Cardinal Health

Manager,NetworkIntegrity

$105–135k United States FULL TIME
The Brief

“Manager, Network Integrity at Cardinal Health. Skills: credentialing strategy, network management, Medicaid growth strategy, cross-functional leadership. Oversee and direct credentialing, re-credentialing, and enrollment activities. Develop, implement, and refine credentialing strategy”

What You'll Achieve.

ensuring accuracy and timely completion of credentialing; align with company's growth objectives; ensure audit-readiness and compliance; prevent claim denials; ensure revenue integrity; grow the company's Medicaid Fee-for-Service and Managed Care organization footprint; ensure all stakeholders are aligned on network status, risk updates, and process improvements that affect the organization's bottom line

Industry & Context.

Problems you'll solve

analytical capabilities; analyze complex operational metrics; synthesize them into clear, actionable insights

What They're Looking For.

Must Have

5+ years of experience in credentialing, network management, or provider enrollment, Proven leadership experience, Proven ability to design, build, and execute a comprehensive strategic roadmap for credentialing operations and network footprint expansion, analytical capabilities, Exceptional written, verbal, and presentation skills, Deep subject matter expertise in Medicaid policy and administrative guidelines, Proven success in spearheading network growth strategies, Comprehensive knowledge of federal and state healthcare compliance standards, accreditation guidelines and quality assurance related to provider credentialing and network integrity

Nice to Have

Managed these processes within the Durable Medical Equipment (DME), Home Medical Equipment (HME), or DMEPOS industry, Relevant experience in the payer space a plus

What You'll Do.

Oversee and direct credentialing

and enrollment activities

and refine credentialing strategy

Maintain a robust quality assurance process for credentialing files

Optimize internal reporting mechanisms for credentialing and network data

Translate complex regulatory changes into actionable operational guidelines

Lead strategic planning and execution for Medicaid footprint growth

Identify new market opportunities and guide application/contracting processes

Assess financial and operational viability of new Medicaid markets

Serve as primary liaison between Network Management

Collaborate with RCM leaders to troubleshoot credentialing issues

Lead cross-functional meetings for stakeholder alignment

How You'll Work.

Team & Collaboration

Ensuring alignment between credentialing, legal, and payer relations functions; Bridging Network Management and Revenue Cycle teams; Partner with leadership to assess viability of new Medicaid markets; Serve as primary liaison connecting internal dots between departments; Proactively collaborate with RCM leaders; Lead cross-functional meetings to ensure stakeholder alignment

Communication Scope

Exceptional written, verbal, and presentation skills; experience presenting complex operational and regulatory strategies

Process & Methodology

strategic roadmap for credentialing operations, network footprint expansion

Free ATS check

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