Healthcare strategy
AI + operating leadership
AI + REVENUE CYCLE
I connect claims, access, reimbursement, workflow automation, and governance so technology is accountable to healthcare operations.
Bring identity, coverage, workflow position, and source provenance.
Define the clinical, coverage, financial, and organizational boundary.
Permit specific tools, transactions, and communications.
Name the reviewer, override, escalation, and recovery route.
Reconcile collected cash, burden, access, quality, and operating cost.
THE EXECUTIVE MANDATE
Eligibility, prior authorization, coding, claims, denials, payment integrity, and patient access are connected decisions. The AI design has to preserve evidence, decision rights, review capacity, and a measurable operating consequence across that sequence.
Carry identity, consent, coverage, clinical and financial context, workflow position, source provenance, and freshness into the decision. An output without the right context can accelerate the wrong task or route an exception to the wrong owner.
Translate benefit rules, contracts, organizational policy, and approved workflow requirements into explicit boundaries. Separate administrative routing and evidence preparation from consequential clinical, coverage, or payment decisions. Define the tools, transactions, and communications the system may initiate.
Name the accountable reviewer, the evidence they must inspect, their capacity to review, the override path, and the escalation threshold. Human oversight needs time and decision rights. Keep actions reversible where possible and preserve a manual recovery route.
Distinguish identified opportunity, prevented error, collected cash, released capacity, avoided cost, and modeled benefit. Account for implementation, monitoring, exceptions, review time, transferred work, provider impact, and patient access. Let finance and operating owners validate the value before scaling.
THE OPERATING QUESTIONS
RELEVANT OPERATING HISTORY
Turn claims, utilization, geography, provider behavior, and payer economics into named accounts, referral corridors, and service-line priorities.
Connect acquisition, clinician supply, referral development, payer coverage, intake, scheduling, and outcomes across a behavioral-health platform.
