For your team / Case management
Remove work without creating another queue.
You are the person who finds out a transition failed, usually after it failed. So the only question worth answering here is what actually leaves your plate and what comes back.
The exception should arrive ready to own.
Case managers see the barrier, prior work, next action, and acceptance state without rebuilding the story.
- 01Barrier surfaced
- 02Prior attempts attached
- 03Navigator work accepted
- 04Licensed handoff packaged
- 05Owner accepts
- 06Record reconciled
Rely removes nonclinical chase work. Clinical decisions return with context.
The exception should arrive ready to own. Case managers see the barrier, prior work, next action, and acceptance state without rebuilding the story. The diagram shows Barrier surfaced, Prior attempts attached, Navigator work accepted, Licensed handoff packaged, Owner accepts, Record reconciled. Rely removes nonclinical chase work. Clinical decisions return with context.
One case, through your lens
Barrier discovery to accepted handoff
One post-discharge case, left to right. Every stage carries a timestamp, an owner and a permitted action set. The case is not finished until it reaches one of three defined states.
| Attempt | Barrier found | Action | Final state | |
|---|---|---|---|---|
| AI voice agentrepeatable attempts | Attempts and channels recorded, including the failed ones Completed | Blocker named in the record, not summarized as a note Completed | ||
| Rely navigatornonclinical, scope-bound | Owner assigned and acceptance recorded Completed | Permitted next step worked Completed | Completed, or closed with a defined reason Completed | |
| Your licensed teamonly where a clinical decision is required | Clinical thread opened separately, with an owner who accepts it Unspoken need | Handed to an owner who accepted the work Completed | ||
| Assignment without acceptancethe state we refuse to call closed | Escalation on its own is never closure Did not happen |
Illustrative shape, not a customer case. Every stage reconciles against your source of truth, so your report and ours do not disagree. What returns to you is anything needing a clinical decision, anything outside the permitted action set, a dependency that will not move without your authority, or a case where the defined fallback fired and you are the fallback owner.
The operating contract
Where the boundary sits for your team
For case management the boundary is not really about diagnosis. It is about which exception a navigator may accept without asking you. Contact repair, transportation, coverage lapses, scheduling across organizations and approved resource referrals are navigator-owned where the program grants them. Anything a licensed user must author, and any clinical thread, comes to your team with an owner and an acceptance clock.
That permission list is agreed per program and never inherited from another one. The exception taxonomy below is the shape of that conversation, not a universal grant.
The ask
Map one failed transition with the person who works it.
Bring one transition that is already failing. A population you can define, a path that breaks often enough that your team describes it from memory, and the person who works it today rather than only the person who reports on it.
In the room we map the actual path rather than the policy. Attempts, blockers, who absorbs each one, where the work goes when it stalls, and which steps genuinely require a license.
- You leave with a working exception taxonomy and a returned-work definition, written in your language.
- Including the measures you would hold us to, and the ones we would refuse to claim.
- We ask you to name your clinical validator, your security reviewer, and the person who signs.
Bring us the exception list you are tired of.
We will map it against what a navigator can work, what stays with your nurses, and what a closed case has to prove.