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Payer Operations Manager Jobs in California (NOW HIRING)

Medvidi

Payer Operations Coordinator

San Jose, CA · On-site +1

You'll help manage payer contracting and credentialing workflows, prepare and track payer ... Track and report key operational metrics, including application aging, payer turnaround times ...

Fay

Business Operations

San Francisco, CA · On-site

... Management * Build and maintain the operating cadence across Member Experience, Provider Growth & Operations, Clinical Operations, and Payer Operations * Own weekly metrics reviews, OKR tracking, and ...

Infusion4Health Inc

Payer Contract Specialist

Brea, CA · On-site

$75K - $90K/yr

Provide administrative and operational support throughout the payer and IPA contracting lifecycle ... Update and maintain the organization's contract management system or centralized contract ...

New

Ra

Health Care Analyst (Medicare)

Los Angeles, CA · Remote

Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ... Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM ...

Ra

Health Care Analyst (Medicare)

El Segundo, CA · Remote

Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ... Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM ...

Ra

Health Care Analyst (Medicare)

San Jose, CA · Remote

Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ... Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM ...

Ra

Health Care Analyst (Medicare)

San Diego, CA · Remote

Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ... Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM ...

Ra

Health Care Analyst (Medicare)

San Francisco, CA · Remote

Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ... Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM ...

Ra

Health Care Analyst (Medicare)

Orange, CA · Remote

Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ... Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM ...

Ra

Health Care Analyst (Medicare)

Sacramento, CA · Remote

Who holds 2+ years' experience in US Payer operations & US Payer system implementations! Who is ... Who holds 2+ years Program management, full lifecycle project, SDLC, Agile, Waterfall, SCRUM ...

Mochi Health

Operations Manager

San Francisco, CA · On-site

$130K - $150K/yr

About the Role We are looking for a Manager of Operations to join our Ops team as a flexible, high ... Payer Operations team). * Transition fluidly onto new priority projects as they arise without ...

Mochi Health

Operations Manager

San Francisco, CA · Remote

$130K - $150K/yr

About the Role We are looking for a Manager of Operations to join our Ops team as a flexible, high ... Payer Operations team). * Transition fluidly onto new priority projects as they arise without ...

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Payer Operations Manager information

What is a payer operations manager?

A Payer Operations Manager oversees the administrative and operational functions related to health insurance payers, such as insurance companies or managed care organizations. Their responsibilities typically include managing claims processing, ensuring compliance with regulatory requirements, optimizing reimbursement processes, and working to improve relationships between healthcare providers and payers. They play a crucial role in streamlining operations, improving efficiency, and ensuring that payments are accurate and timely. Payer Operations Managers often collaborate with a variety of stakeholders, including internal teams, insurance partners, and healthcare providers.

What are some typical challenges faced by a payer operations manager, and how can they be addressed?

Payer Operations Managers often navigate complex relationships between healthcare providers, insurance companies, and internal teams. Common challenges include managing regulatory changes, streamlining claims processing, and ensuring compliance with payer contracts. Addressing these requires strong communication skills, staying up-to-date with industry regulations, and leveraging technology to automate workflows. Building collaborative relationships across departments is essential to efficiently resolve issues and maintain service quality.

What are the key skills and qualifications needed to thrive as a payer operations manager, and why are they important?

To thrive as a Payer Operations Manager, you need expertise in healthcare operations, payer-provider relations, and a strong understanding of insurance regulations, typically backed by a bachelor’s degree in healthcare administration or a related field. Familiarity with claims management systems, EDI transactions, and data analytics tools is crucial. Strong leadership, problem-solving abilities, and effective communication skills help you manage teams and resolve operational challenges efficiently. These competencies ensure streamlined payer processes, regulatory compliance, and improved healthcare outcomes.

What is the difference between Payer Operations Manager vs Payer Account Manager?

AspectPayer Operations ManagerPayer Account Manager
Primary FocusOversees payer processes, claims, and reimbursement operationsManages relationships and negotiations with specific payer accounts
Required SkillsClaims processing, compliance, operational workflowsCustomer service, account management, negotiation skills
Work EnvironmentOperations teams, healthcare organizations, insurance companiesSales, client relations, account management teams
CertificationsTypically requires healthcare or insurance certificationsOften requires sales or account management certifications

The Payer Operations Manager focuses on the internal processes related to payer reimbursements and claims, ensuring smooth operations. In contrast, the Payer Account Manager concentrates on maintaining and growing relationships with specific payer clients. Both roles require healthcare industry knowledge but serve different functions within the payer ecosystem.

What cities in California are hiring for Payer Operations Manager jobs?

Cities in California with the most Payer Operations Manager job openings:

Infographic showing various Payer Operations Manager job openings in California as of June 2026, with employment types broken down into 99% Full Time, and 1% Temporary. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution.

Payer Operations Coordinator

Medvidi

San Jose, CA • On-site, Remote

Full-time

Posted 6 days ago

Job description

Description
About MEDvidi
MEDvidi is a fast-growing, multi-state telehealth practice providing behavioral health and psychiatric care to adults across the United States.
As we continue to scale, we are building the commercial insurance infrastructure that will support our next stage of growth. We're looking for people who are energized by a startup environment-people who are comfortable building processes while executing them, identifying inefficiencies, and using technology to make operations smarter and more scalable.
About the Role
MEDvidi is seeking a Payer Operations Coordinator to help build and execute our growing payer operations function.
This is a hands-on role at the intersection of payer operations, healthcare administration, process improvement, and AI-powered automation.
You'll help manage payer contracting and credentialing workflows, prepare and track payer applications, maintain accurate enrollment data, follow up persistently with payers, and ensure applications move from submission through approval.
Just as importantly, we don't want someone who simply follows an existing process. We're looking for someone who naturally asks:
"How can we make this faster, more accurate, and less manual?"
You'll be expected to identify repetitive or error-prone work and help build AI-enabled workflows, automations, templates, dashboards, and scalable processes to improve the way our payer operations function works.
Responsibilities
What You'll Do
  • Execute payer contracting, credentialing, and enrollment activities, including preparing and submitting payer applications and tracking them through approval.
  • Maintain accurate and up-to-date payer enrollment, credentialing, contracting, and provider-readiness trackers.
  • Conduct persistent follow-up with payers through phone, email, and payer portals to confirm application status, resolve deficiencies, and move outstanding items to completion.
  • Own assigned applications and operational tasks end-to-end rather than waiting for others to drive next steps.
  • Track and report key operational metrics, including application aging, payer turnaround times, deficiencies, approval rates, and provider readiness.
  • Identify repetitive, manual, and error-prone steps across payer and credentialing workflows.
  • Build and implement AI-powered workflows and automation solutions that reduce manual work and improve speed, accuracy, and scalability.
  • Develop standardized templates, trackers, documentation, and dashboards as processes evolve.
  • Test new tools and approaches and continuously look for opportunities to improve existing workflows.
  • Partner closely with Clinical Operations, Product, Compliance, and other internal stakeholders.
  • Help build structure in an evolving function where processes may not yet be fully defined.

Requirements
Must-Have Qualifications
  • 2-4 years of professional experience in a fast-paced startup, consulting, strategy, operations, or similarly high-growth environment.
  • Demonstrated experience building, implementing, or significantly improving automated workflows using AI and/or automation tools.
  • Ability to provide concrete examples of processes you have automated, streamlined, or redesigned.
  • Strong operational and problem-solving mindset-you notice inefficient processes and actively look for better ways to execute them.
  • Excellent written and verbal communication skills.
  • Comfortable conducting persistent outbound follow-up by phone and email.
  • Exceptional attention to detail and ability to manage multiple workstreams, trackers, deadlines, and priorities simultaneously.
  • Strong Excel and/or Google Sheets skills.
  • Self-directed and comfortable owning work from initial assignment through resolution with minimal oversight.
  • Comfortable working in a startup environment where processes are evolving and you may be helping build the playbook while executing it.
  • Curious, adaptable, and comfortable learning new systems and technologies quickly.

Preferred Qualifications
Healthcare payer or credentialing experience is valuable, but we are also interested in strong operators from startup, consulting, and high-growth environments who can learn quickly.
Preferred experience includes:
  • Revenue cycle management, payer enrollment, provider credentialing, or related healthcare operations.
  • CAQH ProView and payer credentialing/enrollment portals.
  • Behavioral health, telehealth, or multi-state healthcare operations.
  • NPI, DEA, and other provider credentialing data.
  • Building automated workflows within healthcare or other complex, highly regulated organizations.
  • Creating dashboards, reporting tools, or operational tracking systems.
  • Working cross-functionally with Product, Operations, Compliance, or technical teams.
  • Supporting or coordinating with offshore or outsourced teams.

You'll Thrive Here If You...
You enjoy environments where there isn't always an established playbook.
You're comfortable moving between detailed execution and process improvement-you can spend part of your day tracking down a payer application and another part figuring out how technology could eliminate ten manual steps from that process.
You take ownership. If something is stuck, you investigate it, follow up, escalate when necessary, and keep going until it's resolved.
You are genuinely interested in AI and automation as practical business tools, not just buzzwords, and you have already experimented with or implemented technology to make work more efficient.
Most importantly, you enjoy building. MEDvidi is creating this function for scale, and you'll have the opportunity to help shape how the work gets done.
Compensation
The anticipated salary range for this full-time position is $60,000-$68,000 annually, based on experience and qualifications.
Why Join MEDvidi?
This is an opportunity to join a growing healthcare organization at a stage where your work can have a direct impact on how an important operational function is built.
You'll have the opportunity to combine healthcare operations with emerging AI and automation capabilities, work cross-functionally across the organization, and help create systems and workflows designed to scale with MEDvidi's continued growth.

Apply