Ohio Chapter, American Academy of Pediatrics (Ohio AAP)

• Own national payer relationships and contract strategy • Negotiate multi-year rate renewals with Tier 1 payers • Accelerate behavioral health payer contracting in new states • Evaluate and build value-based care partnerships • Build payer performance dashboards and lead governance

• Design a system to track every inbound referral from all channels and maximize conversion • Continuously optimize the customer journey across every channel • Build and maintain integration frameworks connecting care settings into a cohesive continuum • Lead the strategic design and operational blueprint for hospital and health system partnerships.

• Ensure provider staff is credentialed and enrolled with payers to ensure sufficient clinical coverage and minimal claims reimbursement denials • Develop and implement policies and procedures for the credentialing and recredentialing process, ensuring they meet industry standards and organizational needs • Manage the primary source verification of education, training, board certification, work history, and licensure of healthcare providers • Maintain CMS NPPES reporting • Support internal credentialing committee in evaluation of newly hired staff • Facilitate the resolution of discrepancies or concerns regarding applicants’ credentials, working closely with medical staff leadership and healthcare providers • Maintain accurate and confidential credentialing databases and files, ensuring the security and integrity of sensitive provider information • Effectively communicate accurate enrollment and credentialing status throughout the organization to support effective decision making • Assist the accounts receivable department with credentialing related payer denials • Coordinate with counsel and compliance on malpractice and related insurance coverage • Serve as the lead expert on all state-specific bylaws, ensuring that urgent care and health system applications adhere to varying regional legal standards.

• Record cash collections • Bank reconciliations • Reconcile collections to RCM • File and pay sales and use taxes • Track and pay personal property taxes • Assist with the corporate credit card program • Enter and code invoices for payment processing • Assist with the management of cash on hand at locations • Various month end close accruals journal entries and workpapers • Assist with providing data and reports for the audit • Various additional invoicing and other ad hoc requests as needed