ZipRecruiter

Log In

1

Medicare Operations Manager Jobs in Washington (NOW HIRING)

Ra

Health Care Analyst (Medicare)

Arlington, VA · 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 ...

Ra

Health Care Analyst (Medicare)

Washington, DC · 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 ...

next page

Showing results 1-20

All JobsMedicare Operations JobsMedicare Operations Manager JobsMedicare Operations Manager Jobs in Washington

Medicare Operations Manager information

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 Washington?

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

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

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

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

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

Medicare Operations Manager jobs near you
Infographic showing various Medicare Operations Manager job openings in Washington as of August 2026, with employment types broken down into 87% Full Time, 11% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution.

Medicare Operations Analyst (Temporary)

ASSOCIATION FOR COMMUNITY AFFILIATED PLANS

Washington, DC • On-site

$36 - $48/hr

Other

Posted yesterday

New

Job description

What You'll Be Responsible For

Reporting to the Medicare Operations Director, this position:

  • Supports Medicare operations, sales, and enrollment functions through analysis and interpretation of Medicare and Medi-Cal data and ensures compliance with applicable state and federal regulations
  • Conducts complex research and analysis in support of Medicare Operations activities
  • Acts as a subject matter expert and liaison to internal and external stakeholders
What You'll Need to Be Successful
  • Knowledge of CMS guidelines related to Medicare sales and enrollment
  • Medicare Advantage enrollment processes and financial reconciliation
  • Contents and interpretation of monthly membership reports
  • Research, analysis, and reporting methods
  • Data analysis tools, CRM/enrollment systems, and the use of databases
  • Analyze complex data sets and present actionable insights
  • Identify issues, gather and analyze information and data, reach logical and sound conclusions, and make recommendations for action
  • Interpret, explain and apply applicable policies, laws, codes, regulations, and contracts
  • Organize work, manage multiple projects, establish priorities, adjust to changing priorities, and meet deadlines
  • Assist with the development and implementation of projects, systems, programs, policies, and procedures
  • Develop and implement operational workflows
Education and Experience
  • Bachelor’s degree in Business Administration, Health Care Administration, Public Health, or a related field
  • Minimum of five years of progressively responsible experience related to Medicare membership operations and or enrollment eligibility
  • Master’s degree may substitute for two years of the required experience; or an equivalent combination of education and experience may be qualifying
Other Information

We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams. While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. This is a temporary position and does not provide the benefits that are listed below (this is standard language from our regular job posts and cannot be altered or removed). Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options.

Compensation Information

Zone 1 Pay Range: $36.00 - $48.00. Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas

Zone 2 Pay Range: $34.00 - $45.00. Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento)

The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to answer any questions that you have or share the applicable pay zone for your location if it’s not one of the typical areas listed. You can reach out to careers@thealliance.health, and a member from our Talent Acquisition team will be in touch. The posted hiring ranges represent a good-faith estimate of what a temporary employee would be paid on this assignment. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate’s qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location).

#J-18808-Ljbffr

Apply