Medical Management Nurse Analyst

Competitive Weekly Pay + Health Benefits, 401(k), and Potential Temp-to-Hire Opportunity! This Jobot Consulting Job is hosted by: Jennifer Whitworth Are you a fit? Easy Apply now by clicking the "Quick Apply" button and sending us your resume. Salary: $32 - $35 per hour A bit about us: A respected managed care organization dedicated to improving healthcare outcomes through quality-driven programs, member-focused services, and collaborative partnerships across Central California. Committed to regulatory excellence and advancing the health of the communities it serves. Job Title: Medical Management Nurse Analyst Compensation: $32.00 - $35.00/hour Location: Fresno, CA Schedule: Monday-Friday, 8:00 AM - 5:00 PM Type: Contract with strong potential for permanent hire Why join us? Competitive hourly compensation paid weekly Health benefits and 401k offered during the contract period Potential for contract to hire Monday-Friday schedule (no weekends) Collaborative and supportive team environment Opportunity to expand managed care experience Meaningful work supporting healthcare services throughout the Central Valley Job Details We are seeking a Medical Management Nurse Analyst to support Appeals & Grievances activities, audit readiness, compliance initiatives, quality improvement programs, and healthcare reporting within a managed care environment. The ideal candidate is an RN or LVN with managed care experience, strong analytical abilities, and a collaborative approach to teamwork. 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 DHCS, DMHC, NCQA, and other regulatory audits. Prepare audit summaries and assist with corrective action plan tracking. Participate in HEDIS, utilization management, quality improvement, and compliance-related projects. Assist with preparation of required clinical and operational reports. Ensure documentation accuracy and audit readiness. Collaborate with internal departments and external healthcare stakeholders. Qualifications: Active California RN or LVN license required. Minimum 2 years of healthcare experience. Managed care experience strongly preferred. Experience with Appeals & Grievances, Utilization Management, Medical Management, Quality Improvement, Healthcare Compliance, Clinical Audits, Regulatory Audits, HEDIS, NCQA, Medi-Cal, or related managed care programs preferred. Strong analytical and problem-solving abilities. Excellent communication and organizational skills. Proficiency with Microsoft Office, including Excel, Word, Outlook, and PowerPoint. Ability to manage multiple priorities and work independently. Team-oriented mindset with strong interpersonal skills. Dependable, professional, and comfortable working within a small-office culture. Interested in learning more? Apply today or confidentially send your resume to Jennifer Whitworth at for consideration. Interested in hearing more? Easy Apply now by clicking the "Quick Apply" button. Jobot is an Equal Opportunity Employer. We provide an inclusive work environment that celebrates diversity and all qualified candidates receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, age (40 and over), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. Jobot also prohibits harassment of applicants or employees based on any of these protected categories. It is Jobot’s policy to comply with all applicable federal, state and local laws respecting consideration of unemployment status in making hiring decisions. Sometimes Jobot is required to perform background checks with your authorization. Jobot will consider qualified candidates with criminal histories in a manner consistent with any applicable federal, state, or local law regarding criminal backgrounds, including but not limited to the Los Angeles Fair Chance Initiative for Hiring and the San Francisco Fair Chance Ordinance. Information collected and processed as part of your Jobot candidate profile, and any job applications, resumes, or other information you choose to submit is subject to Jobot's Privacy Policy, as well as the Jobot California Worker Privacy Notice and Jobot Notice Regarding Automated Employment Decision Tools which are available at jobot.com/legal. By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from Jobot, and/or its agents and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here: jobot.com/privacy-policy