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 ...
Advisor, Medicare and Individual Health
Saint Augustine, FL · On-site
$52K - $70K/yr
... operations, including client contact, maintenance of prospect lists, involvement in civic ... Work with management to develop and execute a plan to create Medicare referral partners and ...
Advisor, Medicare and Individual Health
Saint Augustine, FL · On-site
$52K - $70K/yr
... operations, including client contact, maintenance of prospect lists, involvement in civic ... Work with management to develop and execute a plan to create Medicare referral partners and ...
Advisor, Medicare and Individual Health
Saint Augustine, FL · On-site
$52K - $70K/yr
... operations, including client contact, maintenance of prospect lists, involvement in civic ... Work with management to develop and execute a plan to create Medicare referral partners and ...
Advisor, Medicare and Individual Health
Saint Augustine, FL · On-site
$52K - $70K/yr
... operations, including client contact, maintenance of prospect lists, involvement in civic ... Work with management to develop and execute a plan to create Medicare referral partners and ...
Advisor, Medicare and Individual Health
Saint Augustine, FL · On-site
$52K - $70K/yr
... operations, including client contact, maintenance of prospect lists, involvement in civic ... Work with management to develop and execute a plan to create Medicare referral partners and ...
Advisor, Medicare and Individual Health
Saint Augustine, FL · On-site
$52K - $70K/yr
... operations, including client contact, maintenance of prospect lists, involvement in civic ... Work with management to develop and execute a plan to create Medicare referral partners and ...
Advisor, Medicare and Individual Health
Saint Augustine, FL · On-site
$52K - $70K/yr
... operations, including client contact, maintenance of prospect lists, involvement in civic ... Work with management to develop and execute a plan to create Medicare referral partners and ...
Advisor, Medicare and Individual Health
Saint Augustine, FL · On-site
$52K - $70K/yr
... operations, including client contact, maintenance of prospect lists, involvement in civic ... Work with management to develop and execute a plan to create Medicare referral partners and ...
Director of Operations Home Health
Jacksonville, FL · On-site
$120 - $160/hr
Ensure compliance with Medicare Conditions of Participation, state regulations, and company ... Drive census growth through referral management and market engagement * Ensure high‑quality ...
Director of Operations Home Health
Jacksonville, FL · On-site
$120 - $160/hr
Ensure compliance with Medicare Conditions of Participation, state regulations, and company ... Drive census growth through referral management and market engagement * Ensure high‑quality ...
... referral management and market engagement Ensure highquality, patientcentered care and ... Strong knowledge of Medicare home health regulations * Demonstrated success in staff leadership ...
... referral management and market engagement Ensure highquality, patientcentered care and ... Strong knowledge of Medicare home health regulations * Demonstrated success in staff leadership ...
... management and market engagement • Ensure high-quality, patient-centered care and ... Strong knowledge of Medicare home health regulations * Demonstrated success in staff leadership ...
... management and market engagement • Ensure high-quality, patient-centered care and ... Strong knowledge of Medicare home health regulations * Demonstrated success in staff leadership ...
... management and market engagement · Ensure high‑quality, patient‑centered care and ... Strong knowledge of Medicare home health regulations * Demonstrated success in staff leadership ...
... management and market engagement · Ensure high‑quality, patient‑centered care and ... Strong knowledge of Medicare home health regulations * Demonstrated success in staff leadership ...
Lead Director, Credentialing Operations
Tallahassee, FL · On-site
$139 - $232/hr
Oversee operational management of Commercial, Medicare, Medicaid credentialing operations, as well as ongoing monitoring of all providers. * Manage a team of ~100 employees through multiple managers.
Lead Director, Credentialing Operations
Tallahassee, FL · On-site
$139 - $232/hr
Oversee operational management of Commercial, Medicare, Medicaid credentialing operations, as well as ongoing monitoring of all providers. * Manage a team of ~100 employees through multiple managers.
... operational infrastructure designed to reduce administrative burden and allow you to focus on ... and chronic disease management truly make a difference. We offer a collaborative environment ...
... operational infrastructure designed to reduce administrative burden and allow you to focus on ... and chronic disease management truly make a difference. We offer a collaborative environment ...
DME Intake - Patient, Insurance, and Documentation Specialist
Fort Lauderdale, FL · On-site
$17 - $22.50/hr
Operations Reports To: Owner / Operations Manager Position Summary The Intake, Documentation ... Ensure documentation meets CMS, Medicare, and payer-specific standards prior to fulfillment
Quick apply
DME Intake - Patient, Insurance, and Documentation Specialist
Fort Lauderdale, FL · On-site
$17 - $22.50/hr
Operations Reports To: Owner / Operations Manager Position Summary The Intake, Documentation ... Ensure documentation meets CMS, Medicare, and payer-specific standards prior to fulfillment
Operations Reports To: Owner / Operations Manager Position Summary The Intake, Documentation ... Medicare Advantage vs. Commercial payer rules Submit and track claims under supervision to ...
Operations Reports To: Owner / Operations Manager Position Summary The Intake, Documentation ... Medicare Advantage vs. Commercial payer rules Submit and track claims under supervision to ...
DME Intake - Patient, Insurance, and Documentation Specialist
Fort Lauderdale, FL · On-site
$17 - $22.75/hr
Operations Reports To: Owner / Operations Manager Position Summary The Intake, Documentation ... Medicare Advantage vs. Commercial payer rules • Submit and track claims under supervision to ...
DME Intake - Patient, Insurance, and Documentation Specialist
Fort Lauderdale, FL · On-site
$17 - $22.75/hr
Operations Reports To: Owner / Operations Manager Position Summary The Intake, Documentation ... Medicare Advantage vs. Commercial payer rules • Submit and track claims under supervision to ...
DME Intake - Patient, Insurance, and Documentation Specialist
Fort Lauderdale, FL · On-site
$17 - $22.50/hr
Operations Reports To: Owner / Operations Manager Position Summary The Intake, Documentation ... Medicare Advantage vs. Commercial payer rules • Submit and track claims under supervision to ...
DME Intake - Patient, Insurance, and Documentation Specialist
Fort Lauderdale, FL · On-site
$17 - $22.50/hr
Operations Reports To: Owner / Operations Manager Position Summary The Intake, Documentation ... Medicare Advantage vs. Commercial payer rules • Submit and track claims under supervision to ...
We are building a highly controlled, audit-ready Medicare DME operation and are seeking our first ... Independently manage daily claim submissions and follow-ups. * Reduce preventable denials by 15-20 ...
Quick apply
We are building a highly controlled, audit-ready Medicare DME operation and are seeking our first ... Independently manage daily claim submissions and follow-ups. * Reduce preventable denials by 15-20 ...
We are building a highly controlled, audit-ready Medicare DME operation and are seeking our first ... Independently manage daily claim submissions and follow-ups. * Reduce preventable denials by 15-20 ...
We are building a highly controlled, audit-ready Medicare DME operation and are seeking our first ... Independently manage daily claim submissions and follow-ups. * Reduce preventable denials by 15-20 ...
We are building a highly controlled, audit-ready Medicare DME operation and are seeking our first ... Independently manage daily claim submissions and follow-ups. * Reduce preventable denials by 15-20 ...
We are building a highly controlled, audit-ready Medicare DME operation and are seeking our first ... Independently manage daily claim submissions and follow-ups. * Reduce preventable denials by 15-20 ...
Assists with managing supply inventory & disbursement, as appropriate. * Reports issues and ... Assists the Medicare & Private office by calling clients for feedback. * All other duties as ...
Assists with managing supply inventory & disbursement, as appropriate. * Reports issues and ... Assists the Medicare & Private office by calling clients for feedback. * All other duties as ...
Manage Medicare, Medicaid, out-of-state Medicaid, PECOS, and related provider enrollment activities ... Ability to collaborate effectively with Finance, Revenue Cycle, Compliance, Legal, Operations ...
Manage Medicare, Medicaid, out-of-state Medicaid, PECOS, and related provider enrollment activities ... Ability to collaborate effectively with Finance, Revenue Cycle, Compliance, Legal, Operations ...
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?
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.
What are the most commonly searched types of Medicare Operations jobs in Florida? The most popular types of Medicare Operations jobs in Florida are:
What are popular job titles related to Medicare Operations Manager jobs in Florida? For Medicare Operations Manager jobs in Florida, the most frequently searched job titles are:
What job categories do people searching Medicare Operations Manager jobs in Florida look for? The top searched job categories for Medicare Operations Manager jobs in Florida are:
What cities in Florida are hiring for Medicare Operations Manager jobs? Cities in Florida with the most Medicare Operations Manager job openings:
Full-time
Medical, Life, Retirement, PTO
Re-posted 2 days ago
Job description
System Analyst Epic Health Planet Ambulatoryy
This is a hybrid role which includes some on-site work as needed. Florida residency or Contract 1099
As Mount Sinai grows, so does our legacy in high-quality health care.
Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers.
Culture of Caring: The Sinai Way
Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.
Overview:
We're looking for a dynamic Epic Analyst to join our Digital/Poplation Health team. This role will play a key part in supporting strategic digital health initiatives focused on expanding access, improving patient outcomes, and enhancing the digital front door experience. Ideal candidates will bring strong Epic expertise and a passion for using technology to improve healthcare delivery across our growing population.
Position Responsibilities:
- Design, build, and optimize Epic tools that support population health initiatives, including panels, registries, and outreach workflows
- 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, ensuring accurate member alignment, quality metric tracking, and performance reporting
- Develop and maintain cost and utilization dashboards within Epic to support data-driven decision-making across population health programs
- Lead Epic Cheers! Campaign configuration and deployment to drive proactive outreach for preventative care, gaps in care, and patient engagement
- Build and optimize MyChart online scheduling workflows aligned to program expansions, access initiatives, and care management needs
- Partner with clinical, operations, and digital health stakeholders to translate business needs into Epic-driven solutions that improve patient outcomes and care coordination
- Service Delivery - Takes personal ownership of issues ensures a high degree of accuracy with all communications/deliverables completes tasks according to committed timelines demonstrates excellent service recovery and communicates with customers in a consistent manner.
- Service Management - Actively monitors assigned HEAT tickets documents activities thoroughly and resolves issues within the established service levels in a consistent manner
- Workflow Analysis - Under direction of senior team members performs workflow analysis and design with input and guidance from key operational leadership. Facilitates workflow adoption on new processes.
- Testing - Participates in system testing events by executing scripts. Accurately documents and reports any noted errors or deficiencies.
- Upgrades/Optimizations - Provides support to department/end users during system upgrade and optimization activities
- Projects and New System Implementations - Executes assigned tasks under the supervision of senior team members/management. Tasks are completed within specified time frame.
- Issue Resolution - Utilizes system knowledge and available resources to address routine issues.
- Leadership - Actively participates in departmental and customer team meetings. Provides input and acts as a team resource by taking notes or other support activities.
- Knowledge - Achieves and maintains up-to-date application knowledge for assigned applications/process areas. Utilizes appropriate resources to further knowledge to address issues or complete assigned tasks.
- Downtime Processes - Actively participates in testing of downtime processes. Activities may include executing test scripts working with end users or other tasks to support downtime activities.
- Training - Participates in discussions related to the development of training content for users. Provides support to formal training classes when necessary in the form of proctoring materials preparation or other tasks as necessary.
Qualifications:
- 2 + years' related experience with Epic preferred
The ideal candiate has: Preferred Certifications: Healthy Planet, MyChart, Ambulatory
- Bachelor's Degree or equivalent experience
Benefits:
We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs. Our robust employee benefits package includes:
- Health benefits
- Life insurance
- Long-term disability coverage
- Healthcare spending accounts
- Retirement plan
- Paid time off
- Pet Insurance
- Tuition reimbursement
- Employee assistance program
- Wellness program
About Mount Sinai Medical Center
Sourced by ZipRecruiter
Industry
Hospitals
Company size
1,001 - 5,000 Employees
Headquarters location
Miami Beach, FL, US
Year founded
1949