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Medicare Operations Manager Jobs (NOW HIRING)

Conflux Systems

Medicare Domain SME

Medicare operations workflow This Expert must be able to play a leadership role in managing and coordinating the members of the BIA team. They must have excellent interpersonal skills, be self ...

Stance Health Solutions

MEDICARE SPECIALIST SUPERVISOR

$82K - $100K/yr

Essential Duties and Responsibilities Team Leadership & Management * Supervise, coach, and develop Medicare Specialists and related support staff to support operational performance and compliance ...

Imh

Medicare Market Operations Partner

Murray, UT · On-site +1

$59.50 - $91.84/hr

Medicare Operations * Leadership * Project Management * Data analytics * Strategic planning * Communication * Analytical skills * Communication skills * Problem Solving Minimum Qualifications

Imh

Medicare Market Operations Partner

Lone Tree, CO · On-site +1

$59.50 - $91.84/hr

Medicare Operations * Leadership * Project Management * Data analytics * Strategic planning * Communication * Analytical skills * Communication skills * Problem Solving Minimum Qualifications

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How much do medicare operations manager jobs pay per year?

As of Aug 15, 2026, the average yearly pay for medicare operations manager in the United States is $63,456.00, according to ZipRecruiter salary data. Most workers in this role earn between $41,000.00 and $77,500.00 per year, depending on experience, location, and employer.

What is the difference between Medicare Operations Manager vs Medicare Claims Supervisor?

AspectMedicare Operations ManagerMedicare Claims Supervisor
Required CredentialsBachelor's degree in healthcare administration or related field; certifications like CPC or CMS certificationsHigh school diploma or associate's; certifications like CPC or claims-specific training
Work EnvironmentOversees multiple departments, manages staff, and ensures compliance in healthcare organizationsSupervises claims processing teams, reviews claims, and ensures accuracy in claims submission
Employer & Industry UsageHealth insurance companies, Medicare administrative contractors, healthcare providersHealth insurance companies, Medicare contractors, claims processing centers

The Medicare Operations Manager focuses on overseeing overall Medicare operations, including compliance and staff management, while the Medicare Claims Supervisor concentrates on managing claims processing and accuracy. Both roles require knowledge of Medicare policies and certifications like CPC, but differ in scope and responsibilities.

What are the key skills and qualifications needed to thrive as a Medicare Operations Manager?

To thrive as a Medicare Operations Manager, you need expertise in healthcare administration, Medicare regulations, and process optimization, typically supported by a bachelor's degree in healthcare or business administration. Familiarity with CMS guidelines, claims processing systems, and compliance management tools is essential. Strong leadership, analytical thinking, and effective communication distinguish top performers in this role. These skills are crucial for ensuring regulatory compliance, operational efficiency, and high-quality service in the management of Medicare programs.

What are some of the main challenges faced by a Medicare Operations Manager, and how can they be addressed?

A Medicare Operations Manager often encounters challenges such as staying current with frequently changing CMS regulations, ensuring data accuracy, and coordinating across multiple departments to maintain compliance and operational efficiency. Addressing these challenges involves maintaining robust communication channels, investing in ongoing staff training, and leveraging technology to automate reporting and auditing processes. Building strong relationships with compliance, IT, and customer service teams also helps streamline workflows and foster a proactive approach to problem-solving.

What is a Medicare Operations Manager?

Medicare Operations Managers are professionals responsible for overseeing the daily operations of Medicare-related services within healthcare organizations or insurance companies. They ensure compliance with federal regulations, manage teams that process Medicare claims, and work to optimize workflows and efficiency. Their role also involves monitoring performance, implementing policy changes, and coordinating with other departments to ensure high-quality service for Medicare beneficiaries. These managers play a critical role in maintaining regulatory standards and improving overall operational effectiveness.
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Cities with the most Medicare Operations Manager job openings:

What are the most commonly searched types of Medicare Operations jobs?

The most popular types of Medicare Operations jobs are:

What states have the most Medicare Operations Manager jobs?

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Medicare Operations Manager jobs near you
Infographic showing various Medicare Operations Manager job openings in the United States as of August 2026, with employment types broken down into 86% Full Time, 11% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $63,456 per year, or $30.5 per hour.

Director Medicare Operations

The James Allen Companies Inc

Kansas City, MO • On-site

$130 - $190/hr

Other

Posted 8 days ago

Job description

Director of Medicare Operations

This is not a Medicare sales or producer position. It is an operations, compliance, carrier contracting, technology, and team-development role focused specifically on building the organization's Medicare Supplement capabilities.

About the Organization

The organization provides an alternative to traditional group health benefits through a technology platform that serves brokers and employers. Employees use the platform to shop for individual health plans and enroll directly with the insurance carrier.

The company currently supports ACA and other non-Medicare individual health products. It is now adding a Medicare division and needs an experienced Medicare professional to build the operational infrastructure, compliance framework, carrier relationships, technology solutions, and internal team required to support the new business line.

The person in this position will report directly to Hunter.

Primary Responsibilities

The Director of Medicare Operations will:

  • Develop the company's Medicare Supplement operational model and supporting processes.
  • Establish compliant procedures for Medicare-related enrollments, communications, documentation, and agent activity.
  • Lead carrier contracting and appointment efforts with Medicare Supplement carriers.
  • Evaluate and help select technology solutions that support quoting, enrollment, compliance, reporting, and customer service.
  • Build and develop a Medicare operations team of approximately six employees.
  • Establish workflows, performance standards, training procedures, and quality controls for the team.
  • Work closely with leadership, technology, agency operations, brokers, carriers, and compliance partners.
  • Help scale the Medicare division as the company expands its services.
  • Ensure the Medicare operation integrates effectively with the organization's existing ACA and individual health platform.
Ideal Candidate Background

The strongest candidate will have significant experience with Medicare Supplement products and the operational requirements surrounding them.

The organization would prefer someone who has worked for an independent insurance agency, brokerage, field marketing organization, or similar organization where they were involved in developing or expanding a Medicare business.

The person should understand:

  • Medicare Supplement products and carrier requirements.
  • Medicare-related compliance and operational procedures.
  • Carrier contracting, appointments, licensing, and onboarding.
  • Agency operations and enrollment workflows.
  • Technology platforms used for quoting, enrollment, compliance, and customer management.
  • Team development, training, and performance management.
  • How to build processes and infrastructure within a growing organization.

Experience helping grow an agency, department, startup, or new division would be highly valuable.

What the Role Is Not

This position is not designed for someone whose Medicare experience has primarily consisted of selling policies directly to consumers.

The successful candidate does not need to be a traditional salesperson or business-development producer. The emphasis is on building and managing the operational foundation behind a Medicare Supplement business, including compliance, carrier relationships, technology, processes, and people.

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