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Medicare Operations Analyst Jobs (NOW HIRING)

UCB

Commercial Operations Analyst

Atlanta, GA · On-site

Make your mark for patients We are looking for a Commercial Operations Analyst who is ... Process, validate, and reconcile Commercial, Managed Care, Trade, and Medicare Part D rebate ...

UCB

Commercial Operations Analyst

Atlanta, GA · Hybrid

Make your mark for patients We are looking for a Commercial Operations Analyst who is ... Process, validate, and reconcile Commercial, Managed Care, Trade, and Medicare Part D rebate ...

Grupo Triple-S

Network Operations Analyst

Guaynabo, PR · On-site

Network Operations Analyst Company: Triple-S Salud Job Location (Short): Guaynabo, PR Posting Start ... We serve more than 1 million consumers in Puerto Rico through our Medicare Advantage, Medicaid ...

Humana Inc

$63K - $78K/yr

The Senior Finance Operations Analyst supports finance operations by analyzing financial processes ... These efforts are leading to a better quality of life for people with Medicare and Medicaid ...

Humana Inc

Senior Finance Operations Analyst

Louisville, KY · On-site

$82K - $102K/yr

The Senior Finance Operations Analyst supports finance operations by analyzing financial processes ... These efforts are leading to a better quality of life for people with Medicare and Medicaid ...

Humana

Senior Finance Operations Analyst

Louisville, KY · On-site

$82K - $102K/yr

Become a part of our caring community The Senior Finance Operations Analyst supports finance ... These efforts are leading to a better quality of life for people with Medicare and Medicaid ...

Humana

Senior Finance Operations Analyst

Louisville, KY · On-site

$82K - $102K/yr

Become a part of our caring community The Senior Finance Operations Analyst supports finance ... These efforts are leading to a better quality of life for people with Medicare and Medicaid ...

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Medicare Operations Analyst information

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How much do medicare operations analyst jobs pay per hour?

As of Sep 10, 2026, the average hourly pay for medicare operations analyst in the United States is $33.75, according to ZipRecruiter salary data. Most workers in this role earn between $24.04 and $40.38 per hour, depending on experience, location, and employer.

What is a Medicare Operations Analyst?

Medicare Operations Analysts are professionals who oversee and enhance the operational processes associated with Medicare insurance programs. They analyze data, monitor regulatory compliance, and identify areas for process improvement within healthcare organizations or insurance companies. Their responsibilities often include preparing reports, ensuring claims are processed accurately, and implementing new policies or procedures to align with Medicare regulations. By streamlining workflows and maintaining compliance, they help organizations deliver efficient and effective services to Medicare beneficiaries.

What are some common challenges faced by a Medicare Operations Analyst in ensuring compliance with regulatory requirements?

Medicare Operations Analysts often face the challenge of staying up-to-date with frequently changing regulations and policies from CMS (Centers for Medicare & Medicaid Services). This requires continuous monitoring and interpretation of new guidelines to ensure that all operational processes remain compliant. Additionally, analysts must communicate changes effectively to cross-functional teams and help implement process adjustments without disrupting service quality. Strong analytical skills and attention to detail are essential to address these challenges and maintain compliance in a fast-paced environment.

What are the key skills and qualifications needed to thrive as a Medicare Operations Analyst, and why are they important?

To thrive as a Medicare Operations Analyst, you need a strong understanding of Medicare regulations, data analysis, and healthcare operations, often supported by a bachelor's degree in healthcare administration, business, or a related field. Familiarity with data analytics tools (such as Excel, SQL, or Tableau), claims processing systems, and CMS platforms is typically required. Attention to detail, problem-solving abilities, and effective communication are standout soft skills for this role. These skills ensure accurate compliance, efficient workflow optimization, and clear reporting within the complex Medicare environment.

What cities are hiring for Medicare Operations Analyst jobs?

Cities with the most Medicare Operations Analyst job openings:

What states have the most Medicare Operations Analyst jobs?

States with the most job openings for Medicare Operations Analyst jobs include:

What are popular job titles related to Medicare Operations Analyst jobs?

For Medicare Operations Analyst jobs, the most frequently searched job titles are:

Infographic showing various Medicare Operations Analyst job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 84% Full Time, 12% Part Time, 1% Temporary, 1% Contract, and 1% Nights. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $70,210 per year, or $33.8 per hour.

Commercial Operations Analyst

Atlanta, GA • On-site

UCB
Finance and Insurance • 1 - 5K employees
Learn more about UCBexternal

Contractor

Re-posted 18 days ago

Job description

Make your mark for patients
We are looking for a Commercial Operations Analyst who is intellectually curious, adaptable and analytical to join us in our Contracts & Pricing Team, based in our Atlanta office in Georgia, United States. This hybrid role (at least 40% of the time in office) is limited to 10% travel domestically. About the Role
You will be responsible for supporting payer and Pharmacy Benefit Manager (PBM) contracting operations with significant financial and operational impact. This role ensures the timely and accurate administration of Commercial, Managed Care, Trade, and Medicare Part D contracts and rebate programs through detailed data analysis, contract maintenance, pricing validation, and reimbursement management.
Who you'll work with
Acting as a Subject Matter Expert (SME) and Single Point of Contact (SPOC) for assigned payer and PBM accounts, the Commercial Operations Analyst partners with Market Access, Finance, Sales, Compliance, Legal, IT, and external stakeholders to resolve complex contract and reimbursement issues, optimize revenue performance, and drive operational excellence. Through the analysis of large and complex utilization, pricing, and rebate datasets, this role supports contract execution, forecasting, compliance requirements, system enhancements, and strategic initiatives that strengthen patient access and business outcomes.
What you'll do
  • Serve as the Single Point of Contact (SPOC) for assigned payer and Pharmacy Benefit Manager (PBM) accounts, managing stakeholder communications, issue resolution, and day-to-day contract operations.
  • Manage payer and PBM contracts, including pricing, membership, renewals, amendments, cancellations, and other contract lifecycle activities.
  • Process, validate, and reconcile Commercial, Managed Care, Trade, and Medicare Part D rebate payments in accordance with contractual requirements.
  • Analyze pricing, utilization, reimbursement, and financial data to identify trends, resolve discrepancies, mitigate risk, and optimize revenue performance.
  • Validate contract terms, rebate eligibility, and customer utilization data to ensure payment accuracy, compliance, and data integrity.
  • Support government pricing activities by identifying pricing inconsistencies, outdated rebate amounts, and potential compliance risks.
  • Manage invoice and payment timelines to ensure timely processing, reduce financial exposure, and support cash flow objectives.
  • Develop and maintain dashboards, KPI reporting, payment trackers, and operational analyses to support business and contracting decisions.
  • Partner with Market Access, Sales, Finance, Compliance, Legal, Government Pricing, and IT teams to resolve complex business challenges and improve operational performance.
  • Support system enhancements, User Acceptance Testing (UAT), audits, and continuous improvement initiatives that enhance efficiency, compliance, and customer experience.

Interested? For this role we're looking for the following education, experience and skills
Minimum Experience/Skills Required:
  • Bachelor's degree in Finance, Business, Statistics, Healthcare Management, Economics, Marketing, or a related field.
  • 5+ years of experience in analytics, reporting, forecasting, financial analysis, contract operations, pricing, rebates, or commercial operations.
  • Strong analytical skills with experience working with large and complex datasets.
  • Advanced Microsoft Excel skills and proficiency with PowerPoint and other Microsoft Office applications.
  • Experience with SAP and/or contract, pricing, or revenue management systems.
  • Strong communication, problem-solving, and cross-functional collaboration skills.
  • Experience with Model N, Revitas, Revenue Manager, Validata, or similar revenue management platforms.
  • Experience with rebate processing, formulary validation, reimbursement, or contract administration.

Preferred Experience/Skills:
  • MBA, MHA, or other advanced business or healthcare-related degree.
  • 3+ years of pharmaceutical, biotechnology, managed care, payer, PBM, Market Access, Contracts & Pricing, or Commercial Operations experience.
  • Experience developing dashboards, business intelligence reporting, and performance analytics.
  • Experience leading process improvement, system implementations, or UAT activities.

Internal applicants should be in their current job for at least 12 months, must meet performance standards and are not on formal corrective/disciplinary process (PIP), warning, final warning, or compliance warning letters within the last 12 months. Please inform your Manager or your Talent Partner before applying to any internal job opportunities.
Unless explicitly stated in the description, this role is hybrid with 40% of your time spent in the office, regardless of your current contractual agreement. If your current working arrangements differ, please contact your Talent Partner to discuss before submitting your application.
UCB is an equal opportunity employer. All employment decisions will be made without regard to any characteristic protected by applicable federal, state, or local law. UCB invites you to voluntarily self-identify during the application process. Provision of self-identification information is entirely voluntary and a decision to provide or not provide such information will not have any effect on your application for employment, your employment with UCB, or otherwise subject you to any adverse treatment. Any information you provide will be considered confidential and will be kept separate from your application and/or personnel file and will only be used in accordance with applicable laws, orders, and regulations.
Should you require any adjustments to our process to assist you in demonstrating your strengths and capabilities contact us on US-Reasonable_Accommodation@ucb.com for application to US based roles. Please note should your enquiry not relate to adjustments; we will not be able to support you through this channel.
Requisition ID: 93731
Recruiter: Parth Suthar
Hiring Manager: Trista Schuster
Talent Partner: Yolanda Johnson
Job Level: SA II
Please consult HRAnswers for more information on job levels.

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