Managing payer-specific business rules and decision logic within InRule, the rules engine that integrates with Brightree, across the company's DME businesses is the core of this role. The position translates complex payer policies, coverage criteria, reimbursement requirements, and operational needs into accurate and scalable system rules and decision logic, ensuring payer requirements are appropriately applied throughout end-to-end order to cash workflows with Brightree.
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 of the rules engine supporting Brightree
Translate complex payer policies, coverage criteria, reimbursement requirements, and operational needs into technical business rules and decision logic authored within InRule
Independently develop, refactor, and tune rules, decision tables, and reusable rule components to keep the environment scalable and maintainable as payer complexity grows
Apply and maintain the standards for rule development, testing, approval, deployment, version control, and change management established by the payer rules governance function and recommend improvements based on hands-on experience
Perform impact analysis, testing, validation, and troubleshooting of rule and configuration changes prior to and following production deployment
Maintain a centralized inventory of payer rules, configuration, dependencies, and changes to ensure accuracy and traceability
Monitor rule performance and proactively identify configuration defects, conflicting logic, processing exceptions, and opportunities for optimization
Partner with RCM and Payer Relations/Market Access to translate payer changes, denial trends, and operational findings into rule updates and related system changes
Identify opportunities to prevent denials, unbilled revenue, and manual rework through improved rules configuration and automation
Provide technical direction, design review, and coaching to analysts and configuration specialists within the payer rules team, without direct people-management responsibility
Partner closely with IT and other technical stakeholders on the InRule–Brightree integration, data dependencies, environment management, releases, and production support
Serve as the bridge between business requirements and the rules engine, ensuring requirements are translated into scalable and maintainable rule logic
Support new payer implementations, acquisitions, integrations, and future-state system migrations
Requirements
5+ years of hands-on experience in healthcare technology, payer configuration, business-rules administration, systems configuration, or a related technical function preferred
Millions of jobs, with real people getting hired every day
200,000+
New jobs added daily
7,000,000+
Verified job listings
1,000,000+
Tailored applications submitted
Bachelor's degree in a related field, or equivalent work experience, preferred
Direct experience developing and administering a business-rules engine, decision-management platform, or comparable rules-based technology
Demonstrated ability to independently author, debug, and optimize complex rules and decision logic without relying on an IT developer to perform the technical work
Demonstrated ability to translate complex business requirements into technical rules and decision logic within a rules engine, along with the downstream system configuration needed to support them
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 the data fluency (SQL or equivalent) to trace and validate the data feeding rules
Strong understanding of healthcare payer policies, coverage requirements, reimbursement, and claims processes
Experience with InRule strongly preferred, but comparable rules-engine or decision-management platform experience will be considered
Brightree or other healthcare/DME platform experience preferred, particularly experience building rules or logic that integrate with such a platform rather than residing inside it
Proven ability to operate as the technical expert within a larger team, influencing through expertise and collaboration rather than reporting lines
Benefits
Bonus eligible
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 (FSA)
Short- and long-term disability coverage
Work-Life resources
Paid parental leave
Healthy lifestyle programs
Important Details
Application deadline: 30 November 2026
About the Company
Cardinal Health is responsible for managing the financial lifecycle of patient accounts and ensuring timely and accurate payment for services provided. The company focuses on clinical and administrative processes that healthcare providers utilize to capture, bill, and collect patient service revenue in a manner that is compliant with payer rules and requirements. The revenue cycle shadows the entire patient care journey and begins with patient intake and ends when the patient’s account balance is zero. This team also encompasses a payer administration function that ensures successful operationalization of payer rules and requirements as well as facilitating payer relations and escalation efforts.
Cardinal Health is a distributor of pharmaceuticals, a global manufacturer and distributor of medical and laboratory products, and a provider of performance and data solutions for healthcare facilities.
