A faster referral pathway could improve access while breaking continuity for members whose care plans differ.
The health plan needs visible appointment completion before renewal, while clinical review must preserve consent, eligibility, and appropriate level-of-care matching.
Who you’d be doing this for
“My renewal committee keeps asking why referrals are marked complete when members still have no appointment.”
Agnieszka Ionescu · Behavioral Health Benefits Manager
Oversees Specialty Care performance for the health-plan population facing the referral gap.
What is at stake
Affected substance use referrals are being recorded without members reaching a first appointment. You must weigh a faster pathway against clinical review for every member whose care could be disrupted.
Why it isn’t already fixed
Every obvious fix costs something else. That’s the part you’d have to decide.
- treatment speed vs clinical appropriateness
- renewal proof vs case-level uncertainty
- provider capacity vs individualized matching
- shared information vs member consent
Why Spring Health
Specialty Care navigation depends on turning high-acuity assessments into timely treatment connections across providers, benefits, and member circumstances.
Written with these in mind
Not your kind of problem? 18 more at Spring Health, or browse every organization.
This is the setup. The work is inside.
Running it puts you in the room: the full situation and its constraints, stakeholders who push back in their own words, and the decisions that are yours to make. What you produce becomes a Day One Plan — work you can show someone instead of describing.