Case Manager Registered Nurse - UAS NY Certified
About The Position
This Registered Nurse (RN) position is responsible for conducting quality checks on completed member assessments within the New York Long Term Services and Supports (LTSS) program. The role ensures all assessments meet program requirements, regulatory standards, and UAS-NY Certification guidelines. The RN reviews assessments for accuracy, completeness, clinical appropriateness, and compliance, providing feedback and guidance to support high-quality, consistent assessment outcomes. Working collaboratively with assessment staff, quality teams, and leadership, the RN serves as a clinical subject matter expert, helping to uphold program integrity, support continuous quality improvement, and ensure members’ needs are accurately captured to support appropriate service planning and authorization.
Requirements
- Active RN License in the State of New York
- UAS Certification for New York
- 3 or more years’ experience in MLTC (Managed Long Term Care)
- 3 or more years’ experience in performing UAS NY Assessments
- Bachelor's Degree in Nursing (BSN)
- New York Registered Nurse License, Active and unencumbered
- UAS -NY Certification
Nice To Haves
- Certified Case Manager (CCM) certification
- Strong problem‑solving and decision‑making skills
- Working knowledge of medical terminology
- Comfortable using digital systems and documentation platforms
- Ability to interact tactfully and professionally with staff, members, and community partners
- Demonstrated ability to handle sensitive and confidential information responsibly
- Strong judgment in weighing options to determine the most appropriate clinical and operational decisions
- Experience working effectively within culturally diverse clinical environments
Responsibilities
- Conduct quality checks on completed member assessments within the New York Long Term Services and Supports (LTSS) program
- Ensure all assessments meet program requirements, regulatory standards, and the UAS-NY Certification guidelines
- Review assessments for accuracy, completeness, clinical appropriateness, and compliance
- Provide feedback and guidance to support high-quality, consistent assessment outcomes
- Work collaboratively with assessment staff, quality teams, and leadership
- Serve as a clinical subject matter expert
- Help to uphold program integrity
- Support continuous quality improvement
- Ensure members’ needs are accurately captured to support appropriate service planning and authorization
Benefits
- Comprehensive and competitive mix of pay and benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- CVS Health bonus, commission or short-term incentive program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
