Healthcare Operations · Healthcare AI

Healthcare Operations built for outcome ownership across payer, provider, and patient.

Prior authorization, revenue cycle, workflow automation, and patient access — grounded in operational reality, engineered for AI-era transformation.

Prior Authorization Innovation

Reframing prior auth as an ownership problem across payer and provider — where AI-powered workflow intelligence actually reduces friction and cost.

Healthcare AI

AI applied to real workflows: documentation, eligibility, prior auth, appeals, and patient access — with outcome accountability, not tooling theater.

Revenue Cycle Optimization

Diagnose the seams that create denials, rework, and A/R drag — then close them with workflow governance and outcome ownership.

Workflow Automation

Automate work that should exist. Eliminate work that shouldn't. Design automation around resolution, not task throughput.

Administrative Burden Reduction

Cut the invisible workforce load created by broken payer–provider handoffs, policy variance, and documentation drift.

Patient Access

Reduce access friction with cross-boundary workflow intelligence — so patients experience one system, not five.

Proposed Future Direction · Conceptual

A proposed Intelligence Stack for Healthcare Operations.

The following intelligence layers describe a proposed operating model Donna is exploring through her Founding Partner role at Spirit Works AI. These represent research direction and conceptual product framing — not current production capabilities.

Workflow Intelligence™

Visibility into how work actually moves — where it stalls, escalates, or repeats.

Policy Intelligence™

Payer policy variance operationalized inside workflow — reducing denials and rework.

Documentation Intelligence™

Clinical and administrative documentation quality tied to outcome accountability.

Outcome Intelligence™

Approval, appeal, and resolution outcomes as the operating KPI — not task volume.

Payer & Program Breadth

Experience across the healthcare payment landscape.

Commercial InsuranceMedicareMedicaidWorkers CompensationEmployer Health Plans

Healthcare Operations

Healthcare operations are full of accepted dysfunction — long-term overtime, broken handoffs, administrative drag — that is almost always an ownership problem disguised as a staffing problem.

Payer & Provider Operating Models

Operational design across health insurance and provider environments — where compliance, experience, and cost all matter at once.

Workforce Strategy in Healthcare

Forecasting, scheduling, and operational accountability that resolved a five-year mandatory-overtime dependency at Aetna (CVS Health).

Contact Center Performance

Service level from 23.53% to 89.25%; abandonment from 27.07% to 1.01% — through ownership design, not headcount.

Administrative Burden Reduction

Remove the work that should never have existed: redundant approvals, broken handoffs, and workarounds the workforce is silently absorbing.

  • 23% → 89%
    Service level lift (health insurance)
  • 27% → 1%
    Abandonment reduction
  • −3,677 hrs
    Mandatory overtime eliminated
  • $110K+
    Annual workforce savings