Manager, Revenue Cycle - InRule Administration

Cardinal Health

2d•$89,000 - $114,480

About The Position

The Manager, Revenue Cycle – InRule Administration is the hands-on owner of payer-specific business rules and decision logic within InRule, the rules engine integrated with Brightree across Cardinal Health’s DME businesses. The role translates payer policies, coverage criteria, reimbursement requirements, and operational needs into accurate, scalable system rules, and administers and optimizes InRule so payer requirements are applied throughout end-to-end order-to-cash workflows with Brightree. As a technical expert supporting the payer rules function, this position works with payer rules analysts, configuration specialists, Revenue Cycle partners, IT, and other technical stakeholders. It operates within the payer rules governance framework and provides technical direction and coaching without direct people-management responsibility.

Requirements

Five or more years of hands-on experience in healthcare technology, payer configuration, business-rules administration, systems configuration, or a related technical function is preferred.
Direct experience developing and administering a business-rules engine, decision-management platform, or comparable rules-based technology.
Ability to independently author, debug, and optimize complex rules and decision logic without relying on an IT developer to perform the technical work.
Ability to translate complex business requirements into technical rules and decision logic within a rules engine, including downstream system configuration.
Experience with rule development/configuration, testing, debugging, deployment, version control, and production support.
Ability to troubleshoot rule execution, configuration defects, data dependencies, and system-processing issues.
Experience partnering with technical teams on system integrations, data flows, APIs/interfaces, or application configuration, including SQL or equivalent data fluency to trace and validate data feeding rules.
Strong understanding of healthcare payer policies, coverage requirements, reimbursement, and claims processes.
Ability to operate as a technical expert within a larger team, influencing through expertise and collaboration rather than reporting lines.

Nice To Haves

Bachelor’s degree in a related field, or equivalent work experience.
Experience with InRule; comparable rules-engine or decision-management platform experience will also be considered.
Brightree or other healthcare/DME platform experience, particularly building rules or logic that integrate with such a platform rather than residing inside it.

Responsibilities

Serve as the technical owner and subject matter expert for the InRule environment, including rule authoring, decision logic, rule set design, testing, troubleshooting, deployment, and ongoing optimization.
Translate payer policies, coverage criteria, reimbursement requirements, and operational needs into technical business rules and decision logic in InRule.
Develop, refactor, and tune rules, decision tables, and reusable rule components to keep the environment scalable and maintainable.
Apply and maintain payer rules governance standards for development, testing, approval, deployment, version control, and change management, and recommend improvements.
Perform impact analysis, testing, validation, and troubleshooting of rule and configuration changes before and after production deployment.
Maintain a centralized inventory of payer rules, configuration, dependencies, and changes for accuracy and traceability.
Monitor rule performance and identify configuration defects, conflicting logic, processing exceptions, and optimization opportunities.
Partner with Revenue Cycle and Payer Relations/Market Access to translate payer changes, denial trends, and operational findings into rule updates and related system changes.
Identify ways to prevent denials, unbilled revenue, and manual rework through improved rules configuration and automation.
Provide technical direction, design review, and coaching to payer rules analysts and configuration specialists without direct people-management responsibility.
Partner with IT and other technical stakeholders on the InRule–Brightree integration, data dependencies, environment management, releases, and production support.
Bridge business requirements and the rules engine, translating requirements into scalable, maintainable rule logic.
Support new payer implementations, acquisitions, integrations, and future-state system migrations.