Kevin O'Malley
Complex Care · Eligible · 66 yo · Medicaid ID MCD-120000019
Current Care Plan
Open Care Plan Copilot →No active care plan.
Assessment
Open Assessment Copilot →Comprehensive Reassessment — IN PROGRESS
Tasks, Alerts & Care Gaps
Workflow Orchestration
Rules + SLA engineRules fire only after a care manager approves something. Each item is routed to an owning team and given an SLA clock; anything past SLA escalates to the supervisor queue.
Automation history
- SLA breach sweepSep 15, 2026, 11:24 AM
- SLA breach: Schedule cardiology follow-up → routed to Supervisor — Dana Whitfield, due Sep 15, 2026Escalate on SLA breach · escalations route to the supervisor queue
- SLA breach: Schedule cardiology follow-up → routed to Supervisor — Dana Whitfield, due Sep 15, 2026
Active rules (7) — configuration, not code
- Transmit assessment + care plan to PCPAssessment completed
The completed assessment and care plan have to reach the PCP; today that is a manually generated letter.
- Reset the reassessment clockAssessment completed
Completing a reassessment books the next one and moves the case due date out, instead of leaving it on a spreadsheet.
- Behavioral health co-management reviewAssessment completed
Co-managed behavioral health cases get a second reviewer rather than routing everything back to the primary CM.
- Turn approved interventions into owned tasksCare plan item approved
Each intervention on an approved care plan item becomes a routed, SLA-tracked task rather than free text inside a PDF.
- Distribute the updated care planCare plan item approved
An approved change to the care plan triggers distribution to the PCP and the member.
- Supervisor review on escalationAI suggestion approved
An approved escalation opens a short-SLA supervisor review instead of relying on someone noticing it.
- Care gap outreach on high-risk membersAI suggestion approved
An approved care gap on a high-risk member schedules member outreach so the gap has an owner and a clock.
Notes → Actions
No notes yet.
Timeline
TASK: Schedule cardiology follow-up
Case opened in CCA
Claim received — office visit, evaluation & management
Prescription fill recorded
ESCALATION: SLA breach: Schedule cardiology follow-up