Manager, Network Integrity

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., * 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, * 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

• 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., Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

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