Diana Coye BS, LPN RAC-CT
Cedar Lake,IN
Summary
Results-oriented Clinical Reimbursement Leader with 18+ years of experience transforming MDS operations into revenue-generating engines. Expert in MDS 3.0, PDPM optimization, and CMS compliance, with a proven track record of increasing Medicare reimbursement by 45% and elevating CMI above regional benchmarks. Demonstrates "Regional Readiness" through the development of standardized SOPs, facility-wide audit systems, and interdisciplinary education that reduces risk and maximizes quality measures. Currently pursuing M.S. in Healthcare Administration.
Overview
11
11
years of professional experience
Work History
MDS DIRECTOR
ALIYA Healthcare
Chicago, IL
07.2024 - Current
- Revenue Optimization: Increased Medicare reimbursement by 45% and elevated Case Mix Index (CMI) from 1.566 to 1.8025 by leading IDT collaboration on diagnostic coding and ADL capture.
- System Standardization: Designed and implemented facility-wide MDS SOPs, improving operational efficiency by 35% and reducing documentation errors by 20%.
- Quality & Compliance: Championed QAPI initiatives that optimize regulatory compliance and improved Star Ratings (Long Stay: 2 to 5; Short Stay: 2 to 4).
- Audit & Risk: Mitigated regulatory risk by ensuring 100% assessment accuracy and eliminating missed deadlines (95% improvement) through real-time tracking systems.
- Leadership: Mentored nursing and therapy teams on PDPM logic, ensuring documentation supported the highest justifiable reimbursement rates.
Staff LPN (Per Diem)
Delta-T Group
Oak Brook, IL
01.2015 - Current
- Critical Care & Behavioral Health, Interim MDS Consultant, MDS 3.0, Staff nursing SNF, AL, IL
MDS COORDINATOR
Bria Health – River Oaks
Burnham, IL
01.2022 - 05.2023
- CMI Growth: Analyzed CMI trends to identify reimbursement gaps, successfully increasing CMI dollars by 15% through targeted documentation improvement plans.
- Regulatory Accuracy: Managed full RAI lifecycle with 100% on-time submission rates to CMS.
- Survey Success: Partnered with the DON to ensure Triple Check readiness and successfully navigated state surveys with minimal deficiencies.
DIRECTOR OF HEALTH & WELLNESS
Rittenhouse Village
Valpariso, IN
04.2021 - 12.2021
- Operational Leadership: Managed nursing operations, staffing budgets, and regulatory compliance for the facility.
- Retention: Implemented employee retention programs that stabilized staffing levels and reduced turnover costs.
- Evaluated program effectiveness through resident feedback and health assessments.
WELLNESS DIRECTOR
Eden Supportive Living
Chicago
09.2020 - 10.2021
- Large-Scale Management: Directed wellness services and RAI processes for a census of 150+ residents.
- Safety Compliance: Achieved 100% compliance in workplace safety outcomes through structured prevention programs.
- Trained staff on wellness protocols, fostering a culture of health and well-being within the organization.
Education
Master of Science - Healthcare Administration
Capella University
MN12-2028
Bachelor of Science - Organizational Leadership
Point University
Atlanta,GA2015
Practical Nursing Diploma -
North Metro Technical College
Acworth, GA2008
Skills
- Strategic planning for multiple sites
- PDPM optimization expertise
- Survey design and analysis
- Quality assurance and performance improvement
- SOP standardization
- Training facilitation and support
- Revenue cycle optimization
- Electronic medical record analytics
- People management
- Decision-making, Verbal and written communication
- Strategic planning
- Relationship building
Timeline
MDS DIRECTOR
ALIYA Healthcare
07.2024 - Current
MDS COORDINATOR
Bria Health – River Oaks
01.2022 - 05.2023
DIRECTOR OF HEALTH & WELLNESS
Rittenhouse Village
04.2021 - 12.2021
WELLNESS DIRECTOR
Eden Supportive Living
09.2020 - 10.2021
Staff LPN (Per Diem)
Delta-T Group
01.2015 - Current
Master of Science - Healthcare Administration
Capella University
Bachelor of Science - Organizational Leadership
Point University
Practical Nursing Diploma -
North Metro Technical College
Financial Performance - Analysis Of Strategic Impact
2024-09-01 to 2025-12-31, Medicare A PDPM Rate, +15.86%, Achieved through diagnostic capture and interdisciplinary alignment., Managed PDPM Rate, +8.41%, Revenue gains driven by documentation integrity, reducing audit exposure., Case Mix Index (CMI), +15.10%, High ROI / Low Risk: Growth reflects sustainable clinical accuracy., Low Regulatory Risk (Audit-supported growth) | Low Operational Risk (Standardized SOPs), Performance justified CMS approval to raise CMI goal from 1.6 to 1.7.
Certifications/Hobbies
AAPACN Membership Certification-RAC-CT, 2025
BLS CPR
Community Volunteering with Events
Meeting managements for nonprofits
Coaching/mentoring
Advocacy workshops
Charity Fundraising
Credentials/Recognition
- LPN, Indiana - Compact, Illinois, 2027
- 2025 Aliya MDS Newsletter recognized for leadership Spotlight by Clinical Reimbursement Consultant