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Medicare Operations Manager Jobs in Raleigh, NC (NOW HIRING)

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Claims Specialist (278635)

Durham, NC · On-site

$18 - $20/hr

... operations, or a related field. * Experience processing medical insurance claims, payment adjustments, and claim corrections. * Knowledge of Medicare, health insurance benefits, eligibility ...

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tenavistaffing

Nurse Practitioner

Angier, NC · On-site

$109K - $164K/yr

... operational environments. We are currently seeking a Data Analyst to support enterprise data and ... Medicare-age patients, helping identify care gaps, chronic condition management needs, and ...

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All JobsMedicare Operations JobsMedicare Operations Manager JobsMedicare Operations Manager Jobs in Raleigh, NC

Medicare Operations Manager information

See Raleigh, NC salary details

$30.1K

$61.7K

$115.2K

How much do medicare operations manager jobs pay per year?

As of Jul 17, 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?

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 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.
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:
Medicare Operations Manager jobs near you
Infographic showing various Medicare Operations Manager job openings in Raleigh, NC as of July 2026, with employment types broken down into 95% Full Time, and 5% Part Time. Highlights an 79% In-person, and 21% Remote job distribution, with an average salary of $61,685 per year, or $29.7 per hour.
Director of Finance

Director of Finance

First Choice Community Health Centers

Lillington, NC • On-site

Full-time

Medical, Dental, Vision, Retirement

Re-posted 11 days ago

Job description

Why Join First Choice Community Health Centers
Nestled in the heart of North Carolina, Harnett County offers a unique blend of small-town charm and convenient access to big-city amenities. Located less than an hour from both Raleigh and Fayetteville, residents enjoy the tranquility of rural living with the benefit of nearby urban excitement. 
At First Choice, we’re proud to offer employment opportunities in this beautiful area, giving you the chance to work in a close-knit community while staying connected to the vibrant Triangle region. With a perfect balance of peaceful + affordable living and easy access to cultural and career opportunities, Harnett County is an ideal place to call home.
Position Summary
The Director of Finance and Operations will oversee and serve as the manager of all financial activities/operations and ensure the corporation’s financial health. Develops and executes financial policies and procedures.  Principal responsibilities include overseeing the financial reporting, short range and long-term financial planning, general accounting, subsidiary corporation implementation and billing, audit coordination, taxes, banking, and monthly cash flow. Directly accountable for the functions of the general ledger, payroll, accounts payable, accounts receivable, grants accounting, budget preparation, logistics functions, information management systems and other related operations as may be necessary. Position may involve the performance management of subordinate employees. 
Benefits Offered

  • Company paid Medical Insurance
  • Dental and Vision insurance
  • Retirement Planning (403B)
  • Health Reimbursement Account (HRA)
  • 11 Paid Holidays

Essential Duties and Responsibilities

  • Serves as the primary business advisor to service line teams.
  • Collaborates with physicians and executive leadership to ensure accurate data usage and recommend enhancements based on industry trends.
  • Lead financial reporting and ensure regulatory compliance.
  • Develop internal accounting policies and controls.
  • Manage budgeting, forecasting, and financial operations.
  • Oversee audits and internal control activities.
  • Provide financial analysis and strategic support to executives.
  • Ensure compliance with all financial regulations.
  • Oversee billing and collections.
  • Oversee/handle bookkeeping and Accounting.
  • Asset Management (physical and financial).
  • Oversee accounting operations, managing accounting personnel, and providing training plus the recording of transaction and reconciliation of balance sheets.
  • Handle purchasing and Vendor Relations.

Education and Experience

  • Bachelor’s degree from a four-year college or university  
  • Two years related experience in a health care setting where Federal Medicare cost reporting is used or equivalent combination of experience and education or 5 years experience in accounting.
  • CPA is required, preferably in a business-related discipline. A MBA is strongly preferred. 
  • Applicable certification in computer network management plus two years experience of network management for multiple locations preferably within the medical industry.
  • Possess a minimum of 3 years of financial experience as Director or CFO level finance professional, preferably in the software, internet, technology or consulting medical services industry.
  • Strong leadership, communication and operations experience is required.
  • Knowledge of the principles and practice of not-for-profit health care organizations;
  • Knowledge of state and federal laws, as pertaining to HHS/HRSA-BPHC regulations and policies.
  • Knowledge of the structure and operations of federally qualified health centers (FQHC’s).
  • Experience with computerized accounting systems and spreadsheets.
  • Experience and understanding of computerized accounting systems, budgets, and financial data operations, third party billing, contracting, collections, and cost-reporting (Medicaid & Medicare).
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.
Tasks, duties, and responsibilities, as listed in this position description, are not exhaustive. The Organization, at its sole discretion and with no prior notice, may assign other tasks, duties, and job responsibilities. Equivalent experience, skills and/or education will also be considered, so qualifications of incumbents may differ from those listed in the Position Description. The Organization, at its sole discretion, will determine what constitutes as equivalent to the qualifications described above. Further, nothing contained herein should be construed to create an employment contract. Occasionally, required skills/experiences for jobs are expressed in brief terms.
 

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