Processes

What will AGI do for Perform case management and disease management with members?

AI-deliverabilitydigital

With no seeded child occupations, the assessment relies on the process name and its industry context (Health and Medical Insurance Carriers). In an insurance setting, case and disease management consists of care coordination, telephonic member communication, and clinical documentation—information-heavy, desk-bound tasks rather than direct hands-on patient care.

A member is identified through claims analysis, provider referral, or predictive modeling as having a complex health condition or chronic disease requiring care coordination.

Trigger: A member is identified through claims analysis, provider referral, or predictive modeling as having a complex health condition or chronic disease requiring care coordination.
Outcome: The member adheres to a personalized care plan that stabilizes their condition, mitigates acute episodes, and connects them with necessary health resources.

The work itself

Grounded Work Profile

Measured by

Hospital Readmission RateprocessProfile
Member Engagement RateprocessProfile
Care Plan Adherence RateprocessProfile
Cost Avoidance Per MemberprocessProfile

Key steps

Identify high-risk or chronically ill members via claims and referralsprocessProfile
Conduct comprehensive health and psychosocial risk assessmentsprocessProfile
Develop a personalized care and disease management planprocessProfile
Coordinate medical services and connect to community resourcesprocessProfile
Educate the member on condition management and treatment adherenceprocessProfile
Monitor member progress against clinical goalsprocessProfile
Adjust interventions or transition the member out of active managementprocessProfile

How AGI delivers it

Four ways AGI delivers for Perform case management and disease management with members

Services-as-Software
Get the professional outcome delivered as software, priced on results, not headcount.
Services.do
Autonomous Agents as digital employees
Hire a digital employee that does the job under earned, supervised autonomy.
Agents.do
Business-as-Code
Encode how your work runs, once, as software that executes itself.
Platform.do

Value flow

How Perform case management and disease management with members connects

automated by

Generate Care Plan Recommendationmodel
Schedule Member Outreachmodel
Stratify Member Riskmodel
Care Management Platformmodel
Population Health Management Systemmodel

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