Remote Revenue Cycle & Payer Rules Manager

Cardinal Health; Juneau (AK); Remote; USD 89,000 - 114,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off plan

Health savings account (HSA)

401k savings plan

Access to wages before pay day with my

Flexible spending accounts (FSAs)

Short- and long-term disability

Work-Life resources

Paid parental leave

Healthy lifestyle programs

Job summary

Cardinal Health is seeking a Manager for Payer Rules & Revenue Cycle Optimization to lead a three-FTE team and oversee payer rule administration. You will translate contracts and policies into system rules across Brightree and InRule, ensuring timely applicability, testing, and governance.

The role collaborates with IT, business units, and external partners to reduce denials and accelerate collections. Strong leadership, healthcare revenue cycle expertise, and knowledge of payer requirements are

Qualifications

• Bachelor's degree in healthcare administration, business, finance, information systems, or related field, or equivalent experience.
• 5+ years in healthcare revenue cycle, payer operations, reimbursement, or related areas.
• Demonstrated leadership or supervision of staff.
• Strong knowledge of payer requirements, claims processing, denials, and translating needs into system rules.
• Experience coordinating system configurations, change controls, testing, audits, and process improvement.
• Brightree, InRule, or comparable rules engines; Medicare/Medicaid/payer requirements; EDI and clearinghouse processes preferred.

Responsibilities

• Lead a team of three FTEs; set priorities, allocate work, monitor quality and productivity.
• Oversee readiness for new payer contracts and updates to existing agreements.
• Translate payer contracts and policies into actionable system rules and SOPs across RCM.
• Maintain payer-specific configurations in Brightree and InRule, including coverage, modifiers, eligibility, and documentation.
• Collaborate with IT, vendors, and clearinghouses to test and implement rule changes.
• Establish governance for intake, approvals, and validation of payer rule changes.
• Monitor payer policy updates and communicate impacts to relevant teams.
• Analyze denials and variances to identify system gaps and remediation.
• Implement upstream controls to reduce denials and revenue leakage.
• Drive metrics and reporting on contract implementation and denial trends.

Skills

Leadership

Payer rules

Billing systems

Brightree

InRule

Denials analysis

Contract management

Healthcare operations

Education

Bachelor's degree in healthcare administration or related field

Tools

Brightree

InRule

EDI / Clearinghouse knowledge

Job description

Cardinal Health is seeking a Manager for Payer Rules & Revenue Cycle Optimization to lead a three-FTE team and oversee payer rule administration. You will translate contracts and policies into system rules across Brightree and InRule, ensuring timely applicability, testing, and governance.

The role collaborates with IT, business units, and external partners to reduce denials and accelerate collections. Strong leadership, healthcare revenue cycle expertise, and knowledge of payer requirements are