeing, hearing, speaking, and writing clearly and frequently.  Manual dexterity for examining children and working with medical equipment and a computer. Occasional reaching with hands and arms. Stooping, kneeling, crouching, crawling, frequent sitting, standing and walking, may be required for long periods of time and may involve climbing stairs, walking up inclines, and on uneven terrain. Additional physical requirements may include, frequent lifting and or moving up to 25 pounds. Ability to interact with clients and families in a professional manner and keep calm in stressful situations. Ability to react appropriately in emergency/crisis situations.

Salary : $75,000 - $85,000