Clinical Assessment Manager – Quality Reviewer
Salary: $110,000 - $120,000
Monday - Friday | 8:30 AM - 5:30 PM
Hybrid work schedule: On-site 2 days per week & 3 days working from home
We are seeking an experienced New York State Registered Nurse to serve as a Clinical Assessment Manager – Quality Reviewer. In this quality-focused role, you will review UAS-NY assessments, strengthen documentation accuracy, coach clinical colleagues, and partner with Intake & Enrollment and Care Delivery teams to support timely, person-centered decisions. This is an opportunity to influence quality and consistency across the participant journey—not simply complete assessments.
WHAT YOU’LL DO
- Review and validate UAS-NY assessments and supporting documentation in the Health Commerce System (HCS) 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 (IDT) to resolve assessment questions and support smooth enrollment and care transitions.
- Review clinical information, medication-related documentation, post-discharge needs, proposed service plans, and ADL/IADL support needs; use UAS-NY, Lenavi, and the Tasking Tool as applicable.
- 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; perform duties within RN scope of practice.
WHAT WE’RE LOOKING FOR
Required Qualifications:
- Active, unrestricted Registered Nurse (RN) 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.
Preferred Qualifications:
- Bachelor of Science in Nursing (BSN) or a related health discipline.
- Experience with clinical quality improvement, staff education, and CRM platforms.
- Bilingual communication skills.
WHY JOIN MATTER OF CARE?
- Monday-Friday daytime schedule
- Hybrid work schedule: 3 remote workday per week / 2 days onsite
- 28 Paid Time Off (PTO) days annually
- 9 Paid Holidays
- Tuition reimbursement up to $5,250 annually
- 403(b) retirement plan with employer contributions
- Medical, dental, and vision coverage
- Health Savings Account (HSA) and Health Reimbursement Account (HRA) options
- Flexible Spending Accounts (FSA)
- Transit and commuter benefits
- Gym reimbursement up to $400 annually
- Employee Assistance Program (EAP)
- Relias learning platform and professional development opportunities
Disclaimer:Responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of the company.
Salary Range (Min-Max):$110,000.00 - $120,000.00
Every application is reviewed by our recruitment team. We do not use AI to make hiring decisions or automatically reject applicants. All employment decisions are based on job-related qualifications and applicable employment laws.
