Nurse Analyst - Managed Care Analytics & Appeals

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

Benefits offered by this job

Weekly pay

Health benefits

401(k) offered during contract

Contract-to-hire potential

Monday–Friday schedule

Job summary

Jobot in Fresno, CA seeks a Medical Management Nurse Analyst to support Appeals & Grievances, audits, and quality initiatives in a managed care setting. The role requires an RN or LVN with at least 2 years of healthcare experience and strong analytical skills.

It is a contract role with potential for contract-to-hire, Monday–Friday, on-site, with weekly pay and benefits. The ideal candidate will handle case tracking, data reconciliation, and regulatory audit prep while collaborating with

Qualifications

• Active California RN or LVN license required.
• Minimum 2 years of healthcare experience.
• Managed care experience preferred.
• Experience with Appeals & Grievances, Utilization Management, Medical Management, and related audits 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.
• Prepare audit summaries and assist with corrective action plan tracking.
• Participate in HEDIS, utilization management, and compliance projects.
• Ensure documentation accuracy and audit readiness.

Skills

Analytical thinking

Problem-solving

Communication skills

Organizational skills

Multitasking

Education

Active California RN or LVN license

Tools

Microsoft Office

Job description

Jobot in Fresno, CA seeks a Medical Management Nurse Analyst to support Appeals & Grievances, audits, and quality initiatives in a managed care setting. The role requires an RN or LVN with at least 2 years of healthcare experience and strong analytical skills.

It is a contract role with potential for contract-to-hire, Monday–Friday, on-site, with weekly pay and benefits. The ideal candidate will handle case tracking, data reconciliation, and regulatory audit prep while collaborating with