Timothy Marshall

Experience

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  Aetna

  Jun 2010 - Apr 2013

  Network Consultant

  Manage client relations and accounts. Enhance cooperative working relationships with multiple accounts through personal visits and consistent correspondence. Pitch premium services to prospective clients. Lead internal system strategy by delegating tasks, improving inefficiencies and identifying solutions. Design and develop internal and external communication materials. Write and publish monthly newsletters. Implement network contract documents to ensure appropriate provisions. Create and present training and educational materials for clients and staff reflecting new initiatives and policies. Show less

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  Independence Blue Cross

  Apr 2013 - May 2016

  Senior Network Coordinator

  Responsible for managing Children's Hospital of Philadelphia, including ancillary facilities and primary care physicians in Pennsylvania network. Independently organize and conduct new provider training. Research and analyze issues impacting providers, including but not limited to issues regarding claim payments, provider data file discrepancies, Quality Incentive Payments, capitation, medical policy, utilization management, and compliance initiatives. Responsible for conducting root cause analysis, preparing financial analyses and working with staff in other business areas to assist with resolution of complex provider issues. Provide professional presentations to hospital providers concerning new initiatives and changes in medical policy and related operational procedures. Show less

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  UnitedHealth Group

  Jun 2016 - Sept 2019

  Network Contract Manager

  Negotiated fee for service (FFS) and value based care (VBC) contracts with health systems and physician practices within strict pricing compliance, balancing financial and operational impacts.Served as the lead negotiator for high-stakes, non standard contracts, employing innovative thinking and strategies to navigate complex negotiations and achieve favorable outcomes.Built and maintained strong business relationships with hospitals, physicians, and ancillary providers, ensuring appropriate network adequacy. Identified and resolved provider issues, collaborating with internal partners to implement solutions and improve provider relationship Show less

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  Joseph P. Melvin Company, LLC

  Oct 2019 - Dec 2024

  Director, Contracting and Payer Engagement

  Led strategy and negotiation of payer contracting efforts that resulted in over 600 executed payer contracts for Commercial, Medicare, Medicaid, and Workers Compensation lines of business. Independently led contract negotiations of payer reimbursement and contract language, resulting in annual revenue increases. Presented to and advised c-suite executives, physicians, and board of directors on payer contracting strategies to optimize reimbursement structures, negotiate language, and value-based contracting (VBC) incentives. Advised, supported, and project managed over 50 independent physician practices leading to the formation of 10+ independently owned specialty groups. Collaborated and supported the development of operational efficiencies. Identified and led credentialing vendor relationships and project management efforts, coordinating and managing workloads across multiple teams to ensure successful execution from start to finish. Developed and maintained summary of contract reimbursements and terms for medical groups to track executed contracts supporting efficient use within contract management system. Show less

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  SCA Health

  Jan 2025 - now

  Director, Payer Engagement and Strategy