Tara Kay Maxfield, MBA
Healthcare Consultant at The Viability Company- Claim this Profile
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Bio
S. Helen Roberts-Niemi
I have known Tara for several years, first as her manager at Beech Street and then as her associate and manager at Unitedhealthcare. There's no doubt about it. Tara is a hard worker. The greater the challenge the more Tara digs in to get the job done. Some people work better in crisis mode. Tara is one of these people. She doesn't watch the clock and will take the time necessary to do the job...and do it well. In addition, Tara is smart. She knows contracting and if she doesn't know something she will research it until she knows it inside and out. Even if it is not part of her "job". When I assigned a project to Tara I knew I could count on her to do it without me having to micromanage her. She works very independently but also knows when she is over her head and needs direction. She is OK raising her hand for help. If I ever have the opportunity to hire Tara again, I will. I have the utmost respect for her professionally and personally and am happy to recommend her.
Kelley Harrington
I have had the pleasure of working with Tara Hargroves in two distinctly different capacities within the healthcare industry; and in both positions, I benefited from our interactions. Tara has extensive contracting knowledge, extraordinary communication and interpersonal skills as well as unparalleled experience and professionalism. I have had the benefit of seeing her make presentations and succeed in tough negotiations. She and I worked directly in tandem in the Mid-Atlantic market where we developed in-depth market trend analysis ultimately to form reimbursement strategies. I have benefited greatly from having the opportunity to work with her, not once, but twice during my career. I am sure that her future endeavors will be very lucrative and that she will be an asset to her superiors wherever she may be.
S. Helen Roberts-Niemi
I have known Tara for several years, first as her manager at Beech Street and then as her associate and manager at Unitedhealthcare. There's no doubt about it. Tara is a hard worker. The greater the challenge the more Tara digs in to get the job done. Some people work better in crisis mode. Tara is one of these people. She doesn't watch the clock and will take the time necessary to do the job...and do it well. In addition, Tara is smart. She knows contracting and if she doesn't know something she will research it until she knows it inside and out. Even if it is not part of her "job". When I assigned a project to Tara I knew I could count on her to do it without me having to micromanage her. She works very independently but also knows when she is over her head and needs direction. She is OK raising her hand for help. If I ever have the opportunity to hire Tara again, I will. I have the utmost respect for her professionally and personally and am happy to recommend her.
Kelley Harrington
I have had the pleasure of working with Tara Hargroves in two distinctly different capacities within the healthcare industry; and in both positions, I benefited from our interactions. Tara has extensive contracting knowledge, extraordinary communication and interpersonal skills as well as unparalleled experience and professionalism. I have had the benefit of seeing her make presentations and succeed in tough negotiations. She and I worked directly in tandem in the Mid-Atlantic market where we developed in-depth market trend analysis ultimately to form reimbursement strategies. I have benefited greatly from having the opportunity to work with her, not once, but twice during my career. I am sure that her future endeavors will be very lucrative and that she will be an asset to her superiors wherever she may be.
S. Helen Roberts-Niemi
I have known Tara for several years, first as her manager at Beech Street and then as her associate and manager at Unitedhealthcare. There's no doubt about it. Tara is a hard worker. The greater the challenge the more Tara digs in to get the job done. Some people work better in crisis mode. Tara is one of these people. She doesn't watch the clock and will take the time necessary to do the job...and do it well. In addition, Tara is smart. She knows contracting and if she doesn't know something she will research it until she knows it inside and out. Even if it is not part of her "job". When I assigned a project to Tara I knew I could count on her to do it without me having to micromanage her. She works very independently but also knows when she is over her head and needs direction. She is OK raising her hand for help. If I ever have the opportunity to hire Tara again, I will. I have the utmost respect for her professionally and personally and am happy to recommend her.
Kelley Harrington
I have had the pleasure of working with Tara Hargroves in two distinctly different capacities within the healthcare industry; and in both positions, I benefited from our interactions. Tara has extensive contracting knowledge, extraordinary communication and interpersonal skills as well as unparalleled experience and professionalism. I have had the benefit of seeing her make presentations and succeed in tough negotiations. She and I worked directly in tandem in the Mid-Atlantic market where we developed in-depth market trend analysis ultimately to form reimbursement strategies. I have benefited greatly from having the opportunity to work with her, not once, but twice during my career. I am sure that her future endeavors will be very lucrative and that she will be an asset to her superiors wherever she may be.
S. Helen Roberts-Niemi
I have known Tara for several years, first as her manager at Beech Street and then as her associate and manager at Unitedhealthcare. There's no doubt about it. Tara is a hard worker. The greater the challenge the more Tara digs in to get the job done. Some people work better in crisis mode. Tara is one of these people. She doesn't watch the clock and will take the time necessary to do the job...and do it well. In addition, Tara is smart. She knows contracting and if she doesn't know something she will research it until she knows it inside and out. Even if it is not part of her "job". When I assigned a project to Tara I knew I could count on her to do it without me having to micromanage her. She works very independently but also knows when she is over her head and needs direction. She is OK raising her hand for help. If I ever have the opportunity to hire Tara again, I will. I have the utmost respect for her professionally and personally and am happy to recommend her.
Kelley Harrington
I have had the pleasure of working with Tara Hargroves in two distinctly different capacities within the healthcare industry; and in both positions, I benefited from our interactions. Tara has extensive contracting knowledge, extraordinary communication and interpersonal skills as well as unparalleled experience and professionalism. I have had the benefit of seeing her make presentations and succeed in tough negotiations. She and I worked directly in tandem in the Mid-Atlantic market where we developed in-depth market trend analysis ultimately to form reimbursement strategies. I have benefited greatly from having the opportunity to work with her, not once, but twice during my career. I am sure that her future endeavors will be very lucrative and that she will be an asset to her superiors wherever she may be.
Experience
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The Viability Company
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United States
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Hospitals and Health Care
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1 - 100 Employee
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Healthcare Consultant
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Aug 2022 - Present
Healthcare Consultant Healthcare Consultant
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Principal
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May 2015 - Present
*Conduct research and provide structured analysis for clients on the historical, current, and projected trends in healthcare as they impact applicable segments of the delivery system. *Emphasis on CMS, state Medicaid, and payer or provider driven quality and efficacy programs, including Episodic Payment Reform, ACOs, CMS designations, PCMHs, P4Ps, healthcare legislation, Value Based Care/Contracting, CMS Coverage Determinations, P&T Committee. Network Management/Development, Provider Relations, and more.*Expertise in managed care and governmental contract language and reimbursement terms for all provider types. *Highly skilled and trained negotiator and contractor for network builds and network expansions*In-depth knowledge of plan types and benefit, including medical, dental, behavioral health, Medicare, Medicare Advantage, Medicaid, SNP Tricare, PPACA, worker's compensation, and other governmental plans.*Serving investment and consulting firms, healthcare providers, payer organizations and consumers.
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Catalyst Solutions
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Romania
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Human Resources Services
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1 - 100 Employee
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Healthcare Consultant
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Aug 2021 - Aug 2022
Consultant, full time for 1 year agreement. Launched new Provider Portal website.Negotiated Single Case Agreements and other Provider agreements.Facilitated resolution of provider issues for EDI, data management, acted as a liason and provider resource, educational speaking, worked closely with grievance and appeals, claims, configuration, credentialing, sales and marketing, and Utilization Management. Consultant, full time for 1 year agreement. Launched new Provider Portal website.Negotiated Single Case Agreements and other Provider agreements.Facilitated resolution of provider issues for EDI, data management, acted as a liason and provider resource, educational speaking, worked closely with grievance and appeals, claims, configuration, credentialing, sales and marketing, and Utilization Management.
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Senior Provider Contracting Consultant / Executive
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Jun 2016 - Oct 2017
*Major health system contracting executive servicing the contracting needs of the provider base and overall organization in Pennsylvania, Ohio, and West Virginia for Medicare Advantage, SNP, and Medicaid plan types. * Collaborated and coordinated efforts with other executives in Provider Relations, Systems/ I.T., Utilization Management, and all other areas to facilitate contractual and regulatory compliance, process improvement, and enact change as necessary. *Drafted and implemented various quality and efficacy based hospital and physician bonus programs.*Member of legal and contracting team who revised and implemented new suite of modern contracts and reimbursement methodologies for Medicaid and Medicare Advantage plans participating providers.
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UnitedHealth Group
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Hospitals and Health Care
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700 & Above Employee
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Manager, Network Contracting
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May 2013 - Jun 2015
*Network Management roles serving large groups, independent hospitals, and hospital systems, including ancillary and physician in TriCities, SW VA, and Knoxville markets, where I have nearly 15 years' experience. Network expansion and development for Tenncare, Medicare, Dual Eligible (DSNP), PPACA driven Exchange, and commercial plans. Strategic negotiation and application, reimbursement and competitor analysis, supervisory role, and provider liaison.*Senior Network Manager until Physician Contracting Manager promotion in 2012. Manager, Hospital Contracting promotion in 2013.*Developed and maintained relationships with all the major healthcare providers in my markets.*Restored broken relationships and rebuilt on hard work, earned trust and demonstrated integrity. Networked with consultants and management companies.*Commercial: Network expansion/development. PPACA driven Exchange plans, HEDIS measurement driven Performance Based Compensation programs.*Tenncare: Tenncare and DSNP Network expansion/development. TDCI/Bureau compliancy, Tenncare Rate Variation, Episodic Payment Reform, Sequestration, and Tenncare Budget Reduction.*Medicare: Medicare network expansion/development. HEDIS measurement driven Quality and Efficacy Incentive programs, including shared risk surplus linked to CMS STAR ratings, Network Transformation, Narrow Network Development, Uncompensated Care Payments, Sequestration.
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Sr. Network Account Manager
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Jun 2010 - May 2013
UnitedHealth Group Manager, Hospital Contracting*Network Management role serving large groups, independent hospitals, and hospital systems, including ancillary and physician in TriCities, SW VA, and Knoxville markets, where I have nearly 15 years' experience. Network expansion and development for Tenncare, Medicare, Dual Eligible (DSNP), PPACA driven Exchange, and commercial plans. Strategic application, reimbursement and competitor analysis, supervisory role, and provider liaison.*Sr. Hospital Contractor until Physician Contracting Manager promotion in 2012. Manager, Hospital Contracting promotion in 2013.*Developed and maintained relationships with all the major healthcare providers in my markets.Restored broken relationships and rebuilt on hard work, earned trust and demonstration of integrity. Networked with consultants and management companies.*Commercial: Network expansion/development. PPACA drive Exchange plans, HEDIS measurement driven Performance Based Compensation programs.*Tenncare: Tenncare and DSNP Network expansion/development. TDCI/Bureau compliancy, Tenncare Rate Variation, Episodic Payment Reform, Sequestration, and Tenncare BudgetReduction.*Medicare: Medicare network expansion/development. HEDIS measurement driven Quality and Efficacy Incentive programs, including shared risk surplus linked to CMS STAR ratings, Network Transformation, Narrow Network Development, Uncompensated Care Payments, Sequestration.
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Viant
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Insurance
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100 - 200 Employee
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Assistant Director of Network Development
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2008 - Jun 2010
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Contracting Manager
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2005 - 2008
Contract management and negotiation, modeling, cost and variance analysis, provider and MCO liaison, research, and negotiation for physician, hospital and ancillary member providers. Contract management and negotiation, modeling, cost and variance analysis, provider and MCO liaison, research, and negotiation for physician, hospital and ancillary member providers.
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Contract Specialist
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2000 - 2005
Direct responsibility for negotiating and developing agreements and amendments with payors, government entities, and ancillaries. Liaison to payers for providers. Direct responsibility for negotiating and developing agreements and amendments with payors, government entities, and ancillaries. Liaison to payers for providers.
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Education
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King University
BBA, Marketing -
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King University
MBA, Healthcare Administration
Community
