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William Keough, MD, MSc, FAAP

William Keough, MD, MSc, FAAP

Environmental Scientist

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  • Timeline

  • About me

    VP Senior Medical Director of Utilization Management, Member Appeals and Grievances & Medical Policy at WellSense Health Plan

  • Education

    • Northeastern University

      1991 - 1993
      Master of Science (MS) Biology, General

      Thesis Title: An Evaluation of Ecological Risk Assessment Protocols and Practices

    • University of Massachusetts Amherst

      2022 -
      Master of Business Administration - MBA Candidate

    • Lafayette College

      1986 - 1990
      Bachelor of Arts (B.A.) Honors in Biology with Music Minor

      Activities and Societies: John D. Raymond Academic Music Award

    • UMass Chan Medical School

      1995 - 1999
      Doctor of Medicine (M.D.) Medicine

      Massachusetts Medical Society Senior Student Scholarship AwardJoseph Collins Trust Scholarship AwardStudent Leadership in Primary Care Award

  • Experience

    • Camp Dresser Mc Kee Inc

      Oct 1990 - Feb 1996
      Environmental Scientist

      Environmental Scientist with focus on drinking water supply, quality and permitting studies. Site assessment, ecological and human health risk assessment at EPA designated Superfund sites. Environmental site selection, study, impact statement/report, and permitting for drinking water, wastewater, and solid waste facilities.

    • Children's Hospital of Pittsburgh

      Jun 1999 - Jun 2005

      • Fellow Pediatric Infectious Diseases

        Jul 2002 - Jun 2005

      • Pediatric Resident

        Jun 1999 - Jun 2002

    • Forbes Regional Hospital

      Jan 2003 - Jul 2005
      Pediatric Hospitalist Moonlighting Service

    • Childrens Medical Center of Dallas

      Jun 2005 - Apr 2006
      Asst. Professor of Pediatrics/Pediatric Hospitalist Service

    • Allegheny Health Network

      May 2007 - Jun 2010
      Pediatric Hospitalist/Pediatric Infectious Diseases

    • Drexel University College of Medicine

      Jul 2007 - Jun 2010
      Asst. Clinical Prof. of Pediatrics/Clinical Site Pediatric Clerkship Director

    • University of Kansas Medical Center

      Jun 2010 - Jun 2012
      Assistant Professor of Pediatric Infectious Diseases

      Associate Clerkship Director. Fourth Year Pediatric Student Director.

    • Randstad Healthcare

      May 2013 - Oct 2013
      Pediatric Hospitalist Locum

    • Topeka Pediatrics

      May 2013 - Dec 2013
      Pediatrician

      Part Time General Pediatrician

    • The Children's Hospital of Philadelphia

      Jan 2015 - May 2015
      Pediatric Urgent Care

      Pediatric Urgent Care Attending

    • Pennsylvania Dept of Human Services, Office of Medical Assistance, Bureau of Fee for Services

      Jul 2015 - Mar 2018
      Medical Director

      Medical Director at Pennsylvania Medicaid. Responsible for pharmacy reviews for all ages, Pediatric durable medical equipment, place of service review and pediatric shift nursing care. In addition to performing all Pediatric reviews, am also responsible for same tasks for adult hospitalization, home visits, place of service and durable medical equipment reviews. Review new technology for possible addition to Medicaid Fee Schedule. Review and approval of Pennsylvania Medicaid Managed Care Organizations Prior Authorization Review Policies. Show less

    • UPMC Health Plan

      Mar 2018 - Jun 2021
      Medical Director

    • Pennsylvania Chapter of the American Academy of Pediatrics

      Mar 2020 - Dec 2021
      Co Chairman Advocacy Committee (Volunteer)

    • American Academy of Pediatrics Group Insurance Trust

      Apr 2020 - now
      Trustee (Volunteer)

    • WellSense Health Plan

      Jun 2021 - now

      Oversee medical director utilization, member appeals and grievances and medical policy for a growing health plan.

      • VP Senior Medical Director of Utilization Management, Member Appeals & Grievances, & Medical Policy

        Oct 2023 - now

      • VP Senior Medical Director of Utilization Management & Member Appeals and Grievances

        Aug 2022 - Oct 2023

      • VP Senior Medical Director of Utilization Management

        Jun 2021 - Aug 2022

  • Licenses & Certifications

    • NH Office of Professinal Licensure and Certification

      New Hampshire Board of Medicine
      Jul 2025

    • Pennsylvania Board of Medicine

      Pennsylvania Board of Medicine
      Sept 2001

    • Massachusetts Board of Registration in Medicine

      Massachusetts Board of Registration in Medicine
      Aug 2021

    • American Board of Pediatrics

      Participating in MOC
      Oct 2003

    • Fellow, American Academy of Pediatrics

      American Academy of Pediatrics
      Jul 2002