PJWeissMD Consulting, LLC

 

Peter J. Weiss, MD, FACP
Consultant
pjweissmd@pjweissmd.com
321-794-0298

Dr. Peter Weiss brings decades of experience as a leader and change agent in healthcare. Having served in both physician-specific and CEO roles across a variety of organizations (military, physician group practice, IDS, HMO/insurance company, CIN, healthcare sharing ministry), he understands the rapidly evolving healthcare ecosystem from multiple perspectives. A strategic thinker, he envisions the future and drives innovation for the ultimate purpose of helping people to be well. Dr. Weiss is a person of high integrity and concern for people who excels at bringing diverse stakeholders together, clarifying the vision, creating a culture of teamwork, and getting results.

Career and Education Highlights

  • CEO, Health First Health Plans, Rockledge FL
    • $370 million P&L responsibility for 62,000 lives (Medicare, Commercial, TPA lines of business)
    • Quality and financial outcomes near the highest in plan history
    • Ranked nationally by NCQA/US News and World Report as #31 for Medicare and #60 for Commercial for quality and satisfaction
  • President, Florida Hospital Healthcare System, and
  • President, Employer Choice Insurance Company, Adventist Health System, Orlando FL
    • Entered an unrecognized turnaround situation. Sweeping leadership and management changes. Reevaluation and redesign of insurance/PHM strategy
    • Negotiated partnership agreement with Health First Health Plans launching parent company in new strategic direction
  • 12 years’ experience in Medical Director/Chief Medical Officer roles in provider-sponsored health plans and Clinically Integrated Networks
    • Developing/mentoring physician leaders
    • Medical expense management, case/disease management, concurrent review, utilization management, prior auth., medical policy, clinical programs, care models/pathways, pharmacy/formulary management, health and wellness coaching
    • Quality Improvement, NCQA accreditation, HEDIS/ACO quality measures, peer review
    • Network development and management, provider credentialing and contracting, provider relations
  • 6 years’ private practice of consultative Infectious Disease
  • Lieutenant Commander, Medical Corps, United States Navy – 9 years’ active service
  • MD degree, Washington University School of Medicine, St. Louis, MO, Alpha Omega Alpha
  • Residency in Internal Medicine, Fellowship in Infectious Disease, US Navy

 

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