The extent to which rural community colleges adapt effectively and in alignment with economic and technological trends significantly influences the extent to which the people and communities they serve experience economic success. Advancing understanding of how rural community college presidents across the nation lead their institutions through innovative adaptations represents a significant contribution to the field of community college leadership and rural postsecondary education. A study was conducted to show how innovative rural community college presidents in the United States lead their institutions through adaptations aligned with the changing nature of work. The study explored how these presidents monitor and interpret external environmental factors related to the changing nature of work, empower their institutions to address the organizational factors that inhibit or contribute to innovation, and the principles or concepts they rely on most to lead organizational change and innovation. The study was qualitative in nature, using semi-structured interviews as the primary data collection method. A purposefully unique, criterion-based sampling was applied to identify research participants with experience leading innovation in rural community colleges. Seventeen presidents participated in the study, representing a diverse spectrum of rural community colleges from across the United States. This report provides a synthesis of advice from those community college presidents across 15 states, including North Carolina. While the nature and nuance of innovations at each institution may vary, there were seven key areas that emerged as priorities, each supported by recent research in the field: (1) better engagement of underserved student populations; (2) shorter, stackable credential pathways; (3) more convenient, flexible scheduling; (4) whole student understanding and support; (5) tighter linkage to employment and entrepreneurship aimed at economic mobility; (6) adoption and promotion of current technologies; and (7) continuous monitoring and experimentation of new models. The challenge ahead is cultivating the institutional culture and capacity to make such innovation happen successfully and aligning policy to facilitate it.