Cardinal Health · 4 hours ago
Director, Payer Relations (Revenue Cycle Management)
United States
Full-time
Remote
Director/Executive
$106K/yr - $179K/yr
10+ years expCardinal Health is a healthcare services and products company, and they are seeking a Director of Payer Relations within their Revenue Cycle Management division. This role is responsible for leading payer engagement, managing denial prevention strategies, and ensuring compliance with payer requirements to protect revenue and improve cash performance.
Health CareHospitalMedical
Responsibilities
Provide strategic and operational leadership across the Payer Advisors, Senior Analysts (Global Denials), and Payer Rules Advisors, ensuring alignment between payer escalations, denial prevention efforts, and payer rule execution across ADSG (Advanced Diabetes Supply Group), US MED, and Edgepark
Own the enterprise payer escalation and denial prevention strategy, including prioritization of high-risk payer issues, standardized escalation frameworks, and executive-level engagement with health plan Provider Relations and payer leadership
Build and maintain strong, executive-level relationships with health plan Provider Relations leadership and key payer stakeholders to proactively resolve systemic issues and reduce downstream reimbursement risk
Serve as the final escalation point for complex, unresolved payer issues originating from claims, billing, contracting, or AR teams, mediating disputes and driving resolution in alignment with contractual, regulatory, and compliance requirements
Oversee the stand-up and execution of the Denials Prevention Task Force, ensuring enhanced ATB and enterprise analytics are leveraged to identify upstream risk, quantify financial exposure, and drive systemic remediation
Lead fact-based payer engagement, negotiation, and settlement efforts by leveraging enterprise data and analytics to resolve reimbursement delays and recover material dollars at risk
Partner closely with AR Directors to ensure all receivables impacted by payer escalations, disputes, and settlements are accurately identified, flagged, tracked, and actively managed within AR
Collaborate with Market Access, Legal, Compliance, Finance, and Operations teams to ensure payer contract terms, conditions, and requirements are accurately operationalized within billing systems, workflows, and payer configurations to prevent avoidable denials
Provide strategic input and analytical support to payer contract negotiations by identifying historical denial patterns, operational risks, and reimbursement impacts to ensure negotiated terms are executable and aligned with financial objectives
Establish governance, reporting, and key performance indicators (KPIs) across payer issues, denial prevention, and payer rule execution to ensure transparency, accountability, and sustained improvement
Serve as the executive liaison across Revenue Cycle, IT/Data, Finance, and external payers to ensure payer outcomes are translated into operational and financial results
Bring direct, hands-on experience leading escalations with health plan leadership and navigating regulatory and legal escalation pathways, including engagement with CMS and other oversight agencies, to resolve systemic payer issues and enforce payer field accountability
Qualification
Required
10+ years of experience in payer relations, managed care, revenue cycle, healthcare finance, or regulatory affairs (with demonstrated success resolving high-dollar payer issues)
Prior leadership experience overseeing payer relations, revenue cycle, or policy governance teams
Direct experience leading escalations with health plan Provider Relations leadership and engaging regulatory bodies (e.g., CMS) to resolve reimbursement and compliance disputes
Strong working knowledge of payer contracts, CMS regulations, and escalation mechanisms
Proven ability to lead cross-functional teams and influence executive stakeholders in a complex, multi-entity environment
Highly analytical, with experience leveraging data to support payer negotiations, denial prevention, and performance improvement
Benefits
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
Company
Cardinal Health
Cardinal Health is a manufacturer and distributor of medical and laboratory products.
10001+ employees
H1B Sponsorship
Cardinal Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (128)
2024 (116)
2023 (140)
2022 (158)
2021 (106)
2020 (142)
Funding
Current Stage
Public CompanyTotal Funding
$1.08B2025-08-28Post Ipo Debt· $1B
2006-08-16Post Ipo Debt· $78M
1983-08-12IPO
Leadership Team
Aaron Alt
Chief Financial Officer
T
Tony Caprio
Executive Vice President
Recent News
Morningstar.com
2026-01-16
Company data provided by crunchbase