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Medicare Operations Manager Jobs in Georgia (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 ...

Phamily

Revenue Cycle Operations Manager

Sandy Springs, GA · On-site

$100K - $140K/yr

The Revenue Cycle Operations Manager owns the end-to-end operational management of Jaan Health ... You will ensure our health system partners achieve maximum reimbursement yield from Medicare care ...

Ferrellgas

Operations Supervisor

Commerce, GA · On-site

This position typically requires a bachelors degree in operations management, business ... Wellness program, Employee Assistance Program (EAP), and Medicare support * Employee Perks

Ferrellgas

Operations Supervisor

Commerce, GA · On-site

This position typically requires a bachelor's degree in operations management, business ... Wellness program, Employee Assistance Program (EAP), and Medicare support * Employee Perks

Ferrellgas

Operations Supervisor

Commerce, GA

This position typically requires a bachelor's degree in operations management, business ... Wellness program, Employee Assistance Program (EAP), and Medicare support * Employee Perks

Georgia

Network Adequacy Manager

Atlanta, GA

$75K - $100K/yr

A. 3320E1 et seq. and Centers for Medicare and Medicaid Services (CMS) requirements under 45 CFR ... operational alignment and timely certification review cycles. Draft, review, and approve issuer ...

Ra

Health Care Analyst (Medicare)

Atlanta, GA · Remote

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 ...

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 ...

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 ...

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All JobsMedicare Operations JobsMedicare Operations Manager JobsMedicare Operations Manager Jobs in Georgia

Medicare Operations Manager information

See Georgia salary details

$26.2K

$53.6K

$100.1K

How much do medicare operations manager jobs pay per year?

As of Sep 7, 2026, the average yearly pay for medicare operations manager in Georgia is $53,581.00, according to ZipRecruiter salary data. Most workers in this role earn between $34,600.00 and $65,400.00 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.

What are popular job titles related to Medicare Operations Manager jobs in Georgia?

For Medicare Operations Manager jobs in Georgia, the most frequently searched job titles are:

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

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

What cities in Georgia are hiring for Medicare Operations Manager jobs?

Cities in Georgia with the most Medicare Operations Manager job openings:

Medicare Operations Manager jobs near you

Medicare Operations Senior Program Manager

Bcbsa

On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 7 days ago

Key responsibilities

  • Oversee day-to-day operational work streams supporting Medicare products and services to ensure compliance and operational efficiency.

  • Manage business requirements, system implementations, UAT, and change management in collaboration with cross-functional stakeholders.

  • Monitor operational performance, identify gaps, and implement in-year corrections to maintain product integrity and compliance.

Job description

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 streams that support Medicare products and services to ensure operational/regulatory compliance consistent with FEP, Office of Personnel Management (OPM), and Centers for Medicare and Medicaid Services (CMS), and EGWP policies and procedures. Manage operational efficiencies/continuous improvement initiatives and support operational implementation of cross-functional initiatives to enhance member and provider experiences.
This position partners closely with FEPOC MA Operations, Compliance, Product, Clinical, Network, and Inter Plan & Products (IPP) teams to ensure product builds are compliant, timely, and operationally sound. Position will serve as the primary interface with operations and implementation partners throughout the product cycle and will play a critical role in driving the success of the company's product portfolio by delivering products that meet business objectives.
  • Manages business requirements, system implementations, UAT, and change management in partnership with the FEP Operations Center and cross-functional stakeholders. Ensures adherence to FEP program and ITS processes/procedures and applies deep Medicare Advantage regulatory and operational expertise to ensure CMS compliance and audit readiness.
  • Manages pre/post-launch operational monitoring, identifies execution gaps, and drives in-year corrections to maintain product integrity and compliance.
  • Relationship management skills to build and maintain a positive, collaborative working relationship across various internal and external functional areas/stakeholders. Establish cohesive relationships and influence decisions without having a direct functional reporting structure. Build trust, exhibit sense of urgency, drive consensus in resolving conflicts and decision making. Resolve or escalate issues, propose alternatives and set or manage expectations in a timely fashion.
  • Manages product implementation and operational readiness as directed by product development team in ensuring benefit builds at the operations and implementation partner level align precisely with approved CMS-compliant specifications. Support enrollment, member services, provider network operations, ANOC/EOC planning, and member experience initiatives.
  • Supports Product Development team with strategic planning, multi-year operational roadmaps, and process optimization using Lean Six Sigma and industry benchmarking. Manages vendor relationships, contracts, and RFPs; represent MA operations in governance forums and with CMS.
  • Manages collating MA product operational performance reporting including all applicable KPIs, SLAs, regulatory, and operational reporting metrics and appropriately distributes to BCBSA leadership.
  • Serves as a liaison and communicator to FEPOC Operations team, presenting recommendations to leadership and mentoring operational staff.

The posting range for this position is:

105,400.00 - 152,800.00


Qualifications:
Education

  • Required BS in Healthcare, Business Administration, Public Health, or related field; or equivalent experience

Experience

  • Required 8+ Years experience in Medicare/Medicare Advantage Operations, healthcare operations, and health insurance or managed care.


Knowledge Skills and Abilities

  • Deep knowledge of Medicare Advantage, Part D, and CMS regulations.
  • Experience leading/supporting large, cross functional programs/projects, including working with TPAs/BPOs.
  • Experience working with core processing platforms like - Facets, HealthEdge, QNXT etc.
  • Strong analytical skills with ability to interpret utilization data, competitive benchmarking, and quality/Stars metrics to drive benefit enhancement decisions.
  • Excellent written, oral communication, and presentation skills; proven ability to develop and deliver executive-level materials and represent product initiatives to senior stakeholders.
  • Proficiency in Microsoft Office (Word, Excel, PowerPoint); familiarity with project management tools and data visualization platforms.
  • Strong stakeholder management and relationship-building skills with the ability to influence without authority across Legal, Compliance, Actuarial, Clinical, and Operations functions.


Extra Posting Information:

#LI-Remote

The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate's position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.This job is also eligible for annual bonus incentive pay.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

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