CLINICAL ASSESSMENT MANAGER QUALITY REVIEWER

About the role

At Matter of Care, we believe every older adult deserves the opportunity to age with dignity, independence, and the support they need to thrive in their community. As part of the CenterLight Health System family, we partner with participants and their families to deliver compassionate, coordinated care that improves quality of life and helps individuals remain safely in their homes.

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.

Responsibilities

• 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.

Requirements

• 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.

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.

Benefits

• 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

Pay

Salary range: $110,000 – $120,000 annually.

Schedule

Monday – Friday, 8:30 AM – 5:30 PM. Hybrid work schedule: on-site 2 days per week, 3 days working from home.