Medical Management Nurse Analyst – Appeals & Compliance

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

Benefits offered by this job

Weekly pay

Health benefits

401(k)

Temp-to-hire opportunity

Mon-Fri schedule (no weekends)

Job summary

Jobot is hiring a Medical Management Nurse Analyst in Fresno, CA. This contract role focuses on Appeals & Grievances, audits, compliance, and healthcare reporting within a managed care setting. The ideal candidate is an RN or LVN with managed care experience and strong analytical skills.

You will work Monday–Friday, 8:00 AM–5:00 PM, with competitive hourly pay and benefits during the contract. Potential for permanent hire after the contract period.

Qualifications

• Active California RN or LVN license is required.
• Minimum healthcare experience of 2 years.
• Managed care or related program experience preferred.

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 audits and regulatory reviews.
• Prepare audit summaries and assist with corrective action plan tracking.
• Participate in HEDIS, utilization management, and quality improvement projects.
• Collaborate with internal departments and external healthcare stakeholders.

Skills

Analytical abilities

Communication skills

Microsoft Office

Education

Active California RN or LVN license

Tools

Excel

Word

Outlook

PowerPoint

Job description

Jobot is hiring a Medical Management Nurse Analyst in Fresno, CA. This contract role focuses on Appeals & Grievances, audits, compliance, and healthcare reporting within a managed care setting. The ideal candidate is an RN or LVN with managed care experience and strong analytical skills.

You will work Monday–Friday, 8:00 AM–5:00 PM, with competitive hourly pay and benefits during the contract. Potential for permanent hire after the contract period.