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

... Medicare and Medicaid regulations for the successful operation of a nursing home Beauty Shop ... Records and submits daily sales records to Director/Manager. * Provides billing data to the ...

... Medicare and Medicaid regulations for the successful operation of a nursing home Beauty Shop ... Records and submits daily sales records to Director/Manager. * Provides billing data to the ...

Stakeholder Management: Serve as primary point of contact for asset requestors; manage expectations ... Operations Mindset: Comfortable with the day-to-day foundational work-Jira administration, status ...

... Commercial/Medicaid/Medicare) supporting pharmacy including claims processing and benefit ... Knowledge of systems capabilities and business operations. Job Level: Non-Management Exempt ...

New

Validation of Formulary, Utilization Management & Drug List setup using Claims/Query testing ... Knowledge of systems capabilities and business operations. Please be advised that Elevance Health ...

New

Identify new business opportunities and manage existing accounts to ensure customer satisfaction ... Communicate and explain Medicare, Medicaid, and private insurance procedures, pricing information ...

Identify new business opportunities and manage existing accounts to ensure customer satisfaction ... Communicate and explain Medicare, Medicaid, and private insurance procedures, pricing information ...

Certified Pharmacy Technician

Moncure, NC · On-site

$16.43 - $18.49/hr

... operations, able to assist Pharmacy Manager with operations. Able to begin daily pharmacy ... Medicare Part D. * Work Location: Moncure CHC - 7228 Moncure-Pittsboro Road, Moncure, NC 27559

Showing results 41-60

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 31, 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:
Infographic showing various Medicare Operations Manager job openings in Raleigh, NC as of July 2026, with employment types broken down into 84% Full Time, 13% Part Time, and 3% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $61,685 per year, or $29.7 per hour.

Administrator, Eye Institute Surgery Center

Advocate Aurora Health

Wake Forest, NC • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago


Advocate Aurora Health rating

7.6

Company rating: 7.6 out of 10

Based on 773 frontline employees who took The Breakroom Quiz

185th of 885 rated healthcare providers


Job description

Department:
70100 Wake Forest Ambulatory Ventures: Winston Salem Eye Institute - Surgery Center
Status:
Full time
Benefits Eligible:
Yes
Hours Per Week:
40
Schedule Details/Additional Information:
Regular - Monday - Friday 40 hrs per week
Pay Range:
$59.00 - $88.50
Administrative responsibility for all functions of the Surgery Center(s), including, but not limited to, basic accounting, budgeting and productivity monitoring; personnel administration, guidelines and regulations of external accrediting agencies; and equipment/supplies necessary for provision of services. Enforces compliance with mission/ goals, policies/procedures, and relevant regulations, including Medicare, OSHA, HIPAA, and Corporate Compliance. Maintains all standards required for state licensure of the Surgery Center(s) and AAAHC accreditation. Evaluates the quality of service delivered to all customer groups. Works collaboratively with physicians, hospital administrators and other health system employees. Supervised by: Board of Directors
ESSENTIAL FUNCTIONS:
Develop goals and objectives for the department and administer policies, procedures and departmental processes as needed. Prepare departmental scorecard information based on strategic plan.
Responsible for all clinical, financial and personnel functions of Ambulatory Surgery Center(s). Responsible for compliance with all federal regulations applicable to ASCs (including Medicare ASC Conditions of Pat1icipation, OSHA, HIPAA, etc.), accreditation standards (AAAHC), state ASC licensure requirements, and CDC Infection Control guidelines.
Develops new policies and procedures as necessary and reviews current policies and procedures annually.
Prepares annual budget and all agendas with supporting documents for quarterly and special meetings of the Board of Directors and other committees of the board. Responsible for credentialing, appointment and reappointment of all Medical and Allied Health staff and approval of on-site students. Reviews and updates Medical Staff Bylaws in collaboration with attorneys and physician committees to assure compliance with regulatory and licensure requirements.
Responsible for development, implementation, oversight and annual updates to the Quality Assessment and Improvement and Risk Management programs. Responsible for oversight of the Safety Program. Maintains custody of all official documents in locked file rooms or office.
Evaluates equipment purchases and new services for feasibility, profitability and efficiency. Utilizes attorneys, CPAs, architects, consultants, etc. as needed.
Effectively communicates delegated responsibilities to subordinates as evidenced by a productive and supportive staff; Utilizes proper channels of communication to keep Administration updated on problems/needs related to patient care, clinical personnel, allied health personnel and surgeons.
Assesses complex situations, financial reports, and staffing to improve operations and profitability; Coordinates the planning and changing of programs/services for meeting patient care/nursing staff needs and nursing informational needs.
Performs other duties as assigned by management.
SKILLS/QUALIFICATIONS:
Excellent oral and written communication skills
Strong interpersonal skills
Ability to develop and enforce policies and procedures and Medical Staff Bylaws and Rules and Regulations
Ability to maintain positive working relationships with the Board of Directors, physicians, allied health staff, surgery center staff, and Medical Director
Assess complex situations, financial reports, and staffing to improve operations and profitability
Maintain positive public relations.
EDUCATION/EXPERIENCE: Bachelor's degree required with three years of management experience in a health care setting. MBA, MHA, or comparable degree and more than three years of experience preferred.
WORK ENVIRONMENT:
Clean, well-lit, comfortable office setting. Clean, indoor office environment Ability to travel locally and nationally as required PHYSICAL REQUIREMENTS: 0% 35% 65% to to to 35% 65% 100% N/A Activity X Standing X Walking X Sitting X Bending X Reaching with arms X Finger and hand dexterity X Talking X Hearing X Seeing Lifting, carrying, pushing and or pulling: X 20 lbs. maximum X 50 lbs. maximum X 100 lbs. maximum
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
Compensation
  • Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
  • Premium pay such as shift, on call, and more based on a teammate's job
  • Incentive pay for select positions
  • Opportunity for annual increases based on performance

Benefits and more
  • Paid Time Off programs
  • Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
  • Flexible Spending Accounts for eligible health care and dependent care expenses
  • Family benefits such as adoption assistance and paid parental leave
  • Defined contribution retirement plans with employer match and other financial wellness programs
  • Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

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About Advocate Health

Sourced by ZipRecruiter

Advocate Healthcare, based in Oak Lawn, Illinois, United States, is a leading figure in the health care industry. Accessible via their official website, 'advocatehealth.com', this organization provides a wide variety of medical services and treatment options. Founded in 1995 through a merger of Evangelical Health Systems Corporation and Lutheran General HealthSystem, Advocate Healthcare has grown exponentially over the years. Now, it operates more than 400 sites of care, including 12 hospitals that encompass 11 acute care hospitals, the state’s largest integrated children’s network, five Level I trauma centers, and three Level II trauma centers. Upholding their values of equality, compassion, excellence, partnership and stewardship, Advocate Healthcare's mission is centered on building lifelong relationships with patients by delivering the best health outcomes and highest level of service through an integrated approach to care and wellness.

Industry

Hospitals and health care and social assistance

Company size

10,000+ Employees

Headquarters location

Charlotte, NC, US