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Medicare Operations Manager Jobs (NOW HIRING)

Bcbsa

This role will be responsible for operations management of the Federal Employee Program (FEP) Medicare Advantage (MA) EGWP line of business. Responsible for overseeing day-to-day operational work ...

Bcbsa

This role will be responsible for operations management of the Federal Employee Program (FEP) Medicare Advantage (MA) EGWP line of business. Responsible for overseeing day-to-day operational work ...

Bcbsa

This role will be responsible for operations management of the Federal Employee Program (FEP) Medicare Advantage (MA) EGWP line of business. Responsible for overseeing day-to-day operational work ...

Bcbsa

This role will be responsible for operations management of the Federal Employee Program (FEP) Medicare Advantage (MA) EGWP line of business. Responsible for overseeing day-to-day operational work ...

Bcbsa

This role will be responsible for operations management of the Federal Employee Program (FEP) Medicare Advantage (MA) EGWP line of business. Responsible for overseeing day-to-day operational work ...

Bcbsa

This role will be responsible for operations management of the Federal Employee Program (FEP) Medicare Advantage (MA) EGWP line of business. Responsible for overseeing day-to-day operational work ...

Bcbsa

Medicare Operations Senior Program Manager

OR · On-site +1

This role will be responsible for operations management of the Federal Employee Program (FEP) Medicare Advantage (MA) EGWP line of business. Responsible for overseeing day-to-day operational work ...

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Medicare Operations Manager information

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$31K

$63.5K

$118.5K

How much do medicare operations manager jobs pay per year?

As of Sep 7, 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 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.

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 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.

More about Medicare Operations Manager jobs

What cities are hiring for Medicare Operations Manager jobs?

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?

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

What job categories do people searching Medicare Operations Manager jobs look for?

The top searched job categories for Medicare Operations Manager jobs are:

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 84% Full Time, 13% Part Time, 1% Temporary, 1% Contract, and 1% Nights. 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.

Manager, Medicare Operations

CVS Health

Saint Louis Park, MN • Hybrid

$66K - $145K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 6 days ago

Key responsibilities

  • Oversees day-to-day operations of the Medicare program to support operational excellence, market readiness, and member retention.

  • Supports market team initiatives by developing and executing strategies to ensure efficient and effective service delivery.

  • Defines and drives process improvement and operational projects in collaboration with senior management, stakeholders, and team members.

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,369 frontline employees who took The Breakroom Quiz

92nd of 113 rated pharmacies

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

This is a hybrid role that requires working 2-3 days a week from the St. Louis, Minnesota office.

Position Summary

TheManager of Medicare Operationsis responsible fordesigning and implementing enterprise-wide solutions that address business challenges within ourMedicare organization for Allina Health | Aetna. This role is pivotal in shaping organizational strategy, ensuring compliance, and enhancing operational effectiveness tomaintainour competitive edge in the marketplace. The ideal candidate will partner with business owners to achieve strategicobjectives, including profitable growth and improved service delivery.

Whatyouwilldo

  • Overseesday-to-dayoperationsoftheorganization'sMedicare programtosupportoperational excellence, market readiness, and member retention.

  • Supportsmarketteambydevelopingandexecutingoncross-enterprise initiatives thatensure efficient and effective delivery of services.

  • Conductsquality assurance reviews to ensure year-over-year updates and accuracyin Medicare member materials and resources.

  • Assesses the development of government program opportunities,developsstrategies, presentsrecommendations,andimplementssolutionstoimproveoveralllineofbusinessperformance.

  • Works closely with thelocalaccountmanagementandsalesteamsongrowthand retention strategies.

  • Supportsthe investigation and remediation of operational issues as they arise, serving asthe liaison between the market team and national partners.

  • Defines& drives process improvement and operationalprojectsincollaborationwithsenior management, stakeholders, and senior individual contributors.

  • Manage year-over-year AEP readiness activities including support for product and vendor implementations, benefit and material reviews and markettrainings.

  • Support the annual Medicare bid filing by conducting required analysis,consolidatingcompetitive information, and helping to manage bid tools.

  • Establish andmonitorkey performance indicators (KPIs) to evaluate the success of programs and initiatives.

Requirements:

  • Must reside within commutable distance from the St. Louis, MN office.
  • 3-5 years of experience in health insurance, Medicare, or a related government-sponsored healthcare program.
  • 2+ years of project management, program management, or operational leadership experience.
  • Demonstrated experience leading cross-functional initiatives and influencing stakeholders without direct authority.
  • Strong analytical and problem-solving skills with the ability toleveragedata to drive business decisions.
  • Proven ability to plan, execute, and deliver complex projects and operational initiatives.
  • Excellent written, verbal, and presentation communication skills.
  • Advancedproficiencyin Microsoft Excel and Microsoft Office applications.

Preferred Qualifications

  • Medicare Advantage operational experience.
  • Experience supporting AEP readiness,Medicarebid development, or regulatory compliance activities.
  • Project Management Professional (PMP) certification or equivalent project management training.
  • Experience using Quickbase or similar workflow/project management platforms.
  • Experience working with sales, account management, and market leadership teams to support growth and retention initiatives.

Education

  • Bachelor'sdegreepreferredinBusiness, Healthcare administration, publichealthor related field.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,330.00 - $145,860.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 09/15/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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