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 · 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 · 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
... while driving operational effectiveness across eligibility verification, coding, billing, and ... Ensure compliance with Medicare, Medicaid, commercial insurance, and hospice‑specific regulatory ...
Quick apply
... while driving operational effectiveness across eligibility verification, coding, billing, and ... Ensure compliance with Medicare, Medicaid, commercial insurance, and hospice‑specific regulatory ...
Revenue Cycle Manager, Full-time
Raleigh, NC · On-site
... while driving operational effectiveness across eligibility verification, coding, billing, and ... Adhere to organizational policies, ACHC Standards, and Medicare Conditions of Participation.
Revenue Cycle Manager, Full-time
Raleigh, NC · On-site
... while driving operational effectiveness across eligibility verification, coding, billing, and ... Adhere to organizational policies, ACHC Standards, and Medicare Conditions of Participation.
Operations Specialist Non-Driving
Raleigh, NC · 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 ...
Operations Specialist Non-Driving
Raleigh, NC · 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 ...
Operations Specialist Non-Driving
Raleigh, NC · 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 ...
Operations Specialist Non-Driving
Raleigh, NC · 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 ...
Business Office Manager Assistant
Smithfield, NC · On-site
$13 - $15/hr
JOB DETAILS Are you a detail-oriented professional with a passion for financial operations and ... Oversee the processing of insurance claims, Medicaid, and Medicare billing, ensuring compliance ...
Business Office Manager Assistant
Smithfield, NC · On-site
$13 - $15/hr
JOB DETAILS Are you a detail-oriented professional with a passion for financial operations and ... Oversee the processing of insurance claims, Medicaid, and Medicare billing, ensuring compliance ...
Business Office Manager Assistant
$13 - $15/hr
Are you a detail-oriented professional with a passion for financial operations and resident care ... Oversee the processing of insurance claims, Medicaid, and Medicare billing, ensuring compliance ...
Quick apply
Business Office Manager Assistant
$13 - $15/hr
Are you a detail-oriented professional with a passion for financial operations and resident care ... Oversee the processing of insurance claims, Medicaid, and Medicare billing, ensuring compliance ...
Business Office Manager Assistant
Smithfield, NC · On-site
$13 - $15/hr
JOB DETAILS Are you a detail-oriented professional with a passion for financial operations and ... Oversee the processing of insurance claims, Medicaid, and Medicare billing, ensuring compliance ...
Business Office Manager Assistant
Smithfield, NC · On-site
$13 - $15/hr
JOB DETAILS Are you a detail-oriented professional with a passion for financial operations and ... Oversee the processing of insurance claims, Medicaid, and Medicare billing, ensuring compliance ...
... 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 ...
Design and operate solutions that support Managed Services delivery across GTN, Government Pricing ... S. federal and state pricing regulations (Medicaid Drug Rebate Program, 340B, VA/DoD, Medicare Part ...
Design and operate solutions that support Managed Services delivery across GTN, Government Pricing ... S. federal and state pricing regulations (Medicaid Drug Rebate Program, 340B, VA/DoD, Medicare Part ...
Payer Platform Delivery Lead, Director
$155K - $410K/yr
... management consulting or professional services - Familiarity with Blues plan operations and Medicaid/Medicare analytics - Background in defining clinical quality metrics and care gaps - Experience in ...
Payer Platform Delivery Lead, Director
$155K - $410K/yr
... management consulting or professional services - Familiarity with Blues plan operations and Medicaid/Medicare analytics - Background in defining clinical quality metrics and care gaps - Experience in ...
RN Case Manager, Full-time
Raleigh, NC · On-site
... Centers for Medicare and Medicaid Services CMS Conditions of Participation (CoPs). * Works ... Participate in the identification of clinical or operational performance improvement opportunities ...
RN Case Manager, Full-time
Raleigh, NC · On-site
... 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 · 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 · 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 · 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 · 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 ...
Oversee daily clinical operations across the GUIDE dementia care program. * Ensure plans of care ... Deliver care and services in accordance with ACHC Standards and Medicare Conditions of ...
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Oversee daily clinical operations across the GUIDE dementia care program. * Ensure plans of care ... Deliver care and services in accordance with ACHC Standards and Medicare Conditions of ...
Oversee daily clinical operations across the GUIDE dementia care program. * Ensure plans of care ... Deliver care and services in accordance with ACHC Standards and Medicare Conditions of ...
Oversee daily clinical operations across the GUIDE dementia care program. * Ensure plans of care ... Deliver care and services in accordance with ACHC Standards and Medicare Conditions of ...
Clinical Care Nurse (RN)
Raleigh, NC · 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 · On-site
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population ... 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 ...
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 ...
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-basedpopulation ... Support clinic operations through provider collaboration, care coordination, and community ...
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?
As of Jun 25, 2026, the average yearly pay for medicare operations manager in Raleigh, NC is $61,685.00, according to ZipRecruiter salary data. Most workers in this role earn between $39,900.00 and $75,300.00 per year, depending on experience, location, and employer.
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 is the highest paying job in healthcare management?
In healthcare management, executive roles such as Chief Executive Officer (CEO), Chief Operating Officer (COO), and Chief Financial Officer (CFO) tend to be the highest paying positions, often earning six-figure salaries or more. These roles require extensive experience, leadership skills, and often advanced degrees like an MBA or healthcare administration certification.
What are the key skills and qualifications needed to thrive as a Medicare Operations Manager, and why are they important?
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 are Medicare Operations Managers?
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.
Is ops manager higher than GM?
In most organizations, a General Manager (GM) typically holds a higher or broader leadership position than an Operations Manager (Ops Manager). The GM oversees multiple departments or the entire business unit, while the Ops Manager focuses specifically on managing daily operations within a department or area. The hierarchy can vary depending on the company's structure, but generally, the GM has greater overall responsibility.
What is a medicare manager?
A Medicare Operations Manager oversees the administration and compliance of Medicare insurance programs within an organization. They coordinate claims processing, ensure adherence to regulations, and often use healthcare management software to optimize operations. Strong knowledge of Medicare policies and leadership skills are essential for this role.
What are the 7 roles of an operations manager?
An operations manager is responsible for overseeing daily business activities, managing staff, ensuring efficient processes, implementing policies, coordinating between departments, monitoring performance metrics, and optimizing resource use. In a healthcare setting like Medicare, they also ensure compliance with regulations and improve service delivery. Strong leadership, organizational skills, and familiarity with healthcare systems are essential for this role.
What are popular job titles related to Medicare Operations Manager jobs in Raleigh, NC? For Medicare Operations Manager jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Medicare Operations Manager jobs in Raleigh, NC look for? The top searched job categories for Medicare Operations Manager jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Medicare Operations Manager jobs? Cities near Raleigh, NC with the most Medicare Operations Manager job openings:
Full-time
Posted 8 days ago
Job description
Company Description
About Client:
They help in transforming the leading organizations and communities around the world. Organizations infrastructure and culture is amazing. Best place!!
Job Description
Job Title: Health Payer Technology Medicare Consultant
Job Level: Senior LevelÂ
Job Description:Â
THIS IS WHAT YOU WILL DO...Â
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.Â
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!
Qualifications
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!
Additional Information
All your information will be kept confidential according to EEO guidelines.