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Medicare Operations Manager Jobs (NOW HIRING)

Wipro Limited

Medicare BPO

Jefferson City, MO · On-site

... in managing and processing Medicare claims with precision and attention to detail. This role ... Background in healthcare operations or claims processing is advantageous. Skills and Knowledge

Infinx Healthcare

AR Manager | Medicare

$42 - $48/hr

ABOUT THE ROLE The Billing Operations & Medicare AR Manager is responsible for overseeing Hospital Billing (HB) and Professional Billing (PB) billing operations, ensuring the timely and accurate ...

Shepherd Insurance

Medicare Specialist

Indianapolis, IN · On-site

Shepherd Insurance is a privately-owned insurance agency that has delivered risk management ... Identify process improvements and contribute to enhancing operational workflows across the Medicare ...

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Medicare Operations Manager information

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$31K

$63.5K

$118.5K

How much do medicare operations manager jobs pay per year?

As of Jun 30, 2026, the average yearly pay for medicare operations manager in the United States is $63,456.00, according to ZipRecruiter salary data. Most workers in this role earn between $41,000.00 and $77,500.00 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 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.
More about Medicare Operations Manager jobs
What cities are hiring for Medicare Operations Manager jobs? Cities with the most Medicare Operations Manager job openings:
What are the most commonly searched types of Medicare Operations jobs? The most popular types of Medicare Operations jobs are:
What states have the most Medicare Operations Manager jobs? States with the most job openings for Medicare Operations Manager jobs include:
What job categories do people searching Medicare Operations Manager jobs look for? The top searched job categories for Medicare Operations Manager jobs are:
Medicare Operations Manager jobs near you
Infographic showing various Medicare Operations Manager job openings in the United States as of June 2026, with employment types broken down into 99% Full Time, and 1% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $63,456 per year, or $30.5 per hour.

Operations Manager, Health Economics & Info

Metropolitan Jewish Health System

Manhattan, NY • On-site

$86K - $103K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted yesterday

Key responsibilities

  • Coordinate multiple projects, oversee day-to-day staffing, and administer all standard operating procedures.

  • Oversee project management, change control, test plan development, and documentation for operational data store activities under the guidance of the Director.

  • Manage and prioritize ad-hoc and standardized reporting needs, oversee peer review processes, and provide recommendations based on staff productivity and system performance metrics.

Job description

Overview
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
The MJHS Difference
At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.
Benefits include:
  • Tuition Reimbursement for all full and part-time staff
  • Generous paid time off, including your birthday!
  • Affordable and comprehensive medical, dental and vision coverage for employee and family members
  • Two retirement plans! 403(b) AND Employer Paid Pension
  • Flexible spending
  • And MORE!

MJHS companies are qualified employers under the Federal Government's Paid Student Loan Forgiveness Program (PSLF)
Responsibilities
The manager will coordinate multiple projects, oversee day-to-day staffing, and administer all standard operating procedures.
Operational Data Store
  • Under guidance of Director, oversee project management for all operational data store activities.
  • Work closely with Analysts to create new functional specifications for enhancements or to improve existing logic based on changing business needs.
  • Owner of change control process and documentation for each approved modification.
  • Oversee test plan development, documentation and implementation process.
  • Oversee creation of training documentation for new or updated designs for day-to-day data usage.

Operations Ad-Hoc Reporting
  • Under guidance of Director and in collaboration with business owners, manage projects and prioritize all new reporting needs for daily on-demand and auto-delivered data.
  • Oversee peer review process, ensuring quality and accuracy standards are met.

Operations Standardized Reporting
  • Identify ad-hoc reporting that can be converted to standardized reporting for enhanced automation and increased efficiency.
  • Recommend technological enhancements for improved standardized reporting.

Monitor Staff Productivity and System Performance
  • Obtain functional requirements from business users on how they want to monitor staff productivity. Prepare confidential reports to fulfill this need.
  • Time extracts and reports to oversee the length of time required for each. Merge with overall system performance metrics to provide recommendations to senior leadership.

We truly value our staff and further acknowledge their contributions by offering:
  • Employee and family health coverage
  • Competitive salaries
  • Employer contributed pension plan
  • Generous time off
  • Tuition reimbursement
  • 403(b) retirement plan

Qualifications
Bachelor's Degree in Statistics, Economics, Business or other related field required. Graduate Degree (MBA or CPA) in Statistics, Healthcare, Economics or Business preferred.
5 years experience in Healthcare Economics, Statistics, Data Analysis, Financial Reporting, Actuary, Managed Care, and/or Long Term Care operations experience required. Medicare and/or Medicaid Managed Care experience required. Experience with regulatory reporting required.
Knowledge of CMS & NYS DOH regulations preferred. Experience calculating IBNR, BCR (Benefic Cost Ratios) and other metrics preferred. Experience formulating MMCOR and encounter data preferred. Experience developing rate filings including Medicare Advantage Part C & D and MLTC preferred. Management experience preferred. Excellent organizational skills. Ability to work on multiple projects. Excellent Word, Excel, Access, Project, Visio skills. Excellent SQL Server 2008R2 (or better) skills with Reporting Services preferred.
Min
USD $86,351.78/Yr.
Max
USD $103,622.14/Yr.

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