Who We Are
Specifically designed to address the complexities of our health care system today and tomorrow, EviCore by Evernorth employs 5,000 individuals nationwide, including 500+ board-certified physicians and 1,200+ clinicians for clinical expertise in 60+ medical specialties. We also leverage expertise from multiple sources including network providers, leading academic institutions, national medical societies, and our health plan partners. Our evidence-based approach delivers patient-focused guidelines based on each clinical presentation to ensure consistent, yet personalized patient and provider experiences.
Who We Empower
We empower the improvement of care for all those we serve through our deep service capabilities—from utilization management, decision support, and case management, to member engagement, network management, and payment integrity.
We help to ensure safe, effective and quality evidence-based care, while also helping to strengthen the patient/provider relationship through decision-making transparency and education.
We promote evidence-based decisions and quality reporting while reducing administrative burden and cost. We also provide ongoing education for new products and standards in the marketplace.
We deliver proven medical benefits management solutions that improve care for members, while reducing waste and abuse. Our proprietary analytics highlight areas of low-value spend and pinpoint opportunities to improve care and increase savings.
EviCore by Evernorth is guided by a diverse leadership team united by a single vision: Better health outcomes. To realize this vision, we’re committed to transforming our industry through health care innovation and continued expansion of our portfolio of integrated medical benefits management solutions, services, and products.
President, Medical Benefits Management
Since joining EviCore in 1999, Mr. Smith has served in multiple roles, starting as the Vice President of Operations with MedSolutions (later acquired by CareCore National), now known as EviCore. He led the development and management of the national imaging center network, and has led successful major initiatives in account management and business development.
Currently Mr. Smith serves as the President of EviCore’s Medical Benefits Management division; he is responsible for the profit and loss as well as overall growth of all business units.
Prior to joining EviCore, Mr. Smith spent more than 3 years with Cigna/Healthsource in South Carolina as the VP, provider network management. He was responsible for national contracting for ancillary services for Cigna as well as management of local-market medical cost management activities.
Prior to joining Healthsource, he served as Vice President of Development for Medical Resource Management. Mr. Smith began his career as a CPA in the Internal Audit department at Ernst & Whinney (which later became Ernst & Young). Mr. Smith graduated from Harding University with a BBA in accounting.
Pam Doughty, CHC
Senior Director and Chief Compliance Officer
Pam Doughty, CHC
Ms. Doughty handles the management and oversight of compliance risk at EviCore. She oversees the EviCore Compliance Program, which includes teams responsible for ensuring that EviCore is equipped to comply with state, federal, and accreditation rules and regulations.
Since joining the organization in 2008, Ms. Doughty has served in client management and various leadership positions within compliance. These roles focused on regulatory oversight, utilization and quality management, and enterprise compliance risk.
Ms. Doughty holds a B.S. in Organizational Management from John Brown University where she graduated Magna Cum Laude. She's certified in Healthcare Compliance (CHC) and has held certifications as a Registered Medical Assistant (RMA) and Certified Medical Manager (CMM).
Eric J. Gratias, MD, FAAP
Chief Medical Officer
Eric J. Gratias, MD, FAAP
Dr. Gratias joined EviCore in 2013 and has served as EviCore’s Chief Medical Officer since 2019. He is responsible for the overall clinical performance of the company’s management solutions, as well as the development of innovative capabilities.
Dr. Gratias oversees the company’s formulation and maintenance of clinical guidelines, in addition to its payer and provider relations, utilization and quality management services, and health services research. Dr. Gratias conjointly serves as the senior clinical liaison to EviCore health-plan clients and the broader physician community.
Prior to joining EviCore, Dr. Gratias was Associate Professor of Pediatrics at the University of Tennessee College of Medicine Chattanooga. He also served as a practicing Pediatric Hematologist/Oncologist at Children’s Hospital at Erlanger and as a member of the Renal Tumors Steering Committee of the Children’s Oncology Group. He is a fellowship-trained, continuously board-certified Pediatric Hematologist/Oncologist, and practiced full-time pediatric hematology/oncology in Chattanooga for 9 years.
Dr. Gratias received his medical degree from Wake Forest School of Medicine in Winston-Salem, North Carolina. He completed his residency in general pediatrics and fellowship in pediatric hematology/oncology at the University of Alabama at Birmingham. He is an author of over 20 peer-reviewed publications and nearly 40 regional or national meeting abstracts.
Chief Information Officer
Mr. Narayan is responsible for EviCore’s strategy, planning, and execution of all vital areas of technology supporting the business, including product-related software development, data and analytics engineering, program management, and infrastructure for call center operations.
Prior to assuming the CIO position, he held multiple leadership roles shaping the technology roadmap at EviCore (involving data engineering, business intelligence, and analytics engineering), most recently as the Head of Enterprise Data.
During his 20 years of executive/management experience, he has served as Vice President of Technology of Cigna Government Business and fulfilled senior leadership roles with Blue Cross Blue Shield of Western New York, Federal Express, and Transamerica, as well as management consulting roles with Big 4 organizations.
Managing Director, EviCore Operations
As Managing Director of EviCore Operations, Mr. Schmucker manages the development and execution of the operations strategy for EviCore’s Benefits Management+ Solutions. This includes overseeing the operations for the EviCore solutions’ analytics and technology effectiveness capabilities, experience and integration teams, operations training and auditing teams, client implementations, and the production workforce of physician, nurse, non-clinical contact center, and claims. Mr. Schmucker is equally responsible for advancing the business by leading strategic initiatives and supporting the growth efforts of sales and account management organizations.
Mr. Schmucker joined EviCore in 2010 after a distinguished career with the United States Army as an Active Duty Major. His military career included 12 years of experience with several awards, including a Bronze Star: managing operations deployments at home and abroad in Kosovo; commanding units in the Iraq War; and leading humanitarian efforts in New Orleans following the aftermath of Hurricane Katrina.
Upon joining EviCore, he led operations for the Musculoskeletal solutions and Lab programs. Subsequently as Vice President of Operations he assumed responsibility for new solution development, implementations, and client management.
In his most recent role as Senior Vice President Operations, he oversaw all client-centric operations, including service, client, and program operations, and implementations. He also led the operations centers of excellence teams, consumer engagement initiatives, and the non-clinical contact center operations.
Mr. Schmucker is a graduate of the United States Military Academy at West Point with a Bachelor of Science degree in Business Management and a minor in Systems Engineering. He also earned his Master's Degree from Columbia University in Organizational & Leader Development.