David Evans Email and Phone Number
VALUE PROPOSITION► I am highly effective in revenue cycle management and managed care, with experience building and leading effective strategies for process improvement and enhanced business performance.► My success is driven by my ability to maximize efficiencies through process improvement and system implementations that drive automation. SUMMARY► Engaging professional with a winning blend of subject matter expertise, skill in leading large teams, and practical experience working with large Healthcare organizations.► Leverages a unique mix of strategic and analytical expertise, consistently exceeding performance goals by aligning talent and effort with organizational objectives. LEADERSHIP HIGHLIGHTS★ With Ensemble Health Partners, leads 180 direct reports providing outsourced revenue cycle management for 50 acute care facilities, handling a volume of 100,000 inbound calls each year.★ Established a centralized infusion team and standardized workflow that reduced infusion-related claims denials by $6M per month for the client.★ Prioritized prior authorizations ahead of the scheduling of procedures, substantially lowering claim denials and increasing SLA compliance by 35%.★ Created and implemented a quality assurance program, with a leading BPO.★ Developed highly successful teams responsible for claims adjudication and provider maintenance. ☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲Specialties: Revenue Cycle Management, Insurance Claims Adjudication, Call Center Operations, Operations Management, Strategic Planning, Team Leadership, New Client Onboarding, Process Automation, Engagement with Hospital Leaders
Ensemble Health Partners
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Senior Director Pre-AccessEnsemble Health Partners Oct 2020 - PresentCincinnati, Oh, Us★ Directs a 180-person team in a contact center performing insurance verification and securing prior authorizations from insurance carriers on behalf of 72 acute care facilities. Manages a volume of 50,000 patient accounts per month and 100,000 inbound calls each year.★ Works with C-level executive leaders and other key stakeholders across multiple hospital systems.★ Prioritized prior authorizations ahead of the scheduling of procedures, substantially lowering claim denials and increasing SLA compliance by 35%.★ Reduced infusion-related claim denials by $6M each month by introducing a centralized infusion team and standardized workflow.★ Implemented technologies to automate manual processes, improving efficiency and productivity while enabling a 25% reduction in headcount.★ Streamlined front-end denial review, trending, and resolution process.★ Partners with the global operations team to ensure a seamless client experience. ☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲ABOUT MERCY HEALTH / ENSEMBLE HEALTH PARTNERSEnsemble Health Partners is a revenue cycle management company that serves the Healthcare industry. The company was acquired by Mercy Health in 2016.I also have an extensive history with insurance payer practices, including claims processing, appeals and customer service. This provides me with a well-rounded view of healthcare administration, which helps with creating a logical strategy.
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Pre-Access DirectorEnsemble Health Partners Dec 2019 - PresentCincinnati, Oh, Us
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Revenue Cycle LeaderEnsemble Health Partners Jul 2017 - Dec 2019Cincinnati, Oh, Us
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Manager (Claims, Enrollment And Provider Relations)S&S Healthcare Strategies, Ltd Mar 2016 - Jul 2017Cincinnati, Ohio, Us★ Supervised 30 direct reports engaged in provider relations, member enrollment, and claims processing to support $15M in monthly claims.★ Introduced standard operating procedures and analytics, enabling insight into team productivity and task assignments.★ Led a quality audit that identified training needs within the team, leading to a 20% increase in efficiency.★ Contributed to grievance and appeals panel reviews. Leveraged an adjustment to Staff to Work Volume and cross training to increase accuracy by 15% and lower the turnaround time by 20 days.☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲ABOUT S&S HEALTHCARE STRATEGIESS & S Healthcare Strategies provides insurance products and services. The company offers medical and vision claims, disability administration, self-insurance programs, disease management, and discharge planning services. -
Frontline Leader Employer Concierge TeamHumana Jan 2014 - Mar 2016Louisville, Kentucky, Us★ Managed 20 direct reports across the account concierge and analyst team supporting internal and external clients, including Ford Motor Company, General Electric, Procter & Gamble, and the University of Kentucky. ★Provided information on claim status and prior authorizations while handling escalated client issues. Identified trends and root causes behind claim denials, guiding adjustments to prevent reoccurrence.★ Responsible for training, professional development, and adjustments to staffing levels to maintain customer service standards.★ Worked with the Commercial Sales team to deliver superior client experiences from initial proposal to onboarding and Go Live.★ Communicated the Voice of the Employee to client executives, influencing the selection of health insurance plans in order to meet employee expectations and drive retention.★ Acted as a subject matter expert for medical, dental and vision insurance policies☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲☲ABOUT HUMANA INC.Humana is a Fortune 500 health insurance company and the third largest health insurance provider in the nation. -
National Education Learning FacilitatorHumana 2005 - 2013Louisville, Kentucky, Us★ Designed, managed, and facilitated all aspects of training programs★ Supported claims adjudication and customer service teams ★ Provided comprehensive leadership and coaching to staff ★ Completed needs assessments and program evaluations to identify opportunities for improvement★ Provided clear course objectives, expectations, and goals, and promoted organizational success by offering individualized instruction, and developing productive relationships.Accomplishments include: ★ Collaborating with the service center and other national education leaders to develop and implement strategies and design programs and learning objectives aligned with corporate goals.★ Averaging 4.5 out of 5 in classroom evaluations throughout time as a facilitator.
David Evans Education Details
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Western Governors UniversityHealth/Health Care Administration/Management -
Ohio Christian UniversityPractical Theology
Frequently Asked Questions about David Evans
What company does David Evans work for?
David Evans works for Ensemble Health Partners
What is David Evans's role at the current company?
David Evans's current role is Accomplished Healthcare Leader | Revenue Cycle Management | Managed Care | Acute Pre-Services | Client Relationships | Customer Service | Claims Processing | Grievance and Appeals.
What schools did David Evans attend?
David Evans attended Western Governors University, Ohio Christian University.
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