Ven Mothkur Email & Phone Number

SAN JUAN, PR

Chicago, IL, US

• Via contracting, support strategic transition of providers toward HCP/LAN models 3-4.
• Innovate strategies for new care and reimbursement models, particularly for high-cost treatments, with milestone/value-based APMs.
• Liaise with pharmaceutical and medical directors on operationalizing coverage policies.
• Review and investigate claims brought forth for FWA concerns from contracting and data teams.

Chicago, IL, US

• Founder of a healthcare management consultancy focused on supporting distressed physician practices during COVID.
• Consulted physician groups in their digital transition and compliance, provider workflow, quality, and billing optimization.
• Secured and consulted PE-backed physician group clients in partnership with Scale Physician Group, Inc.

Mishawaka, Indiana, US

• $3 billion, 14-hospital, 18,000-employee health system serving patients from IN, IL, KY, and MI.Re-joined Franciscan Health as the physician leader over clinical revenue cycle management improvement efforts to address.
• Cut final denials $50 million per year. Reduced annual appeals management costs by $3 million.
• Chaired system-wide Value Analysis – Health Technology Assessment Committee for capital expenditures ranging from $50,000 to $15 million. Standardized review process with clinical value and business case templates and.

Mishawaka, Indiana, US

Mishawaka, Indiana, US

• Led system-wide transformation to standardize end-to-end, evidence-based quality practicesacross 14 urban, inner-city, rural, and academic hospitals in 2 states. Managed 60-person team;14 directs. Reported to Chief.
• Achieved an ACO quality index score of 94.48 out of 100 percent, outperforming theaverage quality score of 559 MSSP ACOs (100% in 2020).
• Earned a shared savings bonus awarded to only 37 percent of MSSP participating healthsystems, by generating a savings of $14.4 million for CMS in 2018, due to decreasinginpatient stays, emergency room visits, and.

Mishawaka, Indiana, US

• Recruited, built, and led a physician advisory unit. Managed 20-physician team, locally staffed throughout the care management departments of 14 hospitals. Created additional mid-revenue cycle and population health.
• Structured inpatient UM processes to appropriately document necessity of inpatient admissions and manage concurrent and post-hospitalization denial appeals.
• Developed and implemented monitoring processes for several new population health programs (Medicare Shared Savings Program/MSSP, plus multiple commercial and Medicare Advantage ACOs). Drove creation of outreach.

Murray, Utah, US

Florham Park, New Jersey, US

Mhcm, Health Care Management

Global Mba

Bsc/Md