Public source
Transcarent launched Oncology Care during this specialty-care product period.
Public program context for Oncology Care.
Case study
Routing rules that made care navigation accountable
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
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
Eliminated multi-week exception backlogs across Surgery, Urgent Care, Behavioral Health, and Oncology by assigning explicit role-based decision owners at intake.
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
- Eliminated multi-week exception backlogs across Surgery, Urgent Care, Behavioral Health, and Oncology by assigning explicit role-based decision owners at intake.
- Care plan completion rates converged across all four specialty programs, closing the operational variance between highest- and lowest-performing service lines.
- Routing misassignments were eliminated as a top root-cause driver of care resolution delays.
- Nurses and care guides operated from the same facts for the first time — the unified member record eliminated the information asymmetry that caused most routing exceptions.
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
- Routing rules have to make ownership visible — algorithm output without a workflow owner is just a suggestion.
- Completion dashboards become operational tools when they surface exceptions and accountability.
- Unified records are the prerequisite for any downstream intelligence.
Details are anonymized to preserve healthcare data privacy and proprietary corporate metrics. Public links establish program context. Where exact figures cannot be shared, I describe the operating problem, intervention, and observed directional change.