CVS Health logo
CVS Health

CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca

Case Manager Registered Nurse - UAS NY Certified

Location

United States

Posted

60 days ago

Salary

$66.6K - $142K / year

Seniority

Lead

No structured requirement data.

Job Description

Case Manager Registered Nurse - UAS NY Certified

CVS Health

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 - Experience working effectively within culturally diverse clinical environments Education and License Requirements: - Bachelor's Degree in Nursing (BSN) - New York Registered Nurse License, Active and unencumbered - UAS -NY Certification Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $66,575.00 - $142,576.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 05/17/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Related Categories

Related Job Pages

More Manager Jobs

Full TimeRemoteTeam 1,001-5,000

We understand that the world we want tomorrow starts with how we do business today, and that’s why we’re inspired to make A Better World for Pets. Antech is comprised of a diverse team of individuals who are committed to each other’s growth and development. Our culture is centered on our guiding philosophy, The Five Principles: Quality, Responsibility, Mutuality, Efficiency and Freedom. Today Antech is driving the future of pet health as part of Mars Science & Diagnostics, a family-owned company focused on veterinary care. Current Associates will need to apply through the internal career site. Please log into Workday and click on Menu or View All Apps, select the Jobs Hub app, then click the magnifying glass to Browse Jobs. This is a field based management role with a territory that includes all of Kentucky and Ohio. Candidates must be based within the territory. The Target Base Pay Range for this position is $121,000 - $152,000 annually, with a uncapped commission potential. This position is also eligible for a company vehicle. At Antech, pay decisions are determined using factors such as relevant job-related skills, experience, education, training and budget. Job Purpose/Overview The Regional Business Manager leads a team of field sales professionals to achieve revenue plans in a designated region. Provides sales expertise, operational insight and managerial focus with direct reports while exceeding revenue plans and improved return on investment strategies within a complex marketplace and with a broad span of control. Ensures the continuity between Sales, Marketing, Customer Service and all functional areas designated to support the sale of Antech products and services. Essential Duties and Responsibilities - Responsible for executing designated programs to achieve established objectives. - Manage the reporting, tracking and forecasting of revenue performance vs. goals for Region. - Link individual performance goals for direct reports to Region / Antech Diagnostics business strategies. - Develop a clinic coverage plan which profitably optimizes resources to grow revenue and share. - Conduct regularly-scheduled ride-alongs in-field a minimum of 3 times per week. - Provide a strategic basis for development of Region by: - Developing a comprehensive regional business plan to achieve goals and objectives - Recruiting, hiring, training, developing and evaluating direct reports - Executing and managing against SOP’s - Maximizing spending efficiencies - Developing/ Analyze spending effectiveness thru reports - Maintaining business relationships with key Clients in Region - Provide training resource for the team as needed. - Regional business plan development - Responsible for budget control, tracking, forecasting, and reporting (T&E, Operating, Salary, Marketing). - Complete project work or other duties as assigned. - Support and drive accountability of overall Corporate initiatives throughout organization. - Communicates key information to sales leadership and cross-functionally (professional veterinarians, customer growth, customer service teams, sales enablement, etc.) to enable: - Solid client-based input to Regional programs - Ongoing competitive input on programs, new items, pricing etc. - Methods or ideas to improve profitability, sales or costs and service - Direct responsibility for hiring, training, development and supervision of direct reports in Region. - Conduct annual performance reviews, succession planning, disciplinary actions. - Monitor and update ongoing maintenance of CRM. We share a collaborative obligation to ensure that we conduct ourselves in the utmost ethical manner and that we hold each other accountable to the values and standards of the organization. Every employee has the responsibility to ask questions, seek guidance, and report concerns and/or violations of company policy or ethical standards. Antech Diagnostics has several processes in place to communicate with leadership and expects that employees will have a commitment to integrity and uncompromising values Education and Experience - Bachelor’s Degree in Marketing/Business Administration/Animal Science or related field - Sales experience (3-5 Years) calling on veterinary channel or clinics - 2-5 years field sales experience in Line Management - 3+ years managerial experience of first line managers Knowledge, Skills and Abilities - Alignment with Mars People Leadership expectations - Organized with the ability to multi-task in a fast paced environment - Strong interpersonal, organizational, negotiation and problem solving skills - Excellent verbal and written communication skills - Ability to manage multiple conflicting priorities - Proven ability to work effectively with clients and management is required - Strong working knowledge and experience with CRM, etc. - Strong attention to detail and accuracy - Proficiency with Microsoft Office Products including Word, Excel, and PowerPoint Travel There will be some travel and overnight stays, up to 50% of the time. About Antech Antech is a leader in veterinary diagnostics, driven by our passion for innovation that delivers better animal health outcomes. Our products and services span 90+ reference laboratories around the globe; in-house diagnostic laboratory instruments and consumables, including rapid assay diagnostic products and digital cytology services; local and cloud-based data services; practice information management software and related software and support; veterinary imaging and technology; veterinary professional education and training; and board-certified specialist support services. Benefits Antech offers an industry competitive benefits package and continues to invest in and evolve benefits programs that meet the health, wellness and financial needs of our associates. Benefits eligiblity is based on employment status. - Paid Time Off & Holidays - Medical, Dental, Vision (Multiple Plans Available) - Basic Life (Company Paid) & Supplemental Life - Short and Long Term Disability (Company Paid) - Flexible Spending Accounts/Health Savings Accounts - Paid Parental Leave - 401(k) with company match - Tuition/Continuing Education Reimbursement - Life Assistance Program - Pet Care Discounts Commitment to Equal Employer Opportunities We are proud to be an Equal Opportunity Employer - Veterans / Disabled. For a complete EEO statement, please see our Career page at Antech Careers. Note to Search Firms/Agencies Antech Diagnostics, Inc. and its subsidiaries and affiliates (Antech) do not compensate search firms for unsolicited assistance unless they have a written search agreement with Antech and the requisition is position-specific. Any resumes, curriculum vitae, and other unsolicited assistance from search firms that do not have a written search agreement or position-specific requisition submitted to any Associate of Antech will be deemed the sole property of Antech and no fee will be paid in the event the candidate is hired by Antech.

United States
$121K - $152K / year
Trinity Health logo

Area Claims Manager

Trinity Health

We are one of the largest not-for-profit, faith-based health care systems in the nation.

Manager60 days ago
Full TimeRemoteTeam 10,001+H1B Sponsor

• General Management Responsibilities: Ensures adherence to Trinity Health Insurance and Risk Management Services (IRMS) Policies and Procedures. • Claim Management Responsibilities: Reviews new incidents and opens claims as needed. • Evaluates claims with respect to standard of care, liability, causation, and damages. • Establishes claim resolution strategy and negotiates claims to resolution. • Maintains a diary system to monitor all open claims and ensures adherence to reporting protocols.

Michigan
$50 - $83 / hour
Smile Doctors logo

Sr. Manager, Field Support

Smile Doctors

There's potential in every SMILE. We're changing lives one smile at a time.

Manager60 days ago
Full TimeRemoteTeam 1,001-5,000Since 2015H1B No Sponsor

The vision of Smile Doctors is our people-first culture which creates an environment of passionate, caring Team Members dedicated to providing fun and encouraging relationships with each other and our patients. Smile Doctors offers every Team Member the opportunity to be a part of something bigger. We focus on the importance of the individual and recognize that each person on our Team has something great to offer. We recognize talents and strengths and take care to nurture those abilities to help our Team Members grow into successful people in their careers, in our organization, and beyond. Looking for a position that makes you smile? We’re seeking a Senior Manager, Field Support, to join our growing team. Manages a team of Field Support Technicians who are spread across the US. Oversee the technical process of bringing newly affiliated practices. Works directly with clinic staff during the discovery phases of the projects and will lead the Field Support Technicians in the transitions period to ensure all group systems and standards are implemented. Oversee the technical planning of new office buildouts. How you’ll make us better: - Creates and manages detailed IT project plans - Coordinates scheduling for a team of technicians and 3rd parties - Guides senior level technicians in project and team management - Streamline processes for network migration and support - Solves problems and troubleshoots technical challenges - Communicate with team members to discover needs and facilitate smooth transitions onto standard IT systems  - Works with cross functional teams and communicates with business leaders on scheduling and project timing - Drives success and growth of technical staff - Collaborate with other IT teams to ensure deployment scalable and supportable solutions Your special skills: - Ability to work in cross functional teams - Ability to work in a fast paced, growing, multi-location organization - Ability to communicate both verbally and in writing Prerequisites for success: - Bachelor’s degree in Information Technology Management, Business Management, or related discipline preferred. - Minimum of five (5) years of IT Operations experience required with seven (7) years preferred or any equivalent combination of experience and/or education from which comparable knowledge, skills and abilities have been achievedIn addition to the education and/or experience required above, five (5) years of IT management experience requiredIntermediate knowledge project management required Intermediate knowledge in technical office buildout required - Experience leading IT teams in a multi-location retail or healthcare environment preferred. - Experience deploying technology with remote support of technical assets preferred We saved the best for last. In exchange for the dynamic contribution you’ll bring to our team, we offer: - Competitive salary plus bonus opportunity - Medical, dental, vision and life insurance - Short and long-term disability coverage - 401(k) plan - 3 weeks paid time off in your first year + paid holidays - Discounts on braces and clear aligners for you and your family members Why Smile Doctors? As the nation’s leading Orthodontic Support Organization, Smile Doctors is shaping the future of orthodontics through strategic partnerships with top local doctors. We provide best-in-class support services so our partner orthodontists can focus on what they do best — driving extraordinary treatment outcomes and providing patients with an unmatched experience. With hundreds of partnered practices across the nation, our synergistic approach has made us the fastest-growing organization in our industry and produced an ever-expanding need for top talent as we continue our unprecedented trajectory. To us, there’s no such thing as “top of our game.” We’re always climbing higher — together. And as our business grows, there’s plenty of room for our team to grow their careers, too. Our dynamic support services team is comprised of world-class professionals whose diverse experiences drive innovation and development. Together, we are committed to passionately helping others achieve their best, most confident smiles. This is the perfect opportunity to grow with an expanding organization! Apply today! Smile Doctors and all our affiliating practices are proud to be an equal opportunity workplace and welcome diversity in our organization. We do not discriminate against any team member or applicant for employment regardless of age, race, color, national origin, religion, disability, veteran status, sex, sexual orientation, or gender identity.

United States
Full TimeRemoteTeam 10,001

Assists Case Managers and Social Workers in achieving the goals of the Case Management department through the successful completion of removing accounts from the Do Not Bill work queue and discharge planning, including but not limited to, (1) payer communication, certification and authorization, (2) supports case managers with admission and concurrent denial avoidance, (3) timely delivery, documentation, and tracking of “Important Message” notices to Medicare patient or representative, (4) provision of complete clinical information to a continuum of post-acute care providers including follow up with providers to ensure information was received and is complete, and (5) coordination of facility placements, transportation, home healthcare and other community support services that ensure a safe and appropriate patient discharge, and prevent re-hospitalization. Utilizes department tools and resources to organize and prioritize case load and completing priorities. Supports the efforts of HIM and Patient Accounts by ensuring timely, accurate, and complete data entry in multiple information systems/data bases. Brings workflow barriers or issues to the attention of the Supervisor of Case Management and or the Manager of Utilization Management in an expedient manner. Maintains excellent working relationships with payers and post-acute providers. Ensures that flow of information, including delays, to Case Managers and Social Workers is timely and accurate. Demonstrates ability to multitask and exhibits attention to detail. Responsible for performing job duties in accordance with the mission, vision, and values of Tampa General Hospital. - High School Diploma or GED required. Associates degree in Social Work or related field is preferred. - Two (2) years’ experience in utilization management and hospital case management/ social service and/or managed care performing discharge planning, interfacing with insurance companies and/or utilization review may substitute for the degree. Medical terminology required. - Must be computer literate, have experience with internet browsers, and familiarity with Microsoft Office.

United States