RCM Payer Rules Manager — Revenue Optimization

Cardinal Health; Dover (DE); Remote; USD 89,000 - 114,000; Full time

Benefits offered by this job

Medical, dental and vision

401k

HSA

PTO

FSAs

Disability coverage

Work-Life resources

Paid parental leave

Wellness programs

Job summary

Cardinal Health seeks a Manager, Payer Rules & Revenue Cycle Optimization to lead the operational implementation and maintenance of payer rules across the revenue cycle. You will oversee a team of three FTEs and ensure new and existing payer agreements are translated into workflows and system configurations with Brightree and InRule.

The role partners with Payer Relations, Market Access, IT, and Business Transformation to improve billing accuracy, prevent denials, accelerate collections, and

Qualifications

• Bachelor's degree in healthcare administration, business, finance, information systems, or related field.
• 5+ years in healthcare revenue cycle, payer operations, reimbursement, or payer rules.
• Leadership or supervision experience of staff.
• Strong knowledge of payer contractual and billing requirements and denials.

Responsibilities

• Lead and coach a team of three FTEs, set priorities, allocate work, monitor quality and productivity.
• Oversee readiness for new payer contracts, renewals, amendments, and updates to agreements.
• Translate payer contracts and policies into actionable system rules and SOPs across RCM stages.
• Maintain payer-specific configurations in Brightree and InRule, including coverage and eligibility.
• Collaborate with IT, vendors, and clearinghouses to test changes and resolve conflicts.
• Develop governance for payer rule changes with ownership and change logs.
• Monitor payer updates (Medicare, Medicaid, commercial) and communicate requirements to teams.

Skills

Leadership

Payer rules knowledge

Analytical skills

Problem solving

Communication

Education

Bachelor's degree

Tools

Brightree

InRule

EDI/ Clearinghouse

Job description

Cardinal Health seeks a Manager, Payer Rules & Revenue Cycle Optimization to lead the operational implementation and maintenance of payer rules across the revenue cycle. You will oversee a team of three FTEs and ensure new and existing payer agreements are translated into workflows and system configurations with Brightree and InRule.

The role partners with Payer Relations, Market Access, IT, and Business Transformation to improve billing accuracy, prevent denials, accelerate collections, and