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Medicare Operations Manager Jobs in Massachusetts

Business Operations Manager

Needham, MA ยท On-site

$80 - $100/hr

Support operational compliance with Medicare, HIPAA, DMEPOS accreditation standards, and internal ... Excellent organizational and project management abilities. * Experience working with multiple ...

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 ...

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Medicare Operations Manager information

See Massachusetts salary details

$33.9K

$69.3K

$129.4K

How much do medicare operations manager jobs pay per year?

As of Sep 8, 2026, the average yearly pay for medicare operations manager in Massachusetts is $69,302.00, according to ZipRecruiter salary data. Most workers in this role earn between $44,800.00 and $84,600.00 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 Massachusetts?

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

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

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

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

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

    Business Operations Manager

    Socket.dev

    Needham, MA โ€ข On-site

    $80 - $100/hr

    Other

    Posted 6 days ago


    Job description

    About the Role

    We are looking for a highly organized, analytical, and handsโ€‘on Business Operations Manager to become the operational right hand to the Head of XRHealth America.

    This is a highly visible, crossโ€‘functional role that sits at the center of the business. You will work across operations, finance, systems, customer success, logistics, billing, commercialization, compliance, and marketing to ensure the organization operates efficiently and continues to scale.

    Weโ€™re looking for a builderโ€”not someone who simply manages existing processes, but someone who enjoys improving them. You should naturally organize chaos, identify opportunities for improvement, connect systems, analyze business performance, and help turn strategy into execution.

    No two days will look the same. One day you may be building executive dashboards, the next implementing an AIโ€‘powered workflow, optimizing an operational process, coordinating a crossโ€‘functional project, or solving an operational challenge. If youโ€™re energized by variety, ownership, and continuous improvement, weโ€™d love to meet you.

    Key ResponsibilitiesBusiness Operations
    • Serve as the primary operational partner to the Head of XRHealth America.
    • Support the dayโ€‘toโ€‘day operations of the business across multiple functions.
    • Drive execution of strategic initiatives and company priorities.
    • Coordinate crossโ€‘functional projects and ensure successful execution.
    • Identify operational bottlenecks and implement scalable solutions.
    • Build, document, and continuously improve business processes and Standard Operating Procedures (SOPs).
    • Create operational visibility, accountability, and structure across the organization.
    Systems, Automation & AI
    • Lead initiatives to optimize business systems and workflows.
    • Identify opportunities to leverage automation and AI to improve operational efficiency.
    • Utilize AI tools for reporting, documentation, data analysis, workflow design, and productivity improvements.
    • Manage and improve integrations between business platforms, including HubSpot, NikoHealth, NetSuite, Zendesk, Stripe, AI platforms, and other operational systems.
    • Partner with internal and external technical teams to implement new technologies and process improvements.
    • Ensure data integrity and operational consistency across systems.
    Financial & Business Performance
    • Develop and maintain executive dashboards, KPIs, and operational reporting.
    • Analyze business performance, operational costs, financial trends, and growth opportunities.
    • Support budgeting, forecasting, inventory planning, and business planning.
    • Provide leadership with meaningful insights to support decisionโ€‘making.
    • Identify opportunities to improve efficiency, scalability, and profitability.
    Crossโ€‘Functional Leadership
    • Partner closely with Customer Success, Billing, Logistics, Marketing, Finance, Compliance, Technology, and Commercial teams.
    • Coordinate projects across departments and keep initiatives moving forward.
    • Remove operational roadblocks and improve collaboration across the organization.
    • Support vendor management and implementation of new business initiatives.
    Compliance & Quality
    • Support operational compliance with Medicare, HIPAA, DMEPOS accreditation standards, and internal policies where applicable.
    • Assist with audits, documentation, and operational quality initiatives.
    • Help ensure business processes remain compliant, scalable, and wellโ€‘documented.
    The Ideal Candidate

    You enjoy building businesses, solving problems, and making organizations operate better.

    You are analytical, detailโ€‘oriented, highly organized, and naturally proactive. You donโ€™t wait to be told what to doโ€”you identify opportunities, ask the right questions, and take ownership of driving projects forward.

    You enjoy working across departments and are equally comfortable discussing financial metrics, improving workflows, implementing technology, or coordinating a companyโ€‘wide initiative.

    You embrace new technologies and actively leverage AI to improve your own productivity and identify opportunities to make the organization more efficient.

    Most importantly, youโ€™re a handsโ€‘on operator who enjoys rolling up your sleeves and getting things done.

    QualificationsRequired
    • Bachelorโ€™s degree in Business, Operations, Healthcare Administration, Finance, Industrial Engineering, or a related field.
    • 4โ€“8 years of professional experience in business operations, healthcare operations, consulting, project management, or a similar crossโ€‘functional role.
    • Strong understanding of the U.S. healthcare system is required.
    • Experience working within a healthcare provider, healthcare technology, medical device, payer, or other healthcare organization.
    • Demonstrated success improving business processes and operational efficiency.
    • Strong analytical, financial, and problemโ€‘solving skills.
    • Excellent organizational and project management abilities.
    • Experience working with multiple business systems and software integrations.
    • Advanced proficiency with Microsoft Excel and/or Google Sheets.
    • Excellent written and verbal communication skills.
    • Handsโ€‘on attitude with a strong sense of ownership and accountability.
    • Ability to work fullโ€‘time onโ€‘site in Needham, MA.
    Preferred
    • MBA or other advanced business degree.
    • Experience with AI productivity platforms such as ChatGPT, Claude, Gemini, Microsoft Copilot, or similar tools.
    • Experience with HubSpot CRM.
    • Experience with NikoHealth or another healthcare EHR/DME platform.
    • Experience with NetSuite ERP.
    • Experience with business intelligence and reporting tools.
    • Experience in a fastโ€‘growing healthcare or technology company.
    What Success Looks Like
    • Become a trusted operational partner to the Head of XRHealth America.
    • Improve the efficiency and scalability of the business through better processes, systems, and automation.
    • Build meaningful operational and financial reporting for leadership.
    • Successfully execute highโ€‘impact crossโ€‘functional initiatives.
    • Help establish the operational foundation for the companyโ€™s continued growth.

    This is a fullโ€‘time, 100% onโ€‘site position based in Needham, Massachusetts.

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