Case Manager Registered Nurse - UAS NY Certified

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: Registered Nurse (RN) – Quality Review You will be responsible for conducting quality checks on completed member assessments within the New York Long Term Services and Supports (LTSS) program. This role ensures all assessments meet program requirements, regulatory standards, and the 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. Required Qualifications: 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 Preferred Qualifications: 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...