Public source
Transcarent launched Oncology Care during this specialty-care product period.
Public program context for Oncology Care.
Case study
Care navigation that cut avoidable escalations
Led product work across value-based specialty-care and care-navigation programs (Surgery, Urgent Care, Behavioral Health, Oncology Care).
Timeframe
2021–2022
Focus
Redacted, de-identified outcomes
My role
Led product across value-based specialty-care and care-navigation programs. Managed product managers and designed unified member records, routing rules, and coordination playbooks.
Relevance to healthcare AI governance
AI-generated care recommendations don't help nurses and care guides unless they can see why a patient was routed one way, who owns the next step, and how to escalate when the recommendation conflicts with clinical judgment.
Summary
Led product work across value-based specialty-care and care-navigation programs (Surgery, Urgent Care, Behavioral Health, Oncology Care).
Public launch links establish program context; operational results below are de-identified internal observations. Led product work across value-based specialty-care and care-navigation programs (Surgery, Urgent Care, Behavioral Health, and Oncology Care) while managing and mentoring product managers.
Intervention
Unified member record for clinicians and care guides.
Outcome
Routing and escalation rules cut the exception queue by making ownership visible.
Public evidence and evidence level
Anonymized internal evidence
Exception queues, care-plan completion, and routing-delay signals improved.
Healthcare/client confidentiality prevents exact figures; claims are intentionally directional.
End-to-end flow
1 Member inquiry received → 2 Unified member record look up → 3 Clinician-led routing rules applied → 4 Route to Surgery, Urgent Care, Behavioral Health, or Oncology → 5 Care plan created with assigned coordinator → 6 Completion dashboard tracks progress across programs
Detail
Constraints
- Clinical review and benefit partner rules.
- Variable patient acuity and time-sensitive routing.
- Nurses and care guides needed shared facts for coordination.
Interventions
- Unified member record for clinicians and care guides.
- Routing rules tied to clinician roles.
- Completion dashboards and team check-ins.
Outcomes
- Routing and escalation rules cut the exception queue by making ownership visible.
- Care plan completion rates converged — the gap between highest and lowest programs shrank.
- Frontline teams stopped flagging routing as a top reason for delayed resolutions.
Artifacts
- Routing rule map documenting which roles owned which decisions at each step.
- Care plan completion dashboard summarizing program-level completion trends.
- Coordination checklist aligning nurses, care guides, and benefit partners.
Key takeaways
- Algorithm output without a matching workflow owner is just a suggestion.
- Routing rules have to make ownership visible.
- Completion dashboards become governance tools when they surface exceptions and accountability.
Details are anonymized because of healthcare, client, and commercial confidentiality. Public links establish program context. Where exact figures cannot be shared, I describe the operating problem, intervention, observed directional change, and what I directly owned.