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Medicare Operations Manager Jobs in Washington (NOW HIRING)

Amaray Care

Private Duty RN for Assessment

Rockville, MD · On-site

$80 - $100/hr

Follow Medicare and Medicaid regulations. This position reports to the DON and Operations manager. Qualifications 1. Be a registered nurse (R.N.) with a current license. 3. Work positively and ...

Option Care

RN Nurse Manager - Chantilly

Chantilly, VA · On-site

Management of the nursing operations will consist of 70-90% of the Nurse Manager's time, and the ... Serves as the Administrator and/or Director of Nursing of the home health agency per Medicare ...

New

Kahak DC

Clinical Manager

Washington, DC · On-site

$80 - $100/hr

Position Summary The Clinical Manager is responsible for overseeing the clinical operations of the ... Maintain compliance with Medicare/Medicaid regulations, HIPAA, and DC Department of Health ...

New

Maximus

Sr Project Analyst - Operations

VA · On-site +1

Provides project management support and expertise to the CCO Program, may include training and ... Experience with CCO program (Medicare and Marketplace) knowledge is preferred. * Previous ...

Mosaic Pharmacy

Care Team Manager

Sterling, VA · On-site

$110K - $170K/yr

Description Care Team Manager On-site Sterling, Virginia Pharmacy Operations, Mosaic Pharmacy ... Working knowledge of, or ability to quickly learn, relevant regulatory frameworks (BOP, Medicare ...

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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.

Private Duty RN for Assessment

Amaray Care

Rockville, MD

Full-time

Re-posted 27 days ago

Job description

Registered Nurse

Amaray Care is looking for a Registered Nurse to join our team. This person is responsible for overseeing the treatment of patients with a variety of medical conditions. He/she will observe and document the administration of medication, monitor and record patient progress, and educate families and the patient as needed.

Amaray Care is currently in need of Nurses that are able to travel to different locations in the PG County area for in-person assessments. Demonstrate proficient skills in assessing the potential and current client's condition. Observe and supervise client care administered by caregivers in accordance with the client's plan of care. Maintain compliance with agency policy and procedures. Follow Medicare and Medicaid regulations. This position reports to the DON and Operations manager.

Qualifications

1. Be a registered nurse (R.N.) with a current license.

3. Work positively and favorably with patients, families, and staff.

4. Have reliable transportation.

Responsibilities/Essential Functions

The person in this position must be able to perform the following essential job functions with or without reasonable accommodations.

  • Perform the initial home care patient visit and re-evaluate the patient's needs and progress on a regular basis.
  • Initiate the plan of care under the Doctor's orders.
  • Perform admission, transfer, re-certification, resumption of care, and discharge Oasis for the home care patient.
  • Observe, assess, and document symptoms.
  • Monitor reactions and patient progress.
  • Educate patients and caregivers on disease processes, medications, plans of care, and individualized treatment plans.
  • Educate patients and caregivers on techniques for in-home health care.
  • Coordinate patient services.
  • Supervise LPNs and CNAs.
  • Notify the physician and other personnel (DON, Operations Manager) of changes in the patient's condition.
  • Perform a skill outline in the agency's approved policy and procedure manual.
  • Discharge the patient from skilled nursing services when the discharge criteria have been met.
  • Case conference clinicians providing care to ensure coordination of care.
  • Update clinical records according to policy and procedures.
  • Update knowledge and skills by attending in-service programs, continuing education programs, seminars, and self-study programs annually.
  • Provide onsite supervision of CMTS and CNAs.
  • Adhere to Medicaid and Medicare regulations.

The ideal candidate will display compassion, education, proficiency, and experience while assisting the patient. This critical role assists in creating and managing nursing care plans and will participate in the evaluation of the current and future medical needs of the patient.

Amaray Care is a Home Health Care organization dedicated to the mission of giving families a peace of mind through quality care.

Amaray Care benefits include a sign-on bonus, a flexible schedule, training, and ref

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