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

Centerwell

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 ...

Aveanna Healthcare

HHH - Clinical Manager

Raleigh, NC · On-site

Serves as the clinical expert and assists with the operational and financial management of the ... Medicare Skilled Nursing experience and a basic understanding of OASIS * 3+ years RN experience in ...

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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Showing results 21-40

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 Aug 7, 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?

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 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 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 August 2026, with employment types broken down into 85% Full Time, 12% Part Time, 1% Temporary, and 2% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $61,685 per year, or $29.7 per hour.

Home Health RN Clinical Manager 10K Sign On Bonus

Aveanna Healthcare

Raleigh, NC

$95K - $110K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 21 days ago

Aveanna Healthcare rating

6.7

Company rating: 6.7 out of 10

Based on 202 frontline employees who took The Breakroom Quiz

63rd of 239 rated social care providers

Job description

Position Overview

The RN Clinical Manager – Home Health works under the direction and guidance of the Branch Administrator to provide supervision of all clinical staff working with high medical acuity clients and/or clients receiving extended non‐licensed support services. This leader is responsible to provide staff orientation and ensure competence as a Preceptor and or ensure RN Case Manager/Preceptor resources are in place. Ensures that services are delivered according to licensing guidelines, professional medical standards and agency policies and procedures.

** This role has a 10% incentive plan **

Essential Job Functions:

  • Plans, develops, and manages the clinical programs, services, activities, and employees of the agency consistent with company policy and regional management directives.
  • Assists with the oversight of the agency’s growth related to home care.
  • Serves as the clinical expert and assists with the operational and financial management of the agency.
  • Investigate and take appropriate actions on client/consumer complaints.
  • Participate in the recruiting, hiring, and identifying the training needs of clinical staff
  • Evaluates programs and services regularly to identify opportunities for improvement.
  • Conducts regular client home visits to ensure quality of care and performs home visits as needed.
  • Ensures client compliance with federal/state regulations through policy and procedure administration to staff.
  • Supervises all clinical staff (RN/LPN/CNA) and perform annual employee evaluations for all clinical staff.
  • Responsible for overseeing case management to ensure services that are financially sound.
  • Manage caseload as needed for client coverage.

Requirements:

  • Registered Nurse licensure in the state of practice.
  • Obtain and maintain active CPR per agency policy.
  • Bachelor’s degree preferred
  • Medicare Skilled Nursing experience and a basic understanding of OASIS
  • 3+ years RN experience in a healthcare setting (home health preferred)
  • Valid CPR

Hey, dont let me forget to review this with you when you start to make reqs again please

Comprehensive Benefits (Full-time positions)

Aveanna offers benefits designed to support you inside and outside of work, including:

  • Competitive pay
  • Medical, Dental, Vision, and Life insurance
  • Voluntary Pet Insurance for your fur babies
  • 401(k) with Company match
  • Vacation time, Sick time, Paid Holidays, and Floating Holidays
  • Tuition reimbursement and tuition discounts
  • Free continuing education units (CEUs) for nurses
  • Employee Assistance Program and Employee Relief Fund
  • Employee Stock Purchase Plan

Our Mission

Our mission is to revolutionize the way homecare is delivered, one patient at a time. We are committed to innovation, clinical excellence, and compassionate care—because outcomes improve when care is personal. Join the revolution and make a meaningful difference in the lives of patients and families every day.

HHH

As an employer accepting Medicare and Medicaid funds, employees must comply with all health-related requirements in all relevant jurisdictions, including required vaccinations and testing, subject to exemptions for medical or religious reasons as appropriate.

Notice for Job Applicants Residing in California

Notice for Job Applicants Residing in Florida

What Aveanna Healthcare employees say

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Benefits

Hours and flexibility

Workplace

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About Aveanna

Sourced by ZipRecruiter

Aveanna Healthcare is one of the nation's leading providers of pediatric and adult homecare in the nation. We lead with clinical quality and compassion, delivering care in over 200 locations in 23 states. While we have a national presence, we are very much a local provider in each community we serve. Our stated mission is to revolutionize the way pediatric healthcare is delivered, one patient at a time, and we hope you will help us fulfill that mission by joining the 30,000 nurses who already call Aveanna home. Apply today.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Atlanta, GA, US

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