Max TheodoreChief Advisor, Payer Contracting

    Max Theodore

    Max Theodore is the Chief Advisor of Payer Contracting at SCALE Healthcare.

    Max has more than 32 years of insurance and healthcare experience with a focus on managed care contracting, litigation support, forensic accounting, strategic planning, acquisitions, interim management, and regulatory compliance. He has an extensive background in provider and payer operations and has worked with many for-profit, not-for-profit and government entities.

    Max is a Partner as Harpeth Consulting and serves as their Practice Area Leader for the Litigation Support practice and the Accountable Care Organization Strategy practice.  His wide range of executive experience includes assisting the Tennessee Department of Commerce and Insurance in the supervision of financially troubled Managed Care Organizations (MCOs). In this role, he administered the overall operation of troubled MCOs with a particular focus on accounting, claims administration and litigation support.

    Throughout his career, Max has been integral in litigation proceedings related to claims reconciliation disputes for multiple insurance product types including HMOs, Self-Insured Indemnity, Reciprocal Reinsurance, Medicare Advantage, Managed Medicaid, Workers Compensation.

    Max has served in several payer executive positions including VP of Network Development at Aetna Health Plans and Cigna Health Plan, in addition to VP of Operations for Princeton Medical Management Resources. At Princeton, Max lead due diligence activity and the negotiation of all acquisitions. He also served as CFO for multiple hospitals in Florida and founded and served as President of University Outpatient Rehabilitation Center in Tampa, Florida.

    Max graduated from the University of South Florida in Tampa with a BA in Accounting.