Cory Evans, Otr/L, Rac-Ct Email & Phone Number

Apex, Nc, Us

Raleigh, North Carolina, United States

• As a compliance business partner and subject matter expert for the strategicoperations and patient relations department. I play a key role in guiding andcoaching/training on intricate compliance matters related to payor relationships,distribution, coverage and reimbursement, state/federal pricing transparency,reimbursement activities and patient support programs.• Perform and document an annual risk assessment and work plan, ensuringalignment with organizational goals.• Lead the development, implementation, and strategic direction for compliancestrategy within operations and patient relation functions, ensuring alignment withbroader corporate compliance strategy. This involves providing leadership oncomplex compliance issues, overseeing integration into business operations, andcollaboration with key stakeholders to implement organizational initiatives.• In addition, I offer guidance and support to the pricing and market accesscommittee and actively participate in the governance committee for the company’srevenue cycle operations. Maintaining a constant dialogue with the executive teamand other stakeholders, I effectively communicate, guide, and coach on complianceprogram developments.• Collaboration with local hospital systems on reducing readmission rates on key diagnostic characteristics.• My approach emphasizes on proactive stance towards compliance, centered onfostering partnerships, prevention, and risk mitigation. I am adept at identifyingand addressing compliance issues and questions in a thoughtful, solutions-oriented,and timely manner, aligning actions with best practices in compliance.• Lead multi-audit complexities involving regulatory compliance and correctivemanagement related to clinical and reimbursement policy and procedures.

Apex, North Carolina, United States

• Created a Sustainable Business Model: Leveraged prior industry experience to design a high-value service offering tailored to medical facilities. Successfully secured high-profile clients by presenting customized solutions aligned with their specific value propositions and business objectives.• Conducted Compliance Audits & Process Improvements: Performed on-site and remote audits to assess regulatory compliance, identifying opportunities for process optimization. Provided actionable recommendations that enhanced operational efficiency and supported the organization's overall mission.• Streamlined Operations & Service Delivery: Delivered key insights that led to smoother operations across skilled therapy, nursing, social work, and dietary services, improving service quality and interdepartmental coordination.• Led Team Recruitment & Development: Spearheaded the recruitment and selection of top talent, ensuring alignment with organizational culture and needs. Motivated and developed staff by focusing on service excellence, strategic planning, and effective team building, driving high performance and engagement.• Optimized Leadership & Organizational Effectiveness: Assessed leadership styles and organizational structure, recommending strategic changes to improve management practices and enhance overall operational performance.• Improved Quality Metrics & Performance: Analyzed key quality metrics and the impact of rating systems, identifying areas for improvement and implementing strategies to enhance outcomes and increase ratings.

Hillsborough, North Carolina, United States

• Took ownership of key initiatives which led to strategic partnerships with multiple hospital systems that included ACO Models.• Collaborate with hospital leadership and decision-makers to focus on outcome-driven initiatives and improved quality of care delivery models.• Partnered with hospital management in ACO REACH Model to design and execute new foundations and workflow processes, clarifying standard operating procedures, which paved the way for better communication avenues.• Lead clinical liaison with HMOA carriers to provide strategic clinical updates, medical status changes, discharge planning, and reporting of coordinated care. Efforts led to improvement of vital criteria such as quality of care, financial management, and outcome-based delivery.• Oversee and direct internal medical management for complex patients to ensure continuity of care and clear protocols.• Coordinate and organize data from large datasets to provide data support and actionable insights as an invaluable resource for multi-faceted teams.• Lead oral presenter and analyzing data sets to deliver to key decision-makers for strategic planning/decisions.• Monitor data relating to readmission rates and review of reports outlining findings. Identify gap in procedures, then devise strategies which effectively close the gap to achieving desired outcomes. Resulted in reducing readmission rates by 50% and lowering length-of-stay by 20%, based on national averages.• Conduct internal audits of clinical documentation to support datasets and facilitate completion of audits in conjunction with internal departments.• Ownership of Medicaid and Medicare audits to ascertain compliance with regulations and implement changes based on data analysis.