Remote Payer Rules & RCM Optimization Manager

Cardinal Health; Olympia (WA); A distancia; USD 89.000 - 114.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental and vision coverage

Paid time off

Health savings account (HSA)

401k savings plan

Life and disability coverage

Descripción de la vacante

Cardinal Health seeks a Manager, Payer Rules & Revenue Cycle Optimization to lead a three-person team, translate payer contracts into actionable rules, and drive operational readiness across contracts and policy updates. You will collaborate with Payer Relations, Market Access, IT, and operations to improve billing accuracy and reduce denials.

The role requires expertise in Brightree and InRule, knowledge of payer policies, and a track record of optimizing revenue cycle performance in a

Formación

• Bachelor's degree in healthcare administration, business, finance, information systems, or related field; or equivalent experience preferred.
• 5+ years in healthcare revenue cycle, payer operations, reimbursement, billing systems, or payer rules preferred.
• Demonstrated leadership or supervision of staff.
• Strong knowledge of payer contractual and billing requirements; claims processing and denial management.
• Experience coordinating system configurations, change controls, testing and cross-functional process improvement; strong analytical and communication skills.
• Brightree, InRule, or comparable rules engines; Medicare, Medicaid, and commercial payer requirements; EDI and clearinghouse processes preferred.

Responsabilidades

• Lead, coach, and manage a team of three FTEs; set priorities, allocate work, monitor quality and productivity.
• Oversee end-to-end readiness for new payer contracts, renewals, amendments, and updates to existing agreements.
• Translate payer contracts and billing guidelines into actionable system rules and SOPs across RCM.
• Own configurations within Brightree and InRule, including HCPCS, eligibility, and denials.
• Coordinate with IT and vendors to test changes, validate results, and resolve rule conflicts.
• Develop governance for payer rule changes with ownership, change logs, and status updates.

Conocimientos

Team leadership

Payer rules

Revenue cycle

Denial management

Brightree

InRule

System configuration

Educación

Bachelor's degree in healthcare administration, business, finance, IT, or related field

Herramientas

Brightree

InRule

EDI systems

Clearinghouses

Descripción del empleo

Cardinal Health seeks a Manager, Payer Rules & Revenue Cycle Optimization to lead a three-person team, translate payer contracts into actionable rules, and drive operational readiness across contracts and policy updates. You will collaborate with Payer Relations, Market Access, IT, and operations to improve billing accuracy and reduce denials.

The role requires expertise in Brightree and InRule, knowledge of payer policies, and a track record of optimizing revenue cycle performance in a