Healthcare · Agentic Automation · Featured
Prior Authorization
Automation Agent
A regional health system was spending over 40 hours per week on manual prior authorization processing — a repetitive, error-prone workflow that delayed patient care and burned clinical staff time. We designed and deployed a multi-tool ReAct agent that handles the process autonomously.
The agent reads incoming clinical documents, extracts relevant diagnoses and procedure codes, cross-references payer-specific criteria via a RAG pipeline grounded in clinical guidelines, and either submits the authorization automatically or escalates to a human reviewer with a full reasoning trail.
- Autonomous processing of prior auth requests end-to-end
- Full audit trail logging every reasoning step the agent took
- Escalation queue for edge cases requiring human judgment
- HIPAA-compliant architecture with role-based access control
68%
Reduction in manual review time
94%
Autonomous processing rate
ReAct AgentRAG PipelineLangChainHIPAAClinical NLP
Each project below is a real engagement — a real problem, a real solution, and a measurable result.
Healthcare · Predictive Analytics
Clinical Risk Stratification Platform
Architected a predictive analytics pipeline that stratifies patient populations by readmission and deterioration risk, integrating directly with EHR workflows.
Clinical teams receive risk scores with explainable contributing factors — not just a number, but the reasoning behind it. Built on top of existing EHR data with no new data infrastructure required.
42% improvement in early intervention rate
ML ModelingEHR IntegrationExplainable AIFHIR
Technology · LLM Architecture
Enterprise Knowledge Agent for B2B SaaS
Built a Claude-powered RAG agent grounded in 50,000+ pages of product documentation, support history, and customer contracts.
The agent handles tier-1 support queries autonomously and surfaces the most relevant context for human agents on complex escalations. Reduced the average handle time on escalated tickets by 35%.
40% reduction in tier-1 escalations
Claude APIRAGPineconeSupport Automation
Healthcare · NLP
Clinical Documentation Intelligence Pipeline
Deployed a transformer-based NLP pipeline that extracts structured clinical entities from unstructured physician notes — diagnoses, medications, procedures — and maps them to ICD-10 and SNOMED codes with audit confidence scores.
Eliminated manual coding review for routine documentation, reducing coding time by 60% while improving accuracy through confidence-scored outputs.
94% entity extraction accuracy
TransformersNLPICD-10SNOMED
Technology · AI Governance
AI Governance Framework for Mid-Market FinTech
Designed and implemented a comprehensive AI governance framework including model risk policy, bias monitoring dashboards, decision audit infrastructure, and board-level AI risk reporting.
The framework was designed to satisfy both internal risk committees and external regulatory review — and passed first submission without revision requests.
Passed regulatory review on first submission
Model RiskBias MonitoringAudit TrailsRegulatory
Technology · AI Strategy
Enterprise AI Roadmap for Healthcare Technology Co.
Led a 90-day AI readiness assessment — evaluating data maturity, identifying 14 high-value AI opportunities, prioritizing by impact and feasibility, and delivering a 3-year AI architecture roadmap.
Deliverables included a full board presentation and individual business cases for the top five AI investments. The $12M AI program was authorized within 30 days of the final presentation.
$12M AI investment program authorized
AI ReadinessRoadmappingBoard BriefingBusiness Cases
Healthcare · Process Optimization
Care Coordination Process Optimization Sprint
Mapped end-to-end care coordination workflows across a multi-site health system, identified 11 automation opportunities, and implemented an AI-assisted care gap identification system.
The engagement ran six weeks from kickoff to final delivery, including a KPI dashboard prototype connected to the live EHR and a change management playbook for the clinical operations team.
38% reduction in care gap identification time
BPMCare CoordinationKPI DashboardChange Management