Top 100 Biographies

Dr. Praveen Vemula, MD Executive Director, Utilization Management/ Denial & Appeals Wellstar Health System

Dr. Praveen Vemula is the Executive Director of Utilization Management at Wellstar Health System. In this role, Dr. Vemula’s accomplishments include: initiating and developing a multi-disciplinary process for the adjustment review process for gross denials greater than $100 million, developing a standard Work for Adjustment process for reporting adjustments by denial team nurses, and successfully reducing denials by standardization of work and building constructive relationships with payers. Dr. Vemula has 10 years of experience in quality improvement, patient satisfaction, medical affairs, utilization management, population health, patient safety, epidemiology, biomedical and health informatics, hospital operations and medical education. Due to having started an internal residency earlier in his career, Dr. Vemula serves as the Dean of Clinical Services at BAY University School of Medicine. Dr. Vemula earned his Master’s of Public Health from Tennessee State University.