Chief Executive Officer/President
Shawn Keough-Hartz, President and Chief Executive Officer, and has provided consistent vision and guidance in the 2003 creation and subsequent development of Provider Resources, Inc. (PRI). With above 40-years’ experience in business mergers & acquisitions, small business start-ups, and business management and leadership, including over 30-years of nationally recognized leadership in the health care industry, Ms. Keough-Hartz has skillfully guided PRI to a highly respected reputation for reliable, quality-driven independent clinical review and program oversight, on a national scale, supporting Medicare, Medicaid, Workers Compensation, and many Commercial health care programs. These designations have been beneficial to our clients, the national provider community, beneficiary stakeholders, as well as health care beneficiaries. In one example, as the federal Workers Compensation Review Contractor, PRI received national agency accolades for providing assurance to thousands of beneficiaries, under their Medicare Set-Aside Arrangements, of funds adequate to assure the lifetime availability of necessary drugs and medical supplies, while simultaneously saving over $10 billion in Medicare Trust Fund resources over the five-years of program support.
Through Ms. Keough-Hartz’ careful oversight, PRI has experienced revenue growth of more than 4,000%, while achieving and maintaining: (i) URAC accreditation as an Independent Review Organization; (ii) certification as a quality driven organization, under both ISO 9001:2008 and, now, ISO 9001:2015 requirements; and, (iii) commitment to IT security and federal IT compliance by earning CMMI-Dev Level-3 accreditation. Her success strategy for PRI has included the utilization of several U.S. Small Business Administration programs: a Woman-Owned Certified Small Business; an Economically Disadvantaged Woman-Owned Small Business; an 8(a) Certified Small Business, from which PRI successfully graduated in March 2016; and since August 2016, as a Certified HUBZone Small Business.
Ms. Keough-Hartz, in mid-2016, led PRI to create its wholly-owned affiliate, PRI-Community, Inc., whose catchword is Providing Resources for Improvement. This transitional employment program, directed at improving the common good in the local community, is fully funded by the parent organization and focuses on improving social health determinants by addressing recognized barriers for employment of underserved populations through regular employment, soft-skills training, some limited special skills training, a documented history of W-2 income, language development, and other support facilitating their transition into regular employment opportunities that support better health and lifestyles while also assuring them of leaving public-support programs. Ms. Keough-Hartz has continuously demonstrated that PRI, and its commitment to instilling integrity in health care, truly begins with her vision and compassion for improving first the human condition.
William McBee, CFE, LPI
Chief Compliance Officer/Executive Vice President
William McBee is a retired federal Senior Special Agent with over 40 years’ experience in the investigation and prosecution of complex fraud, including healthcare fraud, related criminal and civil offenses, and criminal and civil compliance with state and federal statutes, regulations, and policies. His training, education, and experience led to numerous successful prosecutions in both state and federal jurisdictions. Mr. McBee, a partner in PRI ownership, serves as its Chief Compliance Officer and Executive Vice President. He also serves as the PRI Privacy Officer. A licensed private investigator, Mr. McBee has been credentialed as a Certified Fraud Examiner since 1997. He is an active member of the Association of Certified Fraud Examiners (ACFE), the National Healthcare Anti-Fraud Association (NHCAA), and the FBI National Academy Associates. He has been a frequent presenter at national compliance conferences on the successful federal investigation and prosecution of healthcare fraud.
Mr. McBee is responsible for PRI’s corporate compliance program while fostering a compliance culture through our compliance policies, including those regarding conflict of interest, HIPAA, the Privacy Act, information technology, security, risk management, quality assurance, Section 508 compliance, confidentiality, and privacy. Mr. McBee chairs the corporate Compliance Committee and is an active member of the Security Committee, the ISO Management Team, the PRI Executive Team, and the PRI Advisory Board of Directors.
In addition to his Bachelor of Science degree in Business Administration/Accounting from the University of Tennessee, Mr. McBee is a graduate of the U.S. Treasury Department’s Federal Law Enforcement Training Center and the FBI National Academy. Mr. McBee, a decorated veteran, served in the intelligence service of the United States Army, including duty in Vietnam with the former Army Security Agency.
Dennis Agostini, PhD, DO, FACEP
Chief Medical OfficerMedical Director
Dr. Agostini has over thirty years’ experience in planning and directing various organizations’ medical policies and programs. As a Senior Associate Dean of Clinical Affairs and Postdoctoral Education, he has been responsible for strategic clinical relationships with physicians and hospital CEOs by overseeing the development of quality content for curriculum and evaluation of all clinical programs for medical students at two medical schools. In addition, he has been responsible for the development and oversight of various post-doctoral graduate medical education (GME) programs. He has written research publications appropriate to support clinical service offerings, and incorporated and developed clerkship handbooks outlining clinical policies instituted at over 100 hospitals, physician offices, and clinics.
His experience includes:
- Serves as Chief Medical Officer of PRI, providing policy recommendations and determinations of medical necessity as it relates to quality of care in multiple specialties
- Oversees PRI’s Peer Reviews at a Department of Veterans Affairs Medical Center facility
- Served on the Utilization Review Committee at Millcreek Community Hospital for over 10 years with responsibility for auditing medical necessity and standards of care for Medicare/Medicaid inpatients
- Founded the Emergency Medical Associates of Millcreek and acted as Director of Emergency Services at Millcreek Community Hospital from 1984-1995
- Served as Chief of Staff for two years at Millcreek Community Hospital
- Served on the Management Advisory Council for the Veterans Integrated Service Network Area 4
- Served as a Medical Expert with the Office of Hearings and Appeals under the Social Security Administration
- Served on various Committees and Bureaus of the American Osteopathic Association and the Pennsylvania Osteopathic Medical Association
- Member of the Evaluator Registry of the American Osteopathic Association for the Committee on College Accreditation and the Committee on Osteopathic Postdoctoral Training Institutes, serving as an evaluator for accreditation teams
- Professor of Emergency Medicine and Biochemistry, Lake Erie College of Osteopathic Medicine
- Professor of Emergency Medicine and Biochemistry, Campbell University School of Osteopathic Medicine
- Life Fellow of American College of Emergency Medicine; certified by the American Osteopathic Board of Family Practice; and was an Instructor in Advanced Cardiac Life Support
- Received the John and Silvia Ferretti Award for Outstanding Clinical Faculty at the Lake Erie College of Osteopathic Medicine
- Received the Item Writer of the Year (2007) from the National Board of Osteopathic Medical Examiners
- Served on the Item Review and Standards Committees at the National Board of Osteopathic Medical Examiners
- Served as a Major in the U.S. Army Reserves, Medical Corps, and active duty in Operation Desert Storm