Master's degree preferred. * 5-7 years of experience in Medicare operations, documentation management, or a related field. * Proven hands-on experience and demonstrated success in a managerial or ...
Master's degree preferred. * 5-7 years of experience in Medicare operations, documentation management, or a related field. * Proven hands-on experience and demonstrated success in a managerial or ...
Coordination of Benefits Specialist
Miami, FL · On-site
$19 - $21/hr
... Medicare operations * Strong understanding of Medicare Secondary Payer (MSP) rules and COB principles * Experience working with CMS eligibility files, Medicare Advantage plans, or managed care ...
Quick apply
Coordination of Benefits Specialist
Miami, FL · On-site
$19 - $21/hr
... Medicare operations * Strong understanding of Medicare Secondary Payer (MSP) rules and COB principles * Experience working with CMS eligibility files, Medicare Advantage plans, or managed care ...
Medicare Sales Manager
Clearwater, FL · On-site
$65K - $72K/yr
The Medicare Sales Manager leads and oversees daily operations for a team of 20-30 licensed Medicare agents in a fast-paced call center environment, based in-office in Clearwater, FL and reporting to ...
New
Medicare Sales Manager
Clearwater, FL · On-site
$65K - $72K/yr
The Medicare Sales Manager leads and oversees daily operations for a team of 20-30 licensed Medicare agents in a fast-paced call center environment, based in-office in Clearwater, FL and reporting to ...
New
Medicare Sales Manager
Clearwater, FL · On-site
$65K - $72K/yr
The Medicare Sales Manager leads and oversees daily operations for a team of 20-30 licensed Medicare agents in a fast-paced call center environment, based in-office in Clearwater, FL and reporting to ...
New
Quick apply
Medicare Sales Manager
Clearwater, FL · On-site
$65K - $72K/yr
The Medicare Sales Manager leads and oversees daily operations for a team of 20-30 licensed Medicare agents in a fast-paced call center environment, based in-office in Clearwater, FL and reporting to ...
New
Medicare Sales Manager
Clearwater, FL · On-site
$65K - $72K/yr
The Medicare Sales Manager leads and oversees daily operations for a team of 20-30 licensed Medicare agents in a fast-paced call center environment, based in-office in Clearwater, FL and reporting to ...
New
Medicare Sales Manager
Clearwater, FL · On-site
$65K - $72K/yr
The Medicare Sales Manager leads and oversees daily operations for a team of 20-30 licensed Medicare agents in a fast-paced call center environment, based in-office in Clearwater, FL and reporting to ...
New
... Medicare Advantage patients in a value-based care model. This role manages a team of Practice ... Strong knowledge of healthcare operations, value-based care, and Medicare Advantage. * Strong ...
... Medicare Advantage patients in a value-based care model. This role manages a team of Practice ... Strong knowledge of healthcare operations, value-based care, and Medicare Advantage. * Strong ...
... Medicare Advantage patients in a value-based care model. This role manages a team of Practice ... Strong knowledge of healthcare operations, value-based care, and Medicare Advantage. * Strong ...
... Medicare Advantage patients in a value-based care model. This role manages a team of Practice ... Strong knowledge of healthcare operations, value-based care, and Medicare Advantage. * Strong ...
... to Medicare Advantage patients in a value-based care model. This role manages a team of Practice Coordinators while also directly engaging with affiliate relationships to drive performance ...
... to Medicare Advantage patients in a value-based care model. This role manages a team of Practice Coordinators while also directly engaging with affiliate relationships to drive performance ...
... to Medicare Advantage patients in a value-based care model. This role manages a team of Practice Coordinators while also directly engaging with affiliate relationships to drive performance ...
... to Medicare Advantage patients in a value-based care model. This role manages a team of Practice Coordinators while also directly engaging with affiliate relationships to drive performance ...
Ensure compliance with CMS, Medicare Advantage, ACO, and other regulatory coding and documentation ... Manage daily BOI and Risk Adjustment operations to ensure timely and accurate execution of ...
Ensure compliance with CMS, Medicare Advantage, ACO, and other regulatory coding and documentation ... Manage daily BOI and Risk Adjustment operations to ensure timely and accurate execution of ...
The Manager supports organizational value-based care initiatives by ensuring operational excellence ... Ensure compliance with CMS, Medicare Advantage, ACO, and other regulatory coding and documentation ...
The Manager supports organizational value-based care initiatives by ensuring operational excellence ... Ensure compliance with CMS, Medicare Advantage, ACO, and other regulatory coding and documentation ...
... a premier Medicare Home Health Agency and in-home personal care company providing services to ... Overview The Clinical Manager provides leadership and oversight for all clinical operations ...
... a premier Medicare Home Health Agency and in-home personal care company providing services to ... Overview The Clinical Manager provides leadership and oversight for all clinical operations ...
You will be understanding the strategic direction set by senior management as it relates to team ... Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ...
You will be understanding the strategic direction set by senior management as it relates to team ... Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ...
You will be understanding the strategic direction set by senior management as it relates to team ... Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ...
You will be understanding the strategic direction set by senior management as it relates to team ... Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ...
Medicare Billing & Enrollment Specialist Join us in our mission to transform healthcare! ... billing, general operations, and data management. Job Responsibilities (but not limited to)
Medicare Billing & Enrollment Specialist Join us in our mission to transform healthcare! ... billing, general operations, and data management. Job Responsibilities (but not limited to)
Medicare Enrollment & Billing Specialist
Tampa, FL · On-site
$17.50 - $23.75/hr
Job Summary: The Medicare Billing & Enrollment Specialist is responsible for the enrollment ... billing, general operations, and data management. Job Responsibilities (but not limited to)
Medicare Enrollment & Billing Specialist
Tampa, FL · On-site
$17.50 - $23.75/hr
Job Summary: The Medicare Billing & Enrollment Specialist is responsible for the enrollment ... billing, general operations, and data management. Job Responsibilities (but not limited to)
Medicare Enrollment & Billing Specialist
Tampa, FL · On-site
$18 - $23/hr
Job Summary: The Medicare Billing & Enrollment Specialist is responsible for the enrollment ... billing, general operations, and data management. Job Responsibilities (but not limited to)
Quick apply
Medicare Enrollment & Billing Specialist
Tampa, FL · On-site
$18 - $23/hr
Job Summary: The Medicare Billing & Enrollment Specialist is responsible for the enrollment ... billing, general operations, and data management. Job Responsibilities (but not limited to)
Collaborate with Medicare operations and clinical teams to implement scalable workflows for managing at-risk and attributed patient populations * Support integration of payor data files into Epic ...
Collaborate with Medicare operations and clinical teams to implement scalable workflows for managing at-risk and attributed patient populations * Support integration of payor data files into Epic ...
Medicare Retention Specialist
Miami, FL · On-site
Basic computer proficiency (Microsoft Office, Excel, Outlook, CRM systems and ability to learn new ... This may be modified at any time at the discretion of the employer as business operations may deem ...
Medicare Retention Specialist
Miami, FL · On-site
Basic computer proficiency (Microsoft Office, Excel, Outlook, CRM systems and ability to learn new ... This may be modified at any time at the discretion of the employer as business operations may deem ...
Medicare Retention Specialist
Miami, FL · On-site
$20 - $21/hr
Basic computer proficiency (Microsoft Office, Excel, Outlook, CRM systems and ability to learn new ... This may be modified at any time at the discretion of the employer as business operations may deem ...
Quick apply
Medicare Retention Specialist
Miami, FL · On-site
$20 - $21/hr
Basic computer proficiency (Microsoft Office, Excel, Outlook, CRM systems and ability to learn new ... This may be modified at any time at the discretion of the employer as business operations may deem ...
Medicare Operations Manager information
What is the difference between Medicare Operations Manager vs Medicare Claims Supervisor?
| Aspect | Medicare Operations Manager | Medicare Claims Supervisor |
|---|---|---|
| Required Credentials | Bachelor's degree in healthcare administration or related field; certifications like CPC or CMS certifications | High school diploma or associate's; certifications like CPC or claims-specific training |
| Work Environment | Oversees multiple departments, manages staff, and ensures compliance in healthcare organizations | Supervises claims processing teams, reviews claims, and ensures accuracy in claims submission |
| Employer & Industry Usage | Health insurance companies, Medicare administrative contractors, healthcare providers | Health 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?
What are some of the main challenges faced by a Medicare Operations Manager, and how can they be addressed?
What is a Medicare Operations Manager?

Full-time
Re-posted 9 days ago
Job description
Job Title: Sr Manager, Professional Services
Position Summary:
Reporting directly to the Senior Director of Professional Services, the Senior Manager of Professional Services plays a pivotal role in overseeing the creation, management, and maintenance of all operational documentation within the organization. This role ensures that all processes, procedures, job aids, and policies are accurately documented, easily accessible, and regularly updated to reflect current practices. The Senior Manager will work closely with various departments to ensure documentation supports operational efficiency, compliance, and continuous improvement. This position requires a professional capable of driving departmental change and maintaining high standards for enterprise documentation and training materials.
Essential Duties and Responsibilities:- Develop and implement a comprehensive documentation strategy that aligns with organizational goals and regulatory requirements.
- Oversee the creation, review, and maintenance of operational documents, including standard operating procedures (SOPs), job aids, process maps, and training materials.
- Proactively collaborate with stakeholders to ensure documentation remains current following changes driven by, but not limited to, the normal course of business, Medicare guidance, and change management initiatives.
- Ensure all documentation is accurate, up-to-date, and compliant with industry standards and regulations.
- Evaluate documentation effectiveness and continuously refine materials based on feedback and performance metrics.
Team Leadership:
- Lead and mentor a team of documentation specialists, providing guidance and support to ensure high-quality output.
- Foster a collaborative and innovative team environment that encourages continuous learning and improvement.
Cross-Functional Collaboration:
- Work closely with department heads and subject matter experts to gather information and ensure documentation accurately reflects current processes and procedures.
- Facilitate regular reviews and updates of documentation to incorporate feedback and changes in operational practices.
Compliance and Quality Assurance:
- Implement and maintain quality control processes to ensure the consistency and accuracy of all documentation.
- Conduct regular audits of documentation to identify areas for improvement and ensure compliance with internal and external standards.
- Remain abreast of changes in CMS regulations and ensure documentation is updated accordingly.
Training and Support:
- Develop and deliver training programs to educate employees on the use and importance of operational documentation.
- Provide ongoing support to ensure employees can effectively access and utilize documentation.
Technology and Tools:
- Evaluate and implement documentation management tools and/or knowledge management tools and technologies to enhance efficiency and accessibility.
- Maintain current knowledge of industry trends and best practices in documentation management and incorporate them into the organization's processes.
- Bachelor's degree in Technical Writing, Healthcare Administration, Business Administration, or a related field. Master's degree preferred.
- 5-7 years of experience in Medicare operations, documentation management, or a related field.
- Proven hands-on experience and demonstrated success in a managerial or leadership role, with a track record of successfully leading documentation projects and teams.
- Excellent written, verbal and presentational communication skills with the ability to communicate at all levels and establish good working relationships and interaction with executives and/or senior management
Knowledge, Skills, and Abilities:
- Good written, verbal and interpersonal communication skills.
- Excellent organizational skills and attention to detail.
- Requires analytical / problem-solving skills
- Requires Supervisory/Management skills
- Ability to read, analyze, and interpret technical journals, financial reports, and legal documents.
- Ability to effectively present information to top management, public groups, and/or boards of directors.
- Skill in organizing and prioritizing tasks.
- Must be able to multi-task and think quickly.
- Ability to analyze data and prepare reports.
- Ability to understand and carry out complex oral and written instructions.
- Ability to be flexible and juggle many assignments or projects at the same time.
- Ability to manage open requests and follow up when necessary without outside direction.
- Ability to manage time effectively with strong attention to detail.
- Ability to constantly meet deadlines.
- Ability to interact politely, tactfully and firmly with a wide range of people and personalities.
- Ability to work in an environment with potential interruptions.
- Ability to manage multiple simultaneous tasks with individual timeframes and priorities.
- The ability to generate positive relationships with internal and external business associates as well as foster a team environment through excellent leadership and management skills.
- Strong change management skills and ability to thrive in a dynamic and fast-paced environment.
Convey Health Solutions, together with Pareto Intelligence, delivers a powerful combination of purpose-built technology, advanced analytics, and expert services to help health plans thrive in a complex, post--Affordable Care Act environment.
As a trusted partner to Medicare and commercial payers, we provide scalable, compliant solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment, Stars performance, and member engagement. Pareto's deep analytics and financial intelligence complement Convey's operational expertise, enabling our clients to improve performance, reduce costs, and create better healthcare experiences for millions of Americans--especially seniors and vulnerable populations.
Together, we help health plans scale smarter, grow stronger, and make healthcare work better for the people who need it most. Learn more at http://www.ConveyHealthSolutions.com
About Convey Health Solutions
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Fort Lauderdale, FL, US
Year founded
2001