John Marshall is a Senior Director at Ankura, based out of Phoenix but located in Louisville, who focuses on regulatory compliance and operations related to government-sponsored healthcare programs. John brings experience working with payers including Medicare Advantage and Part D, Medicaid, and Affordable Care Act and Tricare programs as well as a range of healthcare providers. He specializes in enterprise-wide collaboration and oversight programs, audits and investigations, strategy development for engagement between payers and provider groups, and process improvements.
John joined Ankura in 2018 with the firm’s acquisition of the disputes, forensics & legal technology segment of Navigant. He previously spent nine years in-house with insurer Humana, where he honed his expertise in internal audits in a series of increasingly senior roles before focusing on management systems and risk mitigation. John began his career with PricewatershouseCoopers.
Over the course of his career, John has helped multiple large national payers conduct investigations and improve their investigative processes in addition to conducting multiple Medicare independent audits. He has led internal teams that have supported inside and external counsel investigating such issues as Medicare risk adjustments, Medicare sales, accounts payable, claims processing, enrollment, pharmacy rebates, and identity theft. John has also conducted investigations into Part D coverage determinations and process for reviewing coverage requests.
John has also managed multiple internal and external audit teams responsible for overseeing and monitoring numerous aspects of payer and healthcare delivery operations. He has worked with clients across the industry to map processes, assess effectiveness, identify opportunities for improvement, craft strategies, and implement changes.
John’s professional experience includes: