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 ...
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 ...
Senior Director, Strategic Client Programs
Chapel Hill, NC ยท On-site +1
$175K - $200K/yr
Stakeholder Management: Coordinate closely with Well's internal and external partners to align strategy, training, and operations with specialized Medicare/senior care expertise. Requirements
Senior Director, Strategic Client Programs
Chapel Hill, NC ยท On-site +1
$175K - $200K/yr
Stakeholder Management: Coordinate closely with Well's internal and external partners to align strategy, training, and operations with specialized Medicare/senior care expertise. Requirements
Payor Contract Manager (Infusion) - BioPlus Specialty Pharmacy
Durham, NC ยท Hybrid
$111K - $166K/yr
The Payor Contract Manager, Infusion manages the operational management, analysis, and ... Ensures contracts comply with federal and state regulations including CMS, Medicare Part B and D ...
Payor Contract Manager (Infusion) - BioPlus Specialty Pharmacy
Durham, NC ยท Hybrid
$111K - $166K/yr
The Payor Contract Manager, Infusion manages the operational management, analysis, and ... Ensures contracts comply with federal and state regulations including CMS, Medicare Part B and D ...
Payor Contract Manager (Infusion) - BioPlus Specialty Pharmacy
Durham, NC ยท Hybrid
$111K - $166K/yr
The Payor Contract Manager, Infusion manages the operational management, analysis, and ... Ensures contracts comply with federal and state regulations including CMS, Medicare Part B and D ...
Payor Contract Manager (Infusion) - BioPlus Specialty Pharmacy
Durham, NC ยท Hybrid
$111K - $166K/yr
The Payor Contract Manager, Infusion manages the operational management, analysis, and ... Ensures contracts comply with federal and state regulations including CMS, Medicare Part B and D ...
Responsible for directing the operation of a Walgreens Local Specialty Pharmacy, and accountable ... Medicare, Medicaid, and all other third-party payers, as well as the facilitating of prior ...
Responsible for directing the operation of a Walgreens Local Specialty Pharmacy, and accountable ... Medicare, Medicaid, and all other third-party payers, as well as the facilitating of prior ...
... Centers for Medicare and Medicaid Services CMS Conditions of Participation (CoPs). * Works ... Participate in the identification of clinical or operational performance improvement opportunities ...
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... Centers for Medicare and Medicaid Services CMS Conditions of Participation (CoPs). * Works ... Participate in the identification of clinical or operational performance improvement opportunities ...
Systems Analyst - Payer Encounter Management Platform
Raleigh, NC ยท Remote
$69K - $97K/yr
... Medicare Advantage, and Medicaid. With advanced analytics and realtime intelligence, we give ... Follow standard operational procedures for case management * Continuously improve troubleshooting ...
Systems Analyst - Payer Encounter Management Platform
Raleigh, NC ยท Remote
$69K - $97K/yr
... Medicare Advantage, and Medicaid. With advanced analytics and realtime intelligence, we give ... Follow standard operational procedures for case management * Continuously improve troubleshooting ...
... Centers for Medicare and Medicaid Services CMS Conditions of Participation (CoPs). * Works ... Participate in the identification of clinical or operational performance improvement opportunities ...
... Centers for Medicare and Medicaid Services CMS Conditions of Participation (CoPs). * Works ... Participate in the identification of clinical or operational performance improvement opportunities ...
Systems Analyst - Payer Encounter Management Platform
Raleigh, NC ยท On-site
$69K - $97K/yr
... Medicare Advantage, and Medicaid. With advanced analytics and real-time intelligence, we give ... Follow standard operational procedures for case management * Continuously improve troubleshooting ...
Systems Analyst - Payer Encounter Management Platform
Raleigh, NC ยท On-site
$69K - $97K/yr
... Medicare Advantage, and Medicaid. With advanced analytics and real-time intelligence, we give ... Follow standard operational procedures for case management * Continuously improve troubleshooting ...
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-basedpopulation ... Support clinic operations through provider collaboration, care coordination, and community ...
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-basedpopulation ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Durham, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-basedpopulation ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Durham, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-basedpopulation ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-basedpopulation ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-basedpopulation ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Durham, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Durham, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-basedpopulation ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-basedpopulation ... Support clinic operations through provider collaboration, care coordination, and community ...
Behavioral Health Director
Raleigh, NC ยท On-site
$110K - $120K/yr
Keep us in check with state, federal, Medicaid/Medicare, and accreditation standards. * Ensure we ... Mastery of budget and operational management. * Conflict resolution and negotiation skills to ...
Behavioral Health Director
Raleigh, NC ยท On-site
$110K - $120K/yr
Keep us in check with state, federal, Medicaid/Medicare, and accreditation standards. * Ensure we ... Mastery of budget and operational management. * Conflict resolution and negotiation skills to ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population ... Support clinic operations through provider collaboration, care coordination, and community ...
Clinical Care Nurse (RN)
Raleigh, NC ยท On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population ... Support clinic operations through provider collaboration, care coordination, and community ...
OFFICE ADMIN ASSISTANT / HEALTH INSURANCE AGENT
Cary, NC ยท On-site
$48K - $52K/yr
... operations * Scheduling and administrative responsibilities * Assisting seniors with Medicare ... Comfortable managing multiple tasks at once * Friendly and confident on the phone * Experienced in ...
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OFFICE ADMIN ASSISTANT / HEALTH INSURANCE AGENT
Cary, NC ยท On-site
$48K - $52K/yr
... operations * Scheduling and administrative responsibilities * Assisting seniors with Medicare ... Comfortable managing multiple tasks at once * Friendly and confident on the phone * Experienced in ...
Director of Finance
Lillington, NC ยท On-site
Position Summary The Director of Finance and Operations will oversee and serve as the manager of ... Two years related experience in a health care setting where Federal Medicare cost reporting is used ...
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Director of Finance
Lillington, NC ยท On-site
Position Summary The Director of Finance and Operations will oversee and serve as the manager of ... Two years related experience in a health care setting where Federal Medicare cost reporting is used ...
Medicare Operations Manager information
See Raleigh, NC salary details
$30.1K - $37.9K
20% of jobs
$39.8K is the 25th percentile. Wages below this are outliers.
$37.9K - $45.6K
20% of jobs
The median wage is $51.3K / yr.
$45.6K - $53.3K
14% of jobs
$53.3K - $61.1K
9% of jobs
$61.1K - $68.8K
11% of jobs
$70.4K is the 75th percentile. Wages above this are outliers.
$68.8K - $76.5K
6% of jobs
$76.5K - $84.3K
6% of jobs
$84.3K - $92K
4% of jobs
$92K - $99.7K
3% of jobs
$99.7K - $107.5K
2% of jobs
$107.5K - $115.2K
4% of jobs
$30.1K
$61.7K
$115.2K
How much do medicare operations manager jobs pay per year?
What is the difference between Medicare Operations Manager vs Medicare Claims Supervisor?
| Aspect | Medicare Operations Manager | Medicare Claims Supervisor |
|---|---|---|
| Required Credentials | Bachelor's degree in healthcare administration or related field; certifications like CPC or CMS certifications | High school diploma or associate's; certifications like CPC or claims-specific training |
| Work Environment | Oversees multiple departments, manages staff, and ensures compliance in healthcare organizations | Supervises claims processing teams, reviews claims, and ensures accuracy in claims submission |
| Employer & Industry Usage | Health insurance companies, Medicare administrative contractors, healthcare providers | Health 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 the key skills and qualifications needed to thrive as a Medicare Operations Manager?
What are some of the main challenges faced by a Medicare Operations Manager, and how can they be addressed?
What is a Medicare Operations Manager?

Full-time
Re-posted 20 days ago
Job description
About Client:
They help in transforming the leading organizations and communities around the world. Organizations infrastructure and culture is amazing. Best place!!
Job Title: Health Payer Technology Medicare Consultant
Job Level: Senior Levelย
Job Description:ย
THIS IS WHAT YOU WILL DO...ย
You will be adapting existing methods and procedure to create possible alternative solutions to moderate complex problems.
You will design and implement solutions that are Medicare complaint.
You will be understanding the strategic direction set by senior management as it relates to team goals.ย
WE ARE LOOKING FOR SOMEONE.!!
Who holds 4 years of experience as a consultant!
Who holds consulting experience in US Healthcare Payer market!
Who holds 2+ years' experience in US Payer operations & US Payer system implementations!
Who is experienced in systems and processes required to support health plan!
Who is currently in Medicare/ Medicaid!
Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM experience!
Who holds 2 years experience with Medicare systems and technologies with formal consulting!
Who holds 4 years of experience as a consultant!
Who holds consulting experience in US Healthcare Payer market!
Who holds 2+ years' experience in US Payer operations & US Payer system implementations!
All your information will be kept confidential according to EEO guidelines.