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Medicare Operations Manager Jobs in Tennessee (NOW HIRING)

Abilis Health Plan

Provider Network Manager

Memphis, TN · On-site +1

$70K - $80K/yr

Prior experience with Medicare Advantage plans required; Institutional Special Needs Plan (I-SNP ... Familiarity with health plan operations, including benefits, claims review and resolution ...

Abilis Health Plan

Provider Network Manager

Nashville, TN · On-site +1

$70K - $80K/yr

Prior experience with Medicare Advantage plans required; Institutional Special Needs Plan (I-SNP ... Familiarity with health plan operations, including benefits, claims review and resolution ...

AdaptHealth LLC

Operations Specialist

Jackson, TN · On-site

Meet quality and performance metrics while managing multiple priorities * Perform patient ... Experience within a healthcare organization, pharmacy, HME, medical supply, or Medicare-certified ...

AdaptHealth, LLC

Operations Specialist

Jackson, TN · On-site

Meet quality and performance metrics while managing multiple priorities * Perform patient ... Experience within a healthcare organization, pharmacy, HME, medical supply, or Medicare-certified ...

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All JobsMedicare Operations JobsMedicare Operations Manager JobsMedicare Operations Manager Jobs in Tennessee

Medicare Operations Manager information

See Tennessee salary details

$28.1K

$57.6K

$107.6K

How much do medicare operations manager jobs pay per year?

As of Sep 7, 2026, the average yearly pay for medicare operations manager in Tennessee is $57,594.00, according to ZipRecruiter salary data. Most workers in this role earn between $37,200.00 and $70,300.00 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 Tennessee?

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

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

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

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

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

Medicare Operations Manager jobs near you
Infographic showing various Medicare Operations Manager job openings in Tennessee as of June 2026, with employment types broken down into 85% Full Time, 14% Part Time, and 1% Temporary. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $57,594 per year, or $27.7 per hour.

Medicare Stars Senior Analytics Consultant

Health Care Service Corporation

Nashville, TN • Hybrid

Full-time

Medical, Life, Retirement, PTO

Re-posted 8 days ago

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job SummaryThe Medicare Stars Senior Analytics Consultant will be responsible for leading the analytics strategy for evaluating internal and external program initiatives within the Medicare Stars program. This position is located within the Medicare Stars Analytics team, whose function is to provide operational and analytical support to internal and external partners to improve HCSC's Medicare Star Ratings. The Senior Analytics Consultant will be part of the Advanced Analytics team and will lead development of data analyses utilizing pharmacy claims, clinical outcomes, and Stars quality measures to make recommendations based on relevant findings.
The Senior Analytics Consultant will be responsible for building a framework to analyze performance of external vendors and internal groups and building out reports and dashboards to monitor such performance on an ongoing basis. This individual will use advanced analytics techniques to dive into root causes of issues.
The Senior Analytics Consultant will interface across multiple business areas, including, but not limited to pharmacy, clinical, customer experience, product development and operations as needed. Reports and dashboards created will be utilized by business partners and Stars leadership in making critical business decisions related to enhancements to existing programs, development of new pilots and initiatives, and other opportunities to maximize Stars affordability and enterprise value. The ideal candidate will have a passion for healthcare analytics and a creative mindset for approaching data in innovative ways.

Required Job Qualifications:

  • Bachelor's degree and 6 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR Master's degree with 4 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR PhD with 2 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR 10 years of experience in health care services, statistical analysis, or insurance industry economics or related field

  • Understanding, and being highly proficient at querying a wide variety of internal and external data sources to get meaningful insights.

  • Strong analytical skills and proficiency in computer languages, such as SQL, Python, R, etc.

  • Ability to create a dynamic and visually engaging dashboard leveraging data visualization tools such as Tableau or Power BI

  • High degree of business intelligence and understanding how to take a business case from inception to customer or partner execution.

  • Experience leading an analytic initiative to success.

  • Excellent communication and presentation skills.

  • Ability to work independently and as part of a team.

  • Performance excellence in championing initiatives and collaborating with multiple stakeholders to bring the initiative to life.

  • Ability to work under pressure and delivery high quality output to senior leadership to decision making within short timeline.

  • Experience with version control/collaborative tools, such as GitHub

Preferred Job Qualifications:

  • Experience with project management methodologies.
  • Experience of Healthcare industry - payor, provider, pharmacy, public health, epidemiology, etc.
  • Knowledge of the CMS Star Rating System, including HEDIS, Pharmacy, Administrative, and CAHPS Measures.
  • Extensive knowledge of and experience working with medical claims data, pharmacy claims data, customer eligibility data, and customer experience/self-report data.
  • Ability to understand business operations requirements and translate them into technical applications.
  • Excellent interpersonal and customer service skills and proven ability to perform in a matrix environment.
  • Strong leadership and project management skills.
  • Ability to work autonomously and deal with ambiguity.
  • Experience with automation tools, such as Alteryx or Airflow

This is a Flex (Hybrid) role: 3 days in office, 2 days work from home.

#LI-Hybrid

#LI-TE1

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$84,400.00 - $152,300.00

Exact compensation may vary based on skills, experience, and location.

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