Context

Following the acquisition of AbleTo and Refresh Mental Health (RMH), Optum needed to stand up a national behavioral health intake model capable of supporting multiple care offerings, provider networks, and operational teams.

I designed a unified platform for Patient Navigators that consolidated intake, eligibility, provider matching, and scheduling workflows—reducing operational complexity and accelerating patient access to care.

• Role: Lead Product Designer (sole designer)

• Team: Product · Engineering · Operations · Clinical SMEs

• Scope: Service Design · Systems Design · Internal Tools · UX

  
  

The Challenge

Patient Navigators were the front line for anyone calling in to access behavioral health care — but the tools behind them hadn't caught up to what the business had just become:

• Three organizations, three rulebooks: Optum's own BH care, RMH, and AbleTo each came with different services, eligibility logic (age, state, insurer/payor), and provider data sources — with no unified system built to bring them together yet.

• Fragmented systems: Navigators toggled between a Salesforce workstation, a separate Provider Matching Tool built on a Smartsheet-backed dataset, and additional systems for insurance verification (VOB) and provider availability — with no single source of truth.

• No unified real-time availability: Provider schedules lived in disconnected systems (Athena for RMH, a separate AbleTo Connect flow), so navigators often quoted times that weren't actually open.

  
  

What I Did

To kick off the project, I led a series of service blueprinting workshops with cross-functional leaders from all three organizations, producing a full-funnel service blueprint of the Patient Access Center (PAC) — capturing metrics, touchpoints, systems, and pain points for each phase of the end-to-end journey. This became the source-of-truth artifact that product, engineering, and ops referenced throughout the project.

From there, a list of some but all of the steps I took:

• Listened in on live Patient Navigator intake calls and ran usability testing on old and new workflows

• Wireframed concept models mapping eligibility and provider-matching data logic field by field, screen by screen

• Reconciled provider data by mapping overlapping-but-structurally-different fields (credentialing, license state, therapy type, gender identity, languages) into a single universal provider data schema

  
  

The Solution

Create a single working environment: Consolidated most workflows into Salesforce while leveraging Athena as the source of clinical truth. This reduced context switching and gave Navigators a unified view of the patient journey.

Organize around the care journey—not internal systems: The experience followed the natural flow of dialogue with the patient. This reduced cognitive load and helped Patient Navigators focus on patient needs rather than system limitations.

Surface the right information at the right moment: Provider matching required balancing: clinical needs, insurance coverage, patient preferences, provider availability, geography, scheduling constraints.The platform brought these decision points together into a more actionable workflow, improving confidence and reducing manual reconciliation.

Outcomes + Reflection

The resulting platform significantly simplified the work of Patient Navigators while improving operational efficiency across the organization.

• Improved first-call resolution — Navigators were better equipped to complete intake, matching, and scheduling within a single interaction.

• Reduced intake call times — Simplified systems and workflows reduced searching, duplication, and manual handoffs.

• Accelerated speed to care — Patients were connected to appropriate programs and providers more quickly.

This project reinforced my belief that many healthcare challenges are fundamentally information challenges. Future AI-enabled experiences could help further unify fragmented patient, provider, and operational data—creating more proactive, personalized, and efficient pathways to care while preserving time for the human moments that matter most.