Case Studies

“Working with Anoteros has been a breath of fresh air. They’ve been a true partner — offering guidance not only on what they were implementing, but also on areas outside their scope. Their team went above and beyond, providing clear communication, thoughtful collaboration, and strong knowledge transfer to ensure my team could succeed moving forward. Unlike other vendors, I never felt like I was being nickel-and-dimed. With Anoteros, I always knew they could deliver — and they did. Implementing GuidingCare with Anoteros as the implementation partner was a very different and genuinely positive experience“
– Karen Carlson, Chief Operating Officer

Neighborhood Health Plan of Rhode Island (Neighborhood) is a not-for-profit 501c3 health maintenance organization (HMO) insurance company serving Medicaid, Commercial, and Medicare-Medicaid populations. Neighborhood was preparing for a full-scale transformation of its clinical operations. The organization selected HealthEdge’s® GuidingCare® as its enterprise care management platform, aiming to consolidate fragmented systems and improve efficiency, compliance, and oversight across Case Management, Utilization Management, and Grievances & Appeals.
Prior to implementation, operations were siloed, fragmented, and heavily reliant on manual workarounds, including the use of spreadsheets and email-based coordination. This lack of standardization hindered operations and limited leadership’s visibility across teams. At the same time, the health plan was preparing for a new Dual Eligible Special Needs Plan (D-SNP) contract, which required alignment with CMS readiness standards and D-SNP-specific regulatory requirements.
The organization required a strategic partner to lead the transformation, encompassing workflow redesign, platform configuration, cross-functional integration, and overall program management — while ensuring compliance, scalability, and operational excellence across all lines of business.

Anoteros led a phased engagement designed to deliver immediate operational improvements and long-term sustainability. Phase One of the implementation focused on launching the Medicaid and Commercial lines of business on GuidingCare®. Our engagement began with a comprehensive assessment of the current state. We then brought together stakeholders from across departments to facilitate future state design sessions, leveraging our deep clinical workflow expertise and industry best practices to help the client design the optimal future state. Our team translated contractual obligations, NCQA standards, and HEDIS measures into actionable workflows and system configurations. We designed population-specific workflows, developed desk-level procedures, and configured the platform to reflect real-world operations, ensuring compliance and efficiency were embedded throughout.

We collaborated closely with Neighborhood to analyze its data migration and integration needs, providing detailed guidance and recommendations for historical data migrations. We worked closely with all third-party software vendors and system owners to design and implement a fully integrated ecosystem.  Anoteros also provided expertise in reporting.  We guided Neighborhood in leveraging GuidingCare’s standard reports and built custom queries to meet their compliance and operational reporting needs.

Our team facilitated and led User Acceptance Testing (UAT), created navigation guides and quick-reference tools, and provided go-live support to ensure a smooth and successful launch. The result was a unified system of record that improved consistency, efficiency, communication, and oversight—while eliminating manual tracking and reducing administrative burden.

Phase Two of the implementation centered on D-SNP readiness. Anoteros played a critical role in preparing the Clinical departments for CMS compliance. We conducted future-state design sessions for Case Management, Utilization Management, and Grievances & Appeals, created D-SNP-specific workflows and desk-level procedures, and configured GuidingCare based on contractual, NCQA, and HEDIS requirements.

“The clinical expertise was the reason we chose Anoteros. Plenty of vendors can handle the technical components, but Anoteros not only understood the technology — they guided us on how to use the system and improve our clinical processes for greater efficiency. That’s what made the project successful. During the design phase, they worked closely with our clinical teams to understand workflows, explore strategies, and offer thoughtful solutions. Their subject matter expertise and careful collaboration added real value every step of the way“
– Kristin Russell, Chief Medical Officer

The health plan successfully launched its Medicaid and Commercial operations on GuidingCare®, achieving its goal of implementing a best-in-class Care Management solution with minimal disruption to business operations. Anoteros’ expertise and structured methodology, coupled with a deep commitment by Neighborhood’s leadership team for operational and clinical excellence, helped make this initiative truly transformative and impactful. For D-SNP, the organization entered its readiness phase with efficient workflows, validated configurations, and a clear operational roadmap. Anoteros’ contributions ensured that the health plan was well-positioned to demonstrate CMS readiness and support its expanding clinical operations with confidence.
The platform now serves as a scalable foundation for managing complex member needs and regulatory shifts. Together with Neighborhood and HealthEdge®, we didn’t just implement a system—we architected a high-performance ecosystem that empowers teams, enhances visibility, and drives sustainable success.

“Anoteros was an exceptional partner throughout our GuidingCare implementation. Their team’s deep knowledge and professionalism gave me confidence every step of the way, and we always had the right information to make smart decisions. I truly feel we moved a mountain by implementing GuidingCare successfully in such a short period of time — it was nothing short of heroic!“
– David Madden, Director, Project Management Office (PMO)

A nonprofit regional Medicaid health plan sought to streamline Utilization Management (UM) operations to gain efficiency and achieve cost savings. Existing workflows were heavily manual, relying on fax, email, and phone-based submissions. This fragmented approach created compliance risks, slowed turnaround times, and consumed valuable staff resources.
At the same time, the organization needed to align with updated regional regulatory requirements for electronic prior authorizations, which mandate faster turnaround times compared to traditional submission channels. To remain compliant, reduce administrative burden, and improve provider collaboration, the health plan required a strategic solution that could deliver efficiency, transparency, and oversight.
The organization engaged Anoteros as a strategic partner to lead the implementation of HealthEdge’s GuidingCare® Authorization Portal—a modern digital solution designed to automate preauthorization workflows and provide real-time communication between providers and UM staff.

Anoteros led a structured engagement designed to deliver immediate operational improvements and long-term sustainability. We implemented the Authorization Portal in collaboration with the health plan’s Utilization Management, Care Management, Provider Relations, Customer Care, Claims, IT, and Project Management teams.

• Stakeholder alignment: Facilitated cross-functional sessions to identify the health plan’s pain points, including incomplete submissions, inaccurate diagnosis and procedure codes, overlapping dates of service and provider’s lack of real-time visibility into authorization status.
• System configuration:
  • Identified authorization types eligible for online submission.
  • Designed and configured custom scripts and questionnaires to gather all required information upfront, along with the submission
  • Designed business rules to automate routing authorizations and notifications.
  • Enabled provider self-service capabilities, such as submitting prior authorizations, reauthorizations, discharge notifications, and withdrawal of pending requests.
• Regulatory compliance: Updated workflows and turnaround times to meet electronic submission standards (3 vs 5 business days), electronic notifications, while also aligning with NCQA accreditation requirements.
• Provider readiness: Created external-facing training materials, FAQs, and video vignettes to support provider adoption. Conducted live demonstrations for targeted provider groups.
• UM staff enablement: Developed internal desk-level procedures reflecting new workflows, supported User Acceptance Testing (UAT) with internal and external users, and provided Go-live support to ensure real-time troubleshooting and issue resolution.
• Integration support: Coordinated with a concurrent Provider Portal initiative to enable Single Sign-On (SSO) integration with the GuidingCare® Authorization Portal.

The Authorization Portal launched successfully with minimal provider inquiries and strong adoption. Key impacts included:

• Operational efficiency and Cost Savings: The Utilization Management (UM) department achieved notable reductions in manual effort for both administrative and clinical staff, resulting in enhanced efficiency and cost savings. Contributing factors included:
  • Reduced reliance on fax and email-based requests from high-volume providers
  • Upfront collection of all required information, eliminating the need for follow-up inquiries to Providers
  • Automated routing of requests and associated notifications that reduced supervisor triaging and case-load assignments
• Regulatory compliance: Electronic submission workflows ensured compliance with accelerated turnaround requirements, strengthened data integrity, and improved audit readiness.
• Provider experience: Providers gained real-time visibility into the status of authorization requests submitted from multiple locations according to role-based permissions, the ability to self-serve updates, and timely access to direct communication channels with UM staff—improving collaboration and transparency.
• Sustainable transformation: With standardized processes, clear documentation, and staff/provider readiness, the health plan now operates on a scalable foundation that enhances oversight and supports ongoing UM initiatives.

Through strategic partnership with the health plan and HealthEdge®, we delivered more than technology—we transformed utilization management operations to achieve measurable compliance, efficiency gains, stronger provider relationships and cost savings for the health plan.

Our client, a leading provider of short-term rental (STR) analytics, offers a subscription-based service that helps real estate investors, vacation rental hosts, and property managers better understand and navigate the rental market. By tracking the performance of over 10 million listings, the organization provides insights into pricing, revenue potential, and market comparisons.

The client aimed to deepen its market intelligence by leveraging Artificial Intelligence (AI) to expand its capabilities in two key areas: collecting and organizing regulatory data across targeted cities, and accurately matching property addresses across fragmented online listings. The primary challenges preventing the organization from reaching its goal were the time & labor-intensive nature of manual processes and the inability to scale given the number of cities and volume of data.

Anoteros was tasked by the client to enhance their commercial offerings by automating regulatory data collection and address discovery for listings. Our approach followed a structured, multi-phase methodology: Assess, Prototype, Review, and Implement.

Our engagement began with the Assess phase. During this initial stage, we conducted a current state assessment, looking at existing data sources, experimenting with image comparison, identifying AI/ML opportunities, evaluating new data sources, and developing a milestone plan. This involved reviewing data sources with the client’s internal SMEs and identifying markets for a Proof of Concept (POC).

Following the assessment, we moved into the Prototype phase. In this phase, Anoteros built and validated prototypes through automated solutions, leveraging learnings from the Assess phase. This involved utilizing AI/ML models and developing automated validation methods to ensure the efficacy of our solutions. Both the regulatory data and the address discovery POCs were actively prototyped during this period, incorporating AI/ML and developing validation methods.

The project then progressed to the Review phase. Here, we aggregated findings from the Prototype phase, developed recommendations for the path forward, and reviewed these findings and recommendations with the client’s leadership team. A summary of findings from the Prototype phase and an implementation plan with a proposed budget were also developed.

Requirement 1: Automating Regulatory Data Discovery & Insights for Short-Term Rentals

Business Challenge & Requirements: 
The organization sought to gather city-specific short-term rental regulations and automatically generate clear summaries of complex information such as permitting requirements, zoning rules, and other local restrictions.
The inherent challenges with this requirement included:

• Data Fragmentation and Volatility: Regulatory information is not centralized. It is scattered across disparate sources such as municipal websites, city planning documents, public announcements and discussion forums. The frequent updates to these regulations mean any manually collected data quickly becomes obsolete.
• Semantic Complexity: Municipal regulations are written in dense, legal language. An automated solution must be able to parse this language to accurately identify and extract specific data points such as duration limits, occupancy rules, permit fees, and zoning restrictions.
• Scalability: Manually scaling the research process to over 100 cities is operationally and financially unfeasible. Each new city adds a significant burden on the analyst team, making a manual approach impossible to maintain at scale.
• Trust and Reliability: A core challenge for any automated solution is establishing trust. The system must not only retrieve information but also have confidence in the authority of its sources. A significant technical hurdle is mitigating the risk of LLM “hallucinations”—where the AI generates plausible but incorrect information—to ensure data trust

Our Solution & Technical Implementation: 
To overcome these challenges, Anoteros engineered a sophisticated AI agent designed for automated data discovery and insight generation. This system was built to dynamically crawl the web and extract up-to-date regulatory information from trusted sources

Our implementation involved several key techniques:

• An AI agent leveraging a combination of Large Language Models (LLMs), including Gemini, Claude, and models from OpenAI and Perplexity, was developed to ensure high accuracy and appropriate tone.
• Intelligent Source Prioritization: The system leverages Google Search for real-time web discovery. To ensure source reliability, our scraping logic was designed to prioritize content from top-ranked search results and give special weight to information in Google’s featured answers, using search engine ranking as a strong proxy for source authority. This aligns with our goal of parsing only trusted content.
• Retrieval-Augmented Generation (RAG): To ensure contextual grounding and mitigate model confabulation, we implemented a Retrieval-Augmented Generation (RAG) framework. This system dynamically retrieves the most pertinent and up to date text segments from our prioritized sources based on specific evaluation criteria (e.g., ‘maximum occupancy,’ ‘permit fees’). This retrieved content is stored/indexed and provided as a rich, factual context to the LLM, compelling it to generate answers that are strictly grounded in the verified source material.
• Ensemble Learning for Accuracy: Rather than relying on a single model, we employed an ensemble learning technique. The system queries multiple leading LLMs simultaneously—including Gemini, Claude, OpenAI, and Perplexity models —and then intelligently synthesizes their outputs. This approach creates a more robust and accurate result than any single model could produce alone, effectively cross-verifying the information and minimizing the risk of model-specific errors or hallucinations.
• Robust Fact-Verification: After the ensemble model generates an answer, we deployed dedicated fact-verification layers. This final step cross-references the synthesized information against the prioritized source documents to avoid hallucinations and ensure the highest degree of data trust.
• Traceability for Human Review: To facilitate a final layer of human oversight, the system’s output explicitly includes the source URLs as citations alongside the AI-generated answers. This critical feature enables a human-in-the-loop review process, allowing the client’s analysts to quickly and easily validate the data’s origin before publication, cementing confidence in the final product.
• Advanced Data Processing: We used semantic clustering to group similar information, avoid data duplication, and ensure comprehensive coverage of all relevant regulations. The system was also designed with flexible output formatting for seamless integration into the client’s downstream products.

Diagram 1: Regulatory Data Hybrid Approach Workflow – A flowchart illustrating the process from Google Search result ranking and scraping, feeding content to an LLM, generating tailored answers, populating a database with source links and content, and finally, manual review (Click to enlarge)

Requirement 2: Automating Address Discovery

Business Challenge & Requirements: 
The client sought a method to discover the exact street addresses of property listings found on leading short-term rental websites. This address data is a critical missing link needed to derive valuable data correlations—such as comparing a listing’s performance to local real estate values or neighborhood trends—and ultimately improve their product offerings.
The challenges associated with this requirement are significant:

• Deliberate Data Obfuscation: STR platforms intentionally conceal exact property addresses for the privacy and security of hosts. They typically only show a general radius on a map, making direct extraction impossible.
• Lack of a Single Source: There is no straightforward way to find an address. The solution requires a creative, multi-modal approach that can piece together clues from different data types (images, text) and external sources.
• Scalability: The solution needed to be viable for millions of properties across hundreds of cities, demanding a highly efficient and cost-effective architecture to handle massive volumes of data processing.

Our Solution & Technical Implementation: 
We engineered a creative and highly effective automated address discovery solution. Our initial research explored several potential methods, including attempting to match property photos with Google Maps Street View imagery. However, we ultimately developed a more robust and scalable multi-step process that yielded superior results.
The core components of our final solution include:

1. Image Acquisition & Classification: For a given listing, we first downloaded all available images. We then used OpenAI CLIP for image classification to analyze the photos and identify specific, high-value images, such as exterior shots showing the front elevation of the property.
2. Targeted Reverse Image Search: The classified front elevation images were then used to perform a reverse image search using Google Lens. To avoid false positives, we configured the system to only consider exact image matches from the search results.
3. Source Prioritization & Extraction: We prioritized results from reputable real estate websites (e.g., Zillow, Compass) and other sources from which an address could be reliably extracted. The system then scraped the precise street address from these high-priority pages.
4. Geocoding & Validation: The extracted addresses were converted into precise latitude and longitude coordinates using geocoding for address conversion. We then calculated the distance between our discovered coordinates and the approximate location provided on STR websites’ listings to assess accuracy.
5. Refined Validation Logic: To ensure the highest quality, we developed a rules-based validation system. This included automatically selecting the closest address match or flagging a listing for manual review if the calculated distance exceeded a set threshold or if search results pointed to multiple different street addresses.

This entire solution was designed to be highly scalable, capable of processing millions of properties across hundreds of cities.

Diagram 2: Address Matching Workflow – A flowchart depicting the flow from property image download, classification by Clip by OpenAI, reverse image search via Google Lens, extraction of addresses from search results, conversion to lat/long, distance calculation, and validation (Click to enlarge)

Anoteros successfully addressed the client’s two core problems, delivering automated outputs for regulatory insights and high-accuracy address matches. Anoteros helped the client to significantly reduce manual processes with scalable and highly accurate solutions.

The automation helped reduce manual costs significantly and improve operational efficiency. It also attained 90% accuracy in data validation. Today, the client is actively integrating these tools into its internal workflows, hiring a dedicated regulatory research analyst, and exploring budget expansion to further productionize and scale the address matching process. This strategic partnership has helped our client build a stronger foundation for continued growth and enhanced market intelligence, also opening up new revenue streams by enhancing product offerings.

“What made our Anoteros partnership successful was their ability to manage complex enterprise transformation and accelerated implementation timelines through subject matter expertise combined with domain analyst engagement and excellent project management.”
— Stuart Myer, Chief Information Officer, VillageCareMAX

VillageCareMAX, a New York health plan serving governmental programs, including Medicaid Managed Long-Term Care (MLTC) and Medicare, faced significant operational and technological constraints that were limiting its ability to efficiently serve its members and compete effectively in the market. The organization’s existing administrative and IT infrastructure was creating bottlenecks across critical business functions, resulting in low auto-adjudication rates, extensive manual workarounds, and limited automation capabilities.

The health plan’s core operational areas—spanning enrollment and eligibility, premium billing, claims processing, encounter management, provider network management, and regulatory reporting—were operating with disparate systems and processes that hindered efficiency and scalability. Manual interventions were required for routine tasks, creating operational burden and increasing the risk of errors. Additionally, third-party integrations were insufficient to support seamless data exchange and workflow automation.

Recognizing the need for transformation, VillageCareMAX made the strategic decision to transition to a Business Process as a Service (BPaaS) vendor model to modernize its operations. However, they faced the complex challenge of implementing the new vendor in a very compressed timeline while ensuring the chosen solution could address comprehensive operational needs across all functional areas to ensure a successful transformation.

Anoteros served as VillageCareMAX’s strategic implementation partner, acting as the bridge between the plan and the selected BPaaS vendor to ensure a seamless transition. Our approach centered on five core pillars: strategic partnership facilitation, accelerated implementation management, enterprise system integration, operational excellence, and change management.

Strategic Partnership Facilitation Anoteros positioned itself as an advocate for the health plan and a liaison with the BPaaS vendor, ensuring that the health plan’s operational requirements and regulatory constraints were fully understood and addressed. We partnered with the BPaaS vendor to create clear communication protocols and governance structures that facilitated transparent collaboration between all parties while maintaining the plan’s strategic interests throughout the engagement.

Accelerated Implementation Framework Recognizing the accelerated timeline, Anoteros developed an integrated project plan that encompassed internal and external tasks to align with the go-live dates. Working closely with VillageCareMAX, its other external vendors, and the BPaaS vendor, multiple workstreams were formed that allowed for simultaneous configuration, testing, and training activities. Our team coordinated with all stakeholders by holding daily standups, weekly milestone reviews, and executive-level steering committee meetings to maintain momentum and quickly address any emerging issues.

Comprehensive Enterprise Systems Integration Management Anoteros led the complex technical integration planning required to connect legacy systems, external state systems, and other third-party systems with the new BPaaS partner. We led data mapping exercises, developed integration specifications, and coordinated testing protocols to ensure seamless data flow across enrollment, claims, billing, service delivery, and reporting functions. Our technical team worked closely with both internal IT staff and the BPaaS vendor’s implementation team to resolve integration challenges proactively.

Operational Excellence Our dedicated team of Subject Matter Experts documented business requirements and developed new processes to improve operational outcomes. We assisted with the development of a robust testing strategy, post-go-live quality assurance programs, and risk mitigation strategies to protect the health plan’s operations during the transition and beyond. We worked closely with all parties to develop contingency plans for critical business functions, implemented parallel testing environments, and developed cut-over plans to ensure business continuity. Our team assisted with comprehensive user acceptance testing and regulatory compliance reviews to validate that all systems met operational and regulatory requirements before go-live.

Change Management and Stakeholder Alignment Understanding that successful transformation extends beyond technology, Anoteros developed a comprehensive change management strategy that addressed both organizational and individual adoption challenges as well as internal and external communications. We facilitated stakeholder workshops, developed customized provider communications and training programs, and created communication plans that kept all team members informed and engaged throughout the transition.

VillageCareMAX successfully implemented the new BPaaS vendor within the project timelines while positioning the organization for sustainable growth in the competitive New York health plan market. VillageCareMAX eliminated the bottlenecks that had previously hindered efficient operations, replacing manual workarounds with automated processes to reduce processing times and improve accuracy.

The comprehensive enterprise systems integration successfully connected legacy systems, external state systems, and third-party platforms with the new BPaaS solution. This integration created seamless data flow across enrollment, claims, billing, service delivery, and reporting functions, eliminating the data silos. The unified system architecture now supports real-time dashboards, information sharing, and automated workflow processes across operational areas.

The successful implementation was completed within the compressed timeline while maintaining business continuity and protecting member services throughout the transition. This achievement demonstrated the effectiveness of Anoteros’ strategic partnership approach and VillageCareMAX’s commitment to operational excellence in serving vulnerable populations through Medicaid MLTC and Medicare programs.

Bottom Line: This engagement showcased Anoteros’ ability to serve as a trusted strategic partner, successfully navigating the complexities of healthcare IT transformation while ensuring business continuity and positioning VillageCareMAX for sustainable growth.

Ready to transform your organization’s operational capabilities? Contact Anoteros to discuss how our strategic partnership approach can drive your next critical transformation initiative.

Anoteros brought such strong expertise in health plans and the GuidingCare product — I didn’t even know there were consultants who could do that”
— Director of Care Management

Our client, a nonprofit Medicaid insurance provider serving over 400,000 members, approached Anoteros with significant operational challenges with its care management systems and processes. The organization’s Care Management and Care Coordination teams were struggling with complicated processes that prevented them from fully utilizing the capabilities of their care management system, HealthEdge®’s GuidingCare® care management platform.

The Care Management team was burdened by over 50 workflows that lacked standardization and were cumbersome to navigate. This complexity forced staff to document patient interactions outside the system and later transfer information, creating duplicative work and inefficiencies. Documentation primarily consisted of free-text notes, resulting in high variability and difficulty tracking outcomes through structured data collection. These limitations also hampered reporting capabilities needed to drive improved productivity and quality of care.

Additionally, with NCQA accreditation as a strategic goal, the client needed to ensure their operational processes met accreditation requirements while establishing a solid foundation for compliance

Drawing on our extensive knowledge of GuidingCare® functionality and care management best practices, the Anoteros team began with a comprehensive end-to-end review of all existing workflows, state contracts, and supporting documentation. During the Discovery phase of the project, we analyzed the information provided by the client to identify efficiency opportunities and system capabilities that could support more streamlined processes.
Our analysis also focused on identifying improvements needed to achieve NCQA accreditation and ensure compliance with relevant federal and state regulations. Working collaboratively with the client, we documented and reviewed suggested process changes and completed the system configuration necessary to implement previously unused
functionality. These enhancements added structure to workflows, improved guidance for staff, and created simplified methods for collecting member information in a structured format.

The Anoteros team developed comprehensive desk-level procedures and supporting materials that not only guided the client through implementing the new workflows but also served as valuable training resources for both current and incoming staff. We conducted comprehensive testing alongside the client to ensure the system performed as expected and met end-user requirements.

We shared industry best practices for post-implementation system management and established processes for the submission, review, and implementation of user-requested changes. To support a successful launch, our team assisted in configuration promotion between the lower and production environments and provided monitoring after go-live to ensure users had the knowledge and tools needed for their daily activities under the new workflow system.

The Care Management optimization transformed how the client’s teams operated. By consolidating over fifty workflows into just sixteen, we dramatically simplified how staff carried out their daily activities. Clinical staff gained the ability to improve documentation practices through structured data entry, reducing their reliance on lengthy narrative notes and improving the speed and efficiency of documenting member interactions and outcomes.
These improved practices significantly increased standardization in care management processes, enhancing the organization’s ability to report on outcomes and staff productivity while monitoring quality of care. The structured approach also positioned the client for greater success in achieving NCQA accreditation by aligning workflows with industry best practices.

Ultimately, the partnership between Anoteros and the client resulted in more efficient operations, better documentation, improved reporting capabilities, and enhanced care management for the 400,000 members served by this Medicaid insurance provider. By optimizing their GuidingCare® platform and associated workflows, Anoteros helped the client build a stronger foundation for continued growth and improved member services.

The client is a large NYC-based nonprofit that is primarily grant funded. The organization had been leveraging a simplified version of Sage Intacct that was implemented and supported by a boutique accounting firm for years. The client was often challenged with effectively keeping up with its operational accounting needs and providing timely and detailed financials to key stakeholders and funders. Though the experience with the system had not been overly positive, the Finance leadership team was willing to consider staying with a reconfigured version of the system.

Anoteros provided the client support through its pivotal decision making process, bringing in a consultant with a decade of nonprofit and Sage Intacct experience to conduct an initial assessment. The outcome of the evaluation was a decision to leverage a new Sage Intacct implementation partner with support from Anoteros to guide the client through the re-implementation of the solution.

Anoteros provided specialized experience in the non-profit sector, facilitating in-depth and ultimately crucial planning sessions to determine a blueprint for the reconfigured solution. Coupled with the Sage Intacct expertise of the implementation partner, all three parties were able to deliver an effective and efficient solution to meet the client’s requirements.

After a successful re-implementation, the client is now configured on a more robust, easy-to-use, and deliberate configuration of Sage Intacct that has allowed it to reclaim crucial time previously lost due to the shortcomings of the legacy system. Since go-live, the client has taken on two additional implementations with the Anoteros team, SAP Concur for expense management, and DataBlend for its integration needs. The client continues to improve and invest in its systems to optimize its finance and accounting functions.

Our client is a non-profit organization based in New York City. Following a robust selection process, the client asked Anoteros to manage the implementation of their new human capital management (HCM) system. In addition to the system change, the client had decided to change its pay cycle from semi-monthly current basis to bi-weekly arrears basis. The client also sought Anoteros’ assistance in rolling out this significant change to its staff alongside the system change.

Anoteros provided the following support to the client throughout the implementation project:

• Pay cycle change management: We helped the client develop employee communications and a loan program that would assist employees in managing the shift to arrears pay.
• Project management: We acted as client-side project manager, ensuring the vendor was delivering as expected and that client team members were also fulfilling their responsibilities.
• Business analysis: We worked alongside the HR team and the vendor as they configured the new HCM and helped to ‘translate’ between business needs and system capabilities.
• General ledger expertise: We supported the client’s Finance team in working with the vendor to design a custom post-payroll general ledger export.

The transition to the new system was successful, with no payroll errors. The time taken to run payroll is significantly reduced due to increased automation and elimination of reconciliation ‘re-work’ that is inherent to current basis pay cycles. Additional interfaces with benefits carriers have reduced manual data input and transfer. Supervisors report a much easier timecard approval process, and HR has automated several previously manual processes. In addition, the client’s Finance team has eliminated all manual manipulation that they previously had to do on the HCM general ledger export.

Our client is a non-profit organization based in New York City. The client was on its third human resources and payroll (HR) system in ten years and was frustrated that the current system was not meeting its needs. There was significant manual effort and calculation involved in running payroll each cycle, and employees and managers found the system hard to use. There were also defects which the vendor had not been able to resolve.

The client approached Anoteros for support in sourcing a replacement system, with a clear goal that the new system must meet the client’s need for both the short and long-term.

Anoteros recommended a more thorough selection process than the client had used for its past system selections. This started with a current state assessment where we shadowed and held workshops with the HR and Finance teams to map their current processes and identify where there were issues, gaps, and opportunities. The assessment identified opportunities for improvement not just in the technology but in policies, process, and roles. Using the insight garnered from the assessment, Anoteros developed a list of 650 business requirements for the new HR system and broader recommendations for policy and process improvements.

Perhaps the most significant finding from the assessment was that the client’s current-basis pay approach was an impediment to fully automating the payroll process. The client’s current system simply wasn’t built for it, and therefore had been configured to “fit a round peg into a square hole”, which explained why the current process required so many manual interventions.

Anoteros conducted a market scan to identify HR systems that could meet the client’s requirements, including a current-basis pay approach, as the client was considering in parallel whether to move to arrears-basis and did not want to force that decision due to a system selection. From the market scan, three vendors were identified and we worked with the client to conduct a thorough Request for Proposal, demo, and selection process. After presenting the options and recommendation to the leadership team, the recommended vendor was approved and we then led the contract negotiations process.

When Anoteros and the HR team presented the preferred vendor recommendation to the client’s leadership team, along with the recommendation to change the pay approach from current-basis to arrears-basis, both recommendations received unanimous approval, with the robust approach giving the leaders confidence that they were making the right decision for the organization.

In the contract negotiations, we realized 28% in savings over the term of the contract and secured substantial protections for the client related to data security and system resiliency.

We are now thrilled to be leading the implementation process for the client.

Our client is a home health care provider servicing the New York metro area. The client was seeking assistance with an IT strategy and roadmap, with a primary focus on developing a plan for its highest priority, a cloud-based data warehouse. The organization was growing rapidly via the acquisition of smaller homecare agencies and needed a consolidated view of all its businesses and their underlying performances.

Anoteros assembled a team consisting of a program manager, business analyst, cloud data architect, and an Anoteros partner. Through meetings with key business leaders, IT staff, and other functional experts in the organization, we were able to assess and document the future state IT needs of the organization. Our assessment evaluated all major applications and their pain points and limitations. We developed a roadmap for remediation of these gaps with specific recommendations on solutions and projects for the client to undertake in several key areas including Billing, Accounts Receivable, and Payroll.

We also spent significant time evaluating the client’s data needs by analyzing key source systems, reviewing existing reports and KPIs, and ascertaining the client’s future data needs to support its operations and growth plans. Anoteros developed a plan for an Azure data warehouse solution utilizing various components of Microsoft’s cloud data stack.

Anoteros developed a detailed roadmap with timelines and budgets, providing a blueprint for IT investments required to support the organization’s growth plans. We designed the technical architecture for the new data warehouse and built a dynamic finance model for all Azure-related costs based on the client’s current data needs, but accounting for future growth tied to patient census projections.

Our client is one of the few independent, community-based, providers of integrated addiction treatment and primary care services in the United States, serving New Yorkers with substance use disorder who are disproportionately low-income. Without the resources of major healthcare systems, many independent providers had faced challenges with New York State’s Medicaid redesign transition, as they had gone from billing most of their services through a single-payer (the State) to billing around ten different managed care payors. Our client estimated they had lost 5% in revenue during the transition, an amount that was the difference between operating surplus and loss for this non-profit organization. They were also implementing a new electronic health record system. The CEO hired Anoteros to evaluate the end-to-end revenue cycle process and provide recommendations for improvement.

We assembled a team with a mix of expertise in provider billing, payor claims processing, and healthcare technology. To understand all aspects of the revenue cycle we met with staff from finance, IT, and clinical departments as well as the third-party billing vendor, reviewed service and billing data, and assessed the relevant capabilities of both the clinical electronic health record system and the billing system. We took a methodical approach to assess the current process and systems, identify the gaps, and use that analysis to inform recommended actions. Recognizing that “every dollar counts” we did not wait until the final report to share our recommendations, ensuring that leadership was informed immediately when we found a significant issue, so that adjustments could be made in the current billing cycle.

The client did not have the resources of a major provider system, so we placed a lot of importance on ensuring our recommendations were realistic, actionable, and prioritized. Our work provided the client – and their Board – with a comprehensive understanding of the gaps and issues in their current process and enabled them to take a step-by-step approach to address the issues over the following months.

Our client is one of the US’s largest public defender offices, providing legal representation and advocacy free of cost to people facing charges in criminal, family, and immigration courts. When the Executive Director engaged us, each of their practice areas was using different case and document management systems to manage the workflow and client records for their cases. The capabilities of each system varied, and some of the platforms were outdated and not able to meet the client’s current security and resiliency standards. The siloed systems made it difficult to handle cases that involved multiple practice areas, and there was significant manual effort involved in analyzing case data and preparing reports that our client’s funders required, as well as additional IT burden to manage multiple systems and vendors. The client had already begun researching options for a new, unified, case management system and the Executive Director engaged Anoteros to bring expertise in technology sourcing and to accelerate the process.

We mobilized an Anoteros team to drive the selection process forward. Our business analysis experts held workshops with each practice area to understand their day-to-day working processes and then document detailed functional requirements for the new systems. In parallel, we began reviewing the functional capabilities of the potential vendor systems, as well as using Anoteros’ IT expertise to define service level, system, and security requirements. Once the requirements were defined, we issued a detailed Request for Proposal and then held a series of scripted demos where representatives from each of the practice areas were able to review each product’s suitability for their own unique workflows. The client selected a case management system that was designed specifically for legal case management but built on a Salesforce platform, providing significant capability to customize workflows across the legal practices. We also assisted the client with selecting a document management system that could easily integrate with the chosen case management system. We developed a high-level implementation plan and led contract negotiations with the vendors.

Anoteros enabled the client to conduct a rapid business analysis and selection process, reaching a selection decision within just 12 weeks. Our team complimented the client’s legal practice expertise with application, security, and sourcing expertise, together allowing for a comprehensive and diligent selection process. Anoteros is thrilled to now be assisting the client with the implementation of the chosen systems.

The client, a health plan offering Medicaid plans in the Midwest, had launched the implementation of HealthEdge®’s GuidingCare® platform. Unlike its legacy care management system, GuidingCare® would allow integration with other applications, workflow automation, and importantly, the ability to easily scale and therefore support the health plan’s goal of expanding into new markets. Unfortunately, the legacy system vendor was not willing to participate in this transition and instead opted to provide raw data extracts of the client’s clinical records without documentation on the data model.

Anoteros was hired to migrate the data from the legacy system to GuidingCare®. We tapped into our deep healthcare payer experience, knowledge of care management, and expertise in data and technology. We brought together a team of data and business analysts, developers, and a project manager. The team hit the ground running, quickly learned the data model of the legacy system, and developed a data migration and archival strategy. The strategy not only included the steps to migrate data into GuidingCare® but also included steps to address the front-end and workflow impacts once the data was migrated into GuidingCare®. Our team created the data mapping specifications, developed the data migration routines, performed system testing, and facilitated the user acceptance testing of the migrated data in GuidingCare®.

The data migration was successful and supported a seamless transition between care management platforms for the end-users. The data archival strategy positioned the health plan to easily respond to future audits. Overall, the data migration allowed the client to complete the implementation project and turn their focus to expansion efforts.

Our client is a public health entity dedicated to improving the lives and health of New York City residents. The client sought assistance with implementing a new cloud-based finance accounting system to meet its needs for greater automation and advanced reporting capabilities. To support this transformational project, Anoteros was asked to provide project management services and financial systems expertise.

We assembled a team comprising a program manager, a finance consultant who was a Certified Public Accountant (CPA) with deep product knowledge, and a post-production support team to assist the client team with transitioning from the legacy system to the new solution. Anoteros provided strategic and tactical guidance for redesigning the chart of accounts and assisted with system configuration, testing, and development of extracts for conversion of historical data.

Anoteros helped the client implement the core modules for the new solution – General Ledger, Accounts Payable, and Account Receivable – on time and on budget. Based on the strength of our performance, Anoteros was selected to lead Phase 2 – implementation of the Procurement and Billing modules as well as to provide additional services to the project in the areas of change management, communications, and training-related services.

Our client is a Medicaid Managed Long-Term Care (MLTC) payer in New York with members who are home-bound seniors with long-term care needs. When a new member joins the plan, a nurse visits them at home for an assessment to determine their healthcare needs and develop a care plan. Nurses will visit again periodically for additional assessments to ensure the member’s needs are being met over time.

This is a critical part of the care management clinical workflow, however, the client’s process for scheduling nurses for in-home assessment visits was manual and fragmented. Nurses were frustrated with schedules that took them to different corners of New York City on the same day and did not consider their location, skills, and preferences for assignments. This frustration led to constant turnover in staff and the Assessment team was unable to keep up with the rapid growth of the plan’s membership.

Anoteros was hired as a consulting partner to solve the problem. Our team documented the current state processes, identified the inefficiencies, and produced a comprehensive recommendation to improve the scheduling process. Based on our recommendation, the client selected Salesforce as the technology to automate the scheduling of assessment visits, due to its robust field service management capability. We helped the plan select a Salesforce implementation vendor and led the design of a robust solution. The solution mapped member needs with the skills and location of the nurses and provided automated scheduling capability. The solution also integrated DocuSign with Salesforce for e-signatures, and eliminated the paper forms, mini scanners, and printers that the nurses previously carried to the home visits.

The new system enabled the Assessment unit to increase the number of daily in-home assessments by 40%, ensuring members’ needs were identified in a more timely manner. Nurses now spend most of the day using their clinical talents in visits with members because the time spent traveling between appointments is significantly reduced. In addition, an automated scheduling solution is scalable, so the plan was able to add delegated vendors to perform services in newer markets without any additional investment in technology.

The client is a major software provider for home and community-based healthcare providers and Medicaid-managed care payers. The client wanted to modernize its data warehouse with the goal of achieving near real-time data availability for reporting and analytics, improved ability to react quickly to source schema changes, and improved scalability through a cloud-based architecture. The client was seeking an end-to-end cloud solution utilizing Amazon Redshift as the data warehouse given its existing investments in Amazon Web Services (AWS) infrastructure.

Due to the high stakes of the solution selection decision, we recommended a thorough proof-of-concept and assembled a team of subject matter experts in data architecture, data engineering, and DevOps. After reviewing the current data model, we conducted an architecture review and identified and costed potential tool options. Our engineers set up a development environment and ran an eight-week proof-of-concept where we tested both historic and continuous replication data loads to the new warehouse, created infrastructure and automation scripts, and built sample dashboards. The exercise demonstrated that the client’s requirements could be best met by a combination of Amazon Web Service tools – RedShift and Data Migration Services – coupled with Talend, an Extract, Transform, and Load (ETL) tool Anoteros helped select and license on behalf of the client after testing several market-leading ETL tools.

With the client’s approval to move forward, we set up the production environment, managed the conversion of historic data loads, set up monitoring, alert, and reconciliation mechanisms, and created both automated scripts and procedural manuals for steady-state management. After the new warehouse was live, we continued to support the client team, running both the old and new data pipelines in parallel for a few weeks to ensure the new solution was performing as expected. During this phase, we also built out more robust dashboards for monitoring and trained stakeholders on how to use them, before ultimately disconnecting the old data warehouse and pipeline.

Anoteros’ approach to this complex data warehouse migration gave the client confidence to make vendor and tool selection decisions knowing it could meet their needs. Ultimately, they were able to meet their goals with the implementation of the new data solution including near-time replication from the source systems to the data warehouse. Throughout the project, we complemented the in-house data team’s understanding of the existing data model with expertise in cloud-based data warehousing and were able to guide and coach them so that when our project ended, they were able to independently operate and maintain the new environment.

Our client is one of US’s largest public defender offices, providing legal representation and advocacy free of cost to people facing charges in criminal, family, and immigration courts. Having almost doubled in size over the past five years, the client’s IT capabilities hadn’t kept up with the new scale of the organization. This had been exacerbated by the sudden shift to remote work due to the coronavirus pandemic. The Executive Director saw the need for transformation across all aspects of IT and wanted to think strategically to ensure the change would serve the organization for years to come. Recognizing that achieving this vision would require additional expertise, she asked Anoteros to lead the development of a three-year strategy for IT.

We assembled a team comprising infrastructure and IT service delivery experts and quickly went to work assessing the current state of IT. Through meeting with IT staff, analyzing the network and systems, and conducting an IT satisfaction survey with leaders across the organization, we were able to identify the areas of issue and opportunity. We guided IT and executive leadership on a series of decisions that established the future principles under which IT would operate, for example, making an intentional decision to use cloud-based vs. on-premise services wherever possible, and deciding to optimize the use of the client’s existing investment in the Microsoft environment. We then applied these principles as we formulated recommendations for the future state. We developed a pragmatic roadmap for transforming the organization’s network, security, and data center infrastructure that prioritized increasing security and resiliency. In parallel, we developed recommendations on organization and role design for the IT department, identified areas for skill development, and outlined opportunities for service management process improvements.

IT and executive leadership were thrilled that they had a clear strategy for IT for the first time ever, with a pragmatic roadmap to implement the changes over the next three years and associated expense forecasts to build into the organization’s budget. The client asked us to continue providing support for implementation, for both specialized infrastructure expertise and ‘virtual CIO’ services to guide solution selection decisions and ensure the implementation remains on track.

The client, a national payer with Medicaid and Commercial lines of business, had targets to expand into new Medicaid markets but was beleaguered by operational limitations. The care management and utilization departments’ clinical workflows were heavily manual, as they had to work across seventeen disparate systems. Nurses couldn’t effectively access and update member records when in the member’s home, and several compliance gaps had been identified. The client had purchased HealthEdge®’s  GuidingCare® care management platform and hired a multi-billion-dollar consulting firm to plan and execute the implementation, but after several months the project was at a standstill, with the stakeholders unable to agree on the priorities for implementation.

Due to our track record of successful GuidingCare® implementations and our understanding of the business change approach needed for this platform, Anoteros was hired to replace the first consulting firm and we pivoted the project from a technology implementation to a clinical transformation for the payer. We worked to quickly understand the compliance and operational needs of the clinical teams and used that input to develop a phased implementation roadmap. The first release focused on a Minimal Viable Product (MVP), meeting the essential needs of all clinical teams and enabling the client to retain membership in their current market. Subsequent releases would add automation and efficiency gains, enabling the payer to expand into newer markets. We also mapped dependencies with the client’s other transformation initiatives and the GuidingCare® product roadmap. Instead of telling the stakeholders what they should do, we worked to understand their needs and concerns and used that to inform the roadmap. With all stakeholders now on board, the client – with Anoteros’ help – was able to move forward with implementation.

The transformation consolidated clinical operations from seventeen systems to one, automated key clinical workflows, provided mobile capability for nurses’ home visits, and enabled payer-provider collaboration using portals. As a result, the plan was able to reduce its compliance gaps by 75% and increase staff productivity by 40%. These improvements enabled the payer to secure its current market position and expand into new markets. The client called Anoteros “the key reason for the successful transformation of their clinical operations.”