Manager, Network Integrity

Cardinal Health

Olympia, WA

Apply

JOB DETAILS

SKILLS

Analysis Skills, Billing, Business Support, Cash Flow, Coaching, Cross-Functional, Durable Medical Equipment, Financial Analysis, Financial Operations, Healthcare, Healthcare Providers, Identify Issues, Leadership, Legal, Managed Care, Market Development, Medicaid, Medical Billing, Medical Equipment, Mentoring, Metrics, Network Administration/Management, Network Bridges, Network Integration, Operational Audit, Operational Strategy, Operations Guidelines, Operations Management, People Management, Policy Development, Presentation/Verbal Skills, Problem Solving Skills, Procedure Development, Process Improvement, Process Management, Productivity Management, Provider Credentialing, Quality Assurance, Quality Assurance Methodology, Quality Management, Regulations, Regulatory Compliance, Revenue Management, Risk, Sales, Sales Administration, Sales Operations, Sales Prospecting, Sales Strategy, Sales Support, Sales Tools, Strategic Planning, Time Management, User Interface/Experience (UI/UX), Writing Skills

LOCATION

Olympia, WA

POSTED

3 days ago

The Manager of Network Integrity is a critical leadership role responsible for steering the credentialing, compliance, and Medicaid growth strategy for our DMEPOS operations. The position will lead credentialing staff and a contract advisor responsible for payer contracting and network management activities, ensuring alignment between credentialing, legal, and payer relations functions. They will oversee the end-to-end credentialing lifecycle, balancing day-to-day operational excellence with overarching strategic initiatives. Furthermore, the Manager of Network Integrity will spearhead our strategy to expand our Medicaid Fee-for-Service (FFS) and Managed Care footprint, acting as the crucial connective tissue bridging our Network Management and Revenue Cycle teams. **_What Sales Operations Management contributes to Cardinal Health_** Sales Administration/Operations is responsible for supporting the sales organization and driving operational excellence in order to achieve the strategic and sales objectives established by the sales organization. This includes sales tools/productivity improvement, customer contract administration, business metrics/analytics, and rewards architecture. Sales Operations Management is responsible for strategic oversight and leadership direction within the Sales Operations function. **_Responsibilities:_** + Oversee and direct all day-to-day credentialing, re-credentialing, and enrollment activities for the organization, ensuring accuracy and timely completion. + Develop, implement, and continuously refine the overarching credentialing strategy to align with the company's growth objectives and operational capabilities. + Maintain a robust quality assurance process for all credentialing files and provider databases to ensure audit-readiness and compliance with state, federal, and payer-specific standards. + Optimize internal reporting mechanisms to ensure credentialing and network data visibility meets the specific needs of various internal stakeholders, including Legal, Compliance, and Revenue Cycle Management + Translate complex regulatory changes into actionable operational guidelines for internal teams to prevent claim denials and ensure revenue integrity. + Lead the strategic planning and execution efforts to grow the company's Medicaid Fee-for-Service and Managed Care organization footprint. + Identify new market opportunities and guide the team through the application and contracting processes required to enter new networks. + Partner with leadership to assess the financial and operational viability of entering new Medicaid markets. + Serve as the primary liaison connecting internal dots between the Network Management, Contracting, Revenue Cycle (RCM), and Market Access Sales departments. + Proactively collaborate with RCM leaders to troubleshoot front-end credentialing issues that impact back-end billing and cash flow. + Lead cross-functional meetings to ensure all stakeholders are aligned on network status, risk updates, and process improvements that affect the organization's bottom line **_Qualifications:_** + Bachelor's degree or equivalent experience preferred. + 5+ years of experience in credentialing, network management, or provider enrollment, with a strong preference for candidates who have managed these processes within the Durable Medical Equipment (DME), Home Medical Equipment (HME), or DMEPOS industry strongly preferred + Relevant experience in the payer space a plus + Proven leadership experience with a demonstrated ability to coach, mentor, and develop others. Must possess a strong "player-coach" mentality-capable of guiding strategic initiatives and empowering team members while remaining willing to roll up your sleeves and support day-to-day credentialing operations. + Proven ability to design, build, and execute a comprehensive strategic roadmap for credentialing operations and network footprint expansion that aligns with overarching organizational goals. + Strong analytical capabilities with a demonstrated ability to analyze complex operational metrics and synthesize them into clear, actionable insights and strategic recommendations for executive leadership. + Exceptional written, verbal, and presentation skills, with experience presenting complex operational and regulatory strategies to senior leadership, cross-functional partners, and external stakeholders. + Deep subject matter expertise in Medicaid policy and administrative guidelines, with a proven track record of effectively researching, interpreting, and applying state-specific Medicaid billing and enrollment requirements. + Proven success in spearheading network growth strategies, specifically demonstrating experience in expanding Medicaid Fee-for-Service (FFS) and Managed Care Organization (MCO) footprints across multiple markets or states. + Comprehensive knowledge of federal and state healthcare compliance standards, accreditation guidelines and quality assurance related to provider credentialing and network integrity. **_What is expected of you and others at this level_** + Manages department operations and supervises professional employees, front line supervisors and/or business support staff + Participates in the development of policies and procedures to achieve specific goals + Ensures employees operate within guidelines + Decisions have a short term impact on work processes, outcomes and customers + Interacts with subordinates, peers, customers, and suppliers at various management levels; may interact with senior management + Interactions normally involve resolution of issues related to operations and/or projects + Gains consensus from various parties involved **Anticipated salary range:** $105,100 - $135,090 **Bonus eligible:** Yes **Benefits:** Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with myFlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs **Application window anticipated to close:** 07/28/2026 *if interested in opportunity, please submit application as soon as possible. The salary range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._ _To read and review this privacy notice click_ here (https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal-health-online-application-privacy-policy.pdf)

About the Company

Cardinal Health

INDUSTRY

Other/Not Classified

Resume Resources

Free Resume Templates Free Resume Builder