Get Hired Faster With COMPANY_NAME!
Don't you ever think you landed here by any accident, You are here because you are searching for something bigger. You know what?
- A better Job
- A better Future
- A better Knowledge
- A better Paycheck
- A greater Path to walk on.
And COMPANY_NAME is here to give you exactly what you've been missing for so long. The reality is that most job seekers chase job postings, but successful job seekers attract job offers by chasing the accurate information. Therefore, that's the shift COMPANY_NAME is going to help you make. Here are the top 10 ideas to up-skill yourself, so lean in to begin:
1: COMPANY_NAME Smart Tools and Direct Employer Connections Help Speed Up Your Hiring Process
COMPANY_NAME is a career-changing advantage that most seekers never get access to. Imagine...
- Instead of applying for job after job and still not getting any callbacks, you suddenly bump into a tool that can do the heavy lifting for you.
- Instead of wondering, "What do employers actually want?", you are getting insights straight from the employer's desk.
- Instead of hoping your resume gets noticed, it’s kept on the table of decision-makers who are hiring right now.
That's the difference COMPANY_NAME makes. Our tools will let you reach employers directly, which automatically speeds up your hiring process.
2: With Better Matches, Real-time Job Alerts, and Direct Employer Responses, COMPANY_NAME Helps Many Candidates Secure Interviews and Job Offers Within 15 to 30 Days!
How does COMPANY_NAME make this possible?
On COMPANY_NAME, you get notified for roles aligned with your profile right from the start. When an employer posts a role that matches your qualifications and skills, you’ll know first. When you apply early, your chances of getting noticed and shortlisted increase by 20%.
COMPANY_NAME also offers direct employer responses—no more waiting for weeks. Here you engage with hiring managers who are actively looking for candidates.
When all these features combine in one place, you move from your first match to your first interview within days. And ultimately, from application to offer—all within 15 to 30 days!
3: The Type of Resume You Need to Get Priority Placement
With COMPANY_NAME, you don’t just need a resume—you need a strategy. A system that pushes your name to the right tables. We’ll show you exactly how the most successful candidates take initiative and get noticed.
4: Browse Full-Time, Part-Time, and Freelancing Roles With COMPANY_NAME
The job market isn’t one-size-fits-all—and your career shouldn’t be either. COMPANY_NAME gives you access to a wide range of opportunities including full-time, part-time, and freelancing roles all in one place.
5: COMPANY_NAME Helps You Grow Your Career
COMPANY_NAME provides insights, tools, and role-matching that help you find the right direction, the right skills, and the opportunities aligned with your ambition.
6: The Easiest Way To Find A Job
COMPANY_NAME cuts the noise, the endless scrolling, and the confusion. With accurate matches, direct employer connection, and real-time updates, you get a clear and simple path from application to interview.
7: Find Roles That Offer Growth, Culture & Benefits
COMPANY_NAME helps you find roles where you grow, feel supported, and thrive—not just survive. With us, you discover opportunities that elevate your professional life.
8: Get Support With Resume, Interviews & Career Planning
COMPANY_NAME provides expert guidance on resumes, interviews, and planning so employers instantly recognize your strengths and value.
9: Your Future Starts Today
COMPANY_NAME gives you everything you need—tools, guidance, and opportunities—to step forward confidently and begin a new chapter where your potential is seen and supported.
10: Get Hired Within 15 to 30 Days With COMPANY_NAME
COMPANY_NAME follows a smart, strategic, and proven approach that gets your profile noticed faster and moves you toward interviews and offers within 15 to 30 days.
REMOTE LTSS Appeals RN (NY License)
LTSS Appeals Nurse (Remote)
We are seeking a detail-oriented, self-motivated Registered Nurse to join our team as an LTSS Appeals Nurse. In this role, you will perform high-volume clinical reviews within the appeals process, evaluating complex medical records and Long-Term Services and Supports (LTSS) benefits against regulatory and medical necessity criteria.
Job Responsibilities
Conduct 10-13 clinical reviews per day within the established appeals process.
Review and analyze clinical records, including comparative evaluations of members' two most recent assessments.
Evaluate documentation against applicable benefit, medical necessity, and regulatory standards.
Review LTSS benefits, service authorizations, and related determinations.
Prepare concise, accurate clinical summaries and synthesized findings for the Medical Director.
Research and interpret clinical data to support appropriate appeal decisions.
Thoroughly document findings, determinations, and rationale within internal systems.
Communicate service reductions, benefit changes, or denials to members and providers in a professional, clear, and empathetic manner.
Collaborate with Medical Directors, clinical leadership, and cross-functional teams throughout the review process.
Identify documentation discrepancies or missing clinical info, proactively obtaining necessary details.
Support departmental quality and process-improvement initiatives.
Maintain strict confidentiality while adhering to all organizational policies and healthcare regulations.
Required Qualifications
Education & Licensure: ASN or BSN degree with an active, unrestricted New York Registered Nurse (NY RN) license.
Residency: Must reside in New York (NY), New Jersey (NJ), or Connecticut (CT).
Clinical Experience: Minimum 3 years of relevant nursing/healthcare experience, with dedicated experience involving Long-Term Services and Supports (LTSS).
Review Expertise: Direct experience reviewing medical records, performing utilization review, appeals, grievances, or clinical management activities.
Core Competencies: Strong understanding of healthcare benefits, service determinations, and medical necessity criteria.
Communication: Exceptional written communication skills for synthesizing complex cases, paired with the ability to empathetically communicate difficult decisions (reductions/denials).
Technical Skills: Strong computer proficiency and experience working with electronic medical record systems.
Workstyle: Proven ability to independently manage high daily review volumes in a remote environment.
Preferred Qualifications
Experience with Personal Care Aide (PCA) benefits and the Consumer Directed Personal Assistance Program (CDPAP).
Prior experience in Medicaid managed care, health plans, or managed care organizations.
In-depth knowledge of NYS healthcare regulations and managed-care requirements.
Background in preparing clinical summaries directly for Medical Directors.
Prior experience in quality management or clinical quality initiatives.
Schedule & Location Requirements
Work Location: Remote (Must be located in NY, NJ, or CT).
Shift: Flexible standard Monday-Friday business hours (e.g., 8:00 AM - 4:00 PM, 9:00 AM - 5:00 PM, or 10:00 AM - 6:00 PM).
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.
Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?
