Managed Care Nurse Analyst - Appeals & Quality

Jobot Consulting; Fresno (CA); On-site; USD 44,000 - 48,000; Part time

Benefits offered by this job

Health benefits

401k

Weekly pay

Contract-to-hire potential

Weekdays only

Job summary

Jobot Consulting is seeking a Medical Management Nurse Analyst in Fresno, CA. The role supports Appeals & Grievances, audit readiness, quality improvement, and regulatory reporting within a managed care setting.

Ideal candidates are RNs or LVNs with managed care experience and strong analytical abilities, capable of collaborating across teams. Contract position with strong potential for permanent hire; schedule is Mon-Fri, 8:00 AM to 5:00 PM, in a small-office culture with weekly pay and benefit

Qualifications

• RN or LVN licensed in California.
• Healthcare experience with managed care preferred.
• Strong analytical and communication skills.
• Proficiency with MS Office suite.

Responsibilities

• Review and support Appeals & Grievances activities and case tracking.
• Maintain and reconcile databases, reports, and tracking logs.
• Gather, monitor, and analyze clinical and operational reports.
• Support oversight audits and quality improvement initiatives.
• Assist with preparation for regulatory audits (DHCS, DMHC, NCQA).
• Prepare audit summaries and track corrective actions.
• Participate in HEDIS, utilization management, and related projects.
• Ensure documentation accuracy and audit readiness.
• Collaborate with internal departments and external stakeholders.

Skills

RN or LVN

Analytical skills

Communication skills

Microsoft Office

Education

Active California RN or LVN license

Tools

Excel

Word

Outlook

PowerPoint

Job description

Jobot Consulting is seeking a Medical Management Nurse Analyst in Fresno, CA. The role supports Appeals & Grievances, audit readiness, quality improvement, and regulatory reporting within a managed care setting.

Ideal candidates are RNs or LVNs with managed care experience and strong analytical abilities, capable of collaborating across teams. Contract position with strong potential for permanent hire; schedule is Mon-Fri, 8:00 AM to 5:00 PM, in a small-office culture with weekly pay and benefit