CLINICAL ASSESSMENT MANAGER QUALITY REVIEWER

Matter of Care Home Health Services•New York, NY

4d•$110,000 - $120,000•Hybrid

About The Position

Matter of Care, part of the CenterLight Health System family, is seeking an experienced New York State Registered Nurse for a quality-focused role reviewing UAS-NY assessments and related documentation. The position strengthens documentation accuracy, coaches clinical colleagues, and partners with Intake & Enrollment and Care Delivery teams to support timely, person-centered decisions across the participant journey. The role reviews clinical information, medication-related documentation, post-discharge needs, proposed service plans, and ADL/IADL support needs using systems such as UAS-NY, Lenavi, and the Tasking Tool. It monitors performance measures, identifies trends, escalates complex concerns, and recommends improvements to quality, turnaround times, workflows, and participant experience. The position maintains compliance with applicable New York State Department of Health, CMS, PACE, and organizational standards, and performs duties within RN scope of practice. The schedule is Monday through Friday, 8:30 AM to 5:30 PM, with a hybrid arrangement of two days onsite and three days working from home.

Requirements

Active, unrestricted Registered Nurse license in New York State.
At least 5 years of experience in care/case management, disease management, population health, utilization review, quality assurance, or discharge planning.
3–5 years of experience in MLTC, LTHHCP, MAP, PACE, or another managed care program.
Proficiency using and analyzing UAS-NY and Lenavi, along with clinical documentation systems.
Ability to work independently, manage competing deadlines, communicate clearly, and provide constructive clinical guidance.
At least 1 year working with frail or older adults, or completion of appropriate PACE-provided training upon hire if otherwise qualified.
Comfort using Microsoft Office and preparing clear written documentation and reports.

Nice To Haves

Bachelor of Science in Nursing or a related health discipline.
Experience with clinical quality improvement, staff education, and CRM platforms.
Bilingual communication skills.

Responsibilities

Review and validate UAS-NY assessments and supporting documentation in the Health Commerce System and electronic clinical records for accuracy, completeness, and timeliness.
Complete approximately 8–15 Care Delivery UAS reviews or 5–7 Intake reviews daily, as assigned, and provide actionable feedback to clinical staff.
Coach team members on assessment quality, documentation standards, workflows, and regulatory requirements; support onboarding of new clinical colleagues.
Partner with Intake & Enrollment, Care Delivery, site leadership, and the interdisciplinary team to resolve assessment questions and support enrollment and care transitions.
Review clinical information, medication-related documentation, post-discharge needs, proposed service plans, and ADL/IADL support needs using applicable tools and systems.
Document assessments, reviews, service plans, and follow-up actions accurately and within required timelines, including the 48-hour documentation expectation.
Monitor performance measures, identify trends, escalate complex concerns, and recommend improvements to quality, turnaround times, workflows, and participant experience.
Maintain compliance with applicable NYS Department of Health, CMS, PACE, and organizational standards, and perform duties within RN scope of practice.