1711 South 8th Street                  
Phone: (215)  336-1124
Philadelphia, PA 19148                   
Fax: (215) 336-7807

Boarded Physician Executive with more than a decade of medical management experience.

Demonstrated strengths in managed care, organizing and managing physician joint ventures, clinic development; financial decision-making, communication; credentialing, quality assurance and utilization management, policy-making, provider relations, development of educational programs, and customer service.

American College of Osteopathic Family Practitioners, 1974
American Board of Quality Assurance and Utilization Review, 1999

SUMMARY OF EXPERIENCE

Paul Steinberg Associates Family Practice

Philadelphia, PA
1961-Present
Founder and President

Offers full range of services from pediatrics to geriatrics providing medical care to approximately 100-125 patients weekly.

King of Prussia, PA                                                                                                                
Physician Advisor and Associate Medical Director                                                                      
2000-Present

Provide Utilization Review and Case Management guidelines for 200,000 Union employees

Wayne, PA
Physician Advisor                                                                                                                       
2000-Present

Provide Utilization Review for Workman’s Compensation and Group Health claims

Brentwood, TN
Medical Director Utilization Review (New York)                                                              
1998-Present

Oversee Quality Management Department and problem solving of quality issues and events

Organizational representative attending monthly New York Department of Corrections QI/QA meetings

Prudential Insurance Company
Philadelphia, PA                                                                                                                                                         
1995-1998
Medical Director

•   Oversight of quality care and utilization management and develops protocols and clinical pathways

•   Processes claims, coding, and appeals

•   Develops and implements utilization management and quality assurance criteria

•   Manages Nurse Case Managers and develops educational programs for nursing staff

•   Educates physicians on managed care concepts to ensure quality care and cost containment; interfaces with physicians nationwide

FPA Medical Management
Philadelphia, PA                                                                                                                                                          
1994-1995
Associate Medical Director

•   Developed policies and procedures for managing 20,000 members under risk-sharing contracts with HMOs.

•   Instrumental in reducing hospital length-of-stay from 300/1,000 to below 200/1,000 within a period of six months.

•   Negotiated risk-sharing contracts with insurance companies.

•   Developed critical pathways and specialty care network.

•   Recruited physicians for both affiliation and practice acquisition.

•   Developed core-team of regional medical advisors.

•   Oversight support of IPA.

•   Assisted in budget-review process.

•   Oversight of customer service, provider relations, utilization management, quality assurance, credentialing.

•   Served as clinical consultant for MSO operations.

•   Interfaced-with Corporate Medical Directors.

•   Developed managed care education programs for IPA physicians, and monitored IPA acceptance and performance.

Medi-Services Inc.
Philadelphia, PA                                                                                                                                                         
1986-1993
President

•   Organized and managed physician joint ventures involving approximately 150 physicians and generating revenues of about $3 million annually.

•   Daily management of MRI, CT scanning, complete diagnostic radiology and physiologic testing.

•   Education of physician partners in managed care protocols.

•   Instituted and implemented quality assurance measures.

•   Established utilization review committee to oversee referrals, appropriate medical care, conformity with established medical practices.

Metropolitan Hospital
Philadelphia, PA                                                                                                                                                          
1986-1990
Medical Director

•   Developed satellite clinic and appointed medical director.

•   Coordinated patient care.

•   Recruited specialists from hospital to form working relationship with area family practitioners.

1997-Present - Associate Clinical Instructor, Thomas Jefferson Hospital, Philadelphia, PA
1984-1986 - Auditing Instructor, Philadelphia College of Osteopathic Medicine, Philadelphia; PA
1963-1985 - Visiting Lecturer, Intern/Resident Classes, Metropolitan Hospital, Philadelphia, PA
1957-1960 - Student Instructor, Kirksville College of Osteopathic Medicine, Kirksville, MO

Temple University - School of Pharmacy, Bachelor of Science, Pharmacy, 1955
Kirksville College of Osteopathic Medicine, Kirksville, MO, Doctor of Osteopathic Medicine, 1960
Internship Metropolitan Hospital, Philadelphia, PA  1960-1961

Health Management Alternatives (HMA) Medicaid HMO
1994-Present   Member, Provider Relations Subcommittee

Methodist Hospital
1993-Present   Member, Peer Review and Utilization Committee

Metropolitan Hospital
1980-1990   Vice-Chairman, Department of Osteopathic Manipulative Medicine
1980-1983   Member, Credentials & Ethics Committee

Pennsylvania Osteopathic Medical Association

1996-Present   Member, Managed Care Committee
1996-Present   Delegate
1982-1984        Vice Speaker, House of Delegates
1980-1984      Chairman/Member, Constitution and Bylaws Committee, Insurance Review Committee, Conventions Committee, Sports Medicine Committee
1980-1984       Delegate

Philadelphia County Osteopathic Society
1980-1984                        Trustee

Pennsylvania Osteopathic Family Practice Society
1984-1986                        President

State of Pennsylvania
1982-1986 - Osteopathic Representative, Department of Public Assistance Medical Advisory Committee
1980 -  Member, Peer Utilization Review Committee
1982 - Present  Attending Physician, Pennsylvania State Athletic Commission

Greater Delaware Valley IPA, PA
1994-Present - Member, Board of Directors

Kirksville College of Osteopathic Medicine, Kirksville, MO
2001 - Key note speaker – Student body

LICENSURE
Pennsylvania, Florida, Missouri, New Hampshire

PROFESSIONAL AFFILIATIONS
American College of Physician Executives           
American Osteopathic Association
PA Osteopathic Family Practice Society 
American College of Family Practitioners
National Association of Managed Care Physicians                        
Philadelphia County Osteopathic Society

POST-GRADUATE MANAGED CARE PROGRAMS

Neuman College, Aston, PA, Health Care Administration, 1997
National Committee for Quality Assurance, Boston; MA, Navigating NCQA, 1997
Prudential Health Care, Philadelphia, PA, Clinical Review and Discharge Planning, Concepts and
Applications of the Basic and Ambulatory Case Manager, 1997
Interqual Training Program, 1997