Quality Assurance Nurse Specialist (Hybrid/Remote) – 26020

Sacred Heart University; New York (NY); Hybrid; USD 75,000 - 95,000; Full time

Job summary

A leading healthcare organization is seeking a Quality Assurance Nurse Specialist to enhance the quality of services for children and youth. This hybrid/remote role involves collaborating with various teams, conducting peer reviews, and ensuring compliance with standards. The ideal candidate will have a strong nursing background, excellent communication skills, and a commitment to quality care. Join a diverse team dedicated to improving healthcare outcomes and enjoy a supportive work environment with competitive benefits.

Benefits

Work/Life Balance Support

Competitive Compensation

Comprehensive Insurance Coverage

401K Retirement Savings plan with Company Matching

Paid Time Off

Holistic Wellness Support

Recognition Platform

Tuition Reimbursement

Professional Development

Qualifications

• Current NYS Registered Nurse (RN) license required.
• 3-5 years RN experience in medical/surgical/geriatric/LTC.
• Ability to review health questions based on UAS-CANS-NY criteria.

Responsibilities

• Develop quality monitoring programs with QA Nurse Manager.
• Provide QA training to Nurse Assessors and QA staff.
• Collect and analyze assessment data and outcomes.

Skills

Organizational Skills

Interpersonal Skills

Communication

Education

Accredited Nursing Program

Tools

Microsoft Office

Job description

Quality Assurance Nurse Specialist (Hybrid/Remote) – 26020

Recruitment began on November 18, 2024, and the job listing expires on May 18, 2025.

Maximus is seeking a dynamic Quality Assurance Nurse Specialist to join the Children and Youth Evaluation Service (C-YES) program.

Maximus collaborates with the New York State Department of Health to run the CYES program, which determines eligibility for Medicaid’s home and community-based services (HCBS) for children and youth aged 0-21 identified as Medically Fragile (MDF) or having Serious Emotional Disturbance (SED). The QA Nurse Specialist is responsible for implementing CYES Quality Assurance practices, conducting peer reviews, identifying trends, delivering targeted education, and ensuring high standards of service delivery.

This position is a Hybrid/Remote role for NY State residents only, with travel required for mandatory trainings, meetings, and in-person Fair Hearings as needed.

At Maximus, we are committed to fostering a positive and inclusive work environment and offer:

• Work/Life Balance Support – Flexibility tailored to your needs
• Competitive Compensation – Bonuses based on performance
• Comprehensive Insurance Coverage – Medical, Dental, Vision, Prescription, partially funded HSA, Life insurance, and discounts on Auto, Home, Renter’s, and Pet insurance
• Future Planning – 401K Retirement Savings plan with Company Matching
• Paid Time Off – PTO, Holidays, extended sick leave, Short and Long Term Disability
• Holistic Wellness Support – Resources for physical, emotional, and financial wellness through EAP
• Recognition Platform – Acknowledgment of employee contributions
• Diversity, Equity, and Inclusion Initiatives
• Tuition Reimbursement and Employee Perks
• Wellness Programs and Resources
• Professional Development – Training, workshops, conferences

Essential Duties and Responsibilities

• Collaborate with the QA Nurse Manager to develop quality monitoring programs
• Provide QA training to Nurse Assessors, RN Monitors, and QA staff
• Collect and analyze assessment data and outcomes
• Review cases for completeness, accuracy, and consistency
• Identify outliers and research cases accordingly
• Analyze UAS scores in relation to Nurse Assessor determinations
• Develop reports to track and trend activities/outcomes
• Advise UAS staff on QA and Compliance issues
• Attend Fair Hearing cases and prepare case packets as needed
• Travel as required
• Meet standards outlined in performance criteria and bonus templates
• Perform other duties as assigned
• Develop and teach training modules for C-YES educational activities
• Implement updates to orientation and educational activities based on data and updates from HCS/CANS
• Analyze CANS scores in relation to Nurse Evaluator determinations
• Participate in developing project goals and monitor their achievement
• Collaborate with the Manager – QA and Training on quality monitoring development

Minimum Qualifications

• Current NYS Registered Nurse (RN) license
• Graduate of an accredited nursing program
• 3-5 years RN experience in medical/surgical/geriatric/LTC/ambulatory care
• 2+ years RN experience in relevant fields
• Ability to review health questions and make evaluations based on UAS-CANS-NY criteria
• Proficiency with Microsoft Office
• Knowledge of professional nursing principles, laws, and regulations
• Excellent organizational, interpersonal, written, and verbal communication skills
• Ability to work effectively with diverse populations and in a fast-paced environment
• Strong independent work skills
• Valid NYS Driver’s license or State ID

Preferred Qualifications

• 2+ years experience in Quality and Risk Management conducting peer reviews in a hospital setting
• Experience with UAS-CANS-NY and QA training

Home Office Requirements

• Reliable high-speed internet (minimum 20 Mbps download, 50 Mbps shared, 5 Mbps upload)

#NYMC #LI-Hybrid

EEO and Additional Information

Maximus values diversity and is an Equal Opportunity Employer. We support transitioning military members, veterans, and their families with inclusive career opportunities. We adhere to all regulatory wage and pay transparency standards.