“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)