Mary Simon is a high-level expert, working in Tog Network Solutions main office of which is in 5. as a Program Director and Healthnet Federal Services Tricare Western Region since 2017. This expert gained professional experience in more than 20 positions at different companies. Mary Simon went to the The University of Georgia and received education. Atlanta, Georgia is the area, where the professional was known to live. Mary's phone and email can be easily accessed through this website on demand.
Name variants:
Maria Simon,
Marie Simon,
Mare Simon,
Mame Simon,
Mamie Simon,
Mimi Simon,
Moll Simon,
Molly Simon,
Polly Simon,
Mae Simon,
May Simon,
Mollie Simon,
Minnie Simon
Last updated Jun 06, 2024
Contact Information
Last Update
Jul 9, 2022
Email
ma**@bellsouth.net
Location
Atlanta, GA
Company
Tog Network Solutions, Llc
Workplace
Program Director and Healthnet Federal Services Tricare Western Region
Work History
Program Director and Healthnet Federal Services Tricare Western Region
Ponte Vedra Beach, FL
Overall Program management for the T2017 West network build. Responsibilities included Liaison between TOG and HNFS Senior management team, management of 20 plus consultants, understanding o...
Feb 2017 — Oct 2017
Network Development Consultant
224 south Michigan Ave SUITE 700, Chicago, IL 60604
Responsible for negotiating major hospital systems, FQHC's, specialist providers and carve-out agreements for NLHP's Medicaid products in Cook County.
Feb 2016 — Aug 2017
Network Development Consultant
Development of an Accountable Care Organization Network focused on the Star Plus and Dual Eligible MMP population. Responsible for the development of a strategic network of PCP, Specialist, ...
Jul 2015 — Sep 2016
Network Development Consultant
14201 Dallas Pkwy, Dallas, TX 75254
Network build for 2016 Medicare Advantage filing and 2015 Medicaid rebid project. Contracted with all major healthcare systems in SE Michigan, IPA, PO's, and Individual providers.
Oct 2014 — Jul 2015
Network Development Consultant
400 north Michigan Ave SUITE 450, Chicago, IL 60611
Development of a non-traditional PPO network to support the HealthEngine healthcare open marketplace portal and concierge program. Responsibilities include targeting specific provider types ...
Sep 2014 — Dec 2014
Network Development Consultant
3600 northwest Samaritan Dr, Corvallis, OR 97330
Responsible for building a statewide large and small group hospital and provider network. Developed contracts, target lists and reporting tools.
May 2014 — Sep 2014
Network Development Consultant
5100 Commerce Crossings Dr, Louisville, KY 40229
Responsible for network development for Medicaid state expansion project to include Hospital , Multi-specialty, large group and individual provider contracting. Statewide Focus. Additional r...
Mar 2013 — Jan 2014
Marketing and Business Development Consultant
Kansas City, MO
Business Development
Develop and Manage revenue based strategic channels for Diabetes Direct to Consumer Provider.
Global Medical Direct: Design, implemented program resulting in a $12 mi...
Nov 2006 — Dec 2013
Network Development Consultant
44 south Broadway SUITE 1200, White Plains, NY 10603
Responsible for network development for a Medicare Advantage Duel Eligible Special Needs Plan. Managed contract negotiations for current providers and expansion markets, researched providers...
Jan 2013 — May 2013
Network Development Consultant
100 Stevens Dr, Philadelphia, PA 19113
Network Development for New Florida Medicaid Plan
Apr 2012 — Oct 2012
Network Development Consultant
Build Network for statewide Dental plan
Sep 2011 — Mar 2012
Network Development Consultant
200 Oceangate, Long Beach, CA 90802
Network Development Consultant for the initial build of a network in order to respond to a state Medicaid RFP. Responsible for the management of a team of consultants, identification of IPA’...
Aug 2010 — Apr 2011
Network Development Consultant
Network Development Consultant for a Medicare Advantage Special Needs plan seeking expansion approval from CMS for the PA and VA markets. Contracting efforts were focused on Hospitals, PCP, ...
Aug 2010 — Apr 2011
Network Development Consultant
333 west Wacker Dr SUITE 1010, Chicago, IL 60606
Development Provider Network for plan expansion in TX
Sep 2009 — May 2010
Network Development Consultant
7700 Forsyth Blvd, Saint Louis, MO 63105
Network Development Consultant for a start up SC Medicaid HMO seeking approval of the state. Responsible for all aspects of contract and rate negotiation with PCP, Specialist, RHC’s, FQHC’s,...
2006 — 2009
Network Development Consultant
Developed a Medicare PPO Network for one of their clients.
Jan 2008 — Apr 2008
Network Development Consultant
Network Development Consultant for a Mississippi Medicare Advantage Plan seeking Medicare approval for expansion. Responsible for provider recruitment of PCP’s and Specialist in North MS.
Jan 2007 — Jul 2007
National Accounts Director
1505 Lbj Fwy, Farmers Branch, TX
Responsible for business development within the health plan arena. Responsible for revenue growth of 12mm annually
Jul 2003 — Dec 2006
Director Managed Care Pls Division
100 Abbott Park Rd, North Chicago, IL 60064
Responsible for negotiating health plan contracts for the Pharmacy Lab and supply division. Managed the credentialing process department.
Jan 2000 — Jul 2003
Consulting Partner
5578 Chamblee Dunwoody Rd, Atlanta, GA 30338
Specialties: Managed Care Consultant specializing in Payer and Provider Network Development and Contract Negotiation for Medicaid, Medicare Advantage, ABD, Special Needs Plans, Long Term Car...
from Apr 2000
Education
Occupations
Executive
Partner
Program Director
Health Specialist
Hospital Care Professional
Counselor
Cook
Cook
Chief Executive
Operations Manager
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Skills
Managed Care
Medicaid
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Network Development
Health Policy
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Physicians
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Ppo
Leadership
Provider Relations
Health Insurance
Hospitals
Hipaa
Healthcare Consulting
Hmo
Long Term Care
Healthcare Information Technology
Credentialing
Ehr
Physician Relations
Provider Network Development
Disease Management
Revenue Cycle
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Contract Negotiation