Module 4

Care Navigation & Clinical Intelligence

Explore how Belong uses clinical data, AI, and human touchpoints to keep complex members healthier and out of the hospital.

Risk Stratification

Tier 1 — Complex/High Risk

Multiple chronic conditions, recent hospitalization. Assigned dedicated care navigator + clinical oversight.

Tier 2 — Rising Risk

Increasing ED use, new diagnoses, medication gaps. Proactive outreach and monitoring.

Tier 3 — Stable/Preventive

Relatively healthy. Focus on HEDIS gap closure, preventive care, and AWV completion.

Scenario: TOC Intervention

Post-Discharge: CHF Member

Mr. Johnson, 74, was discharged 3 days ago after a CHF exacerbation. He lives alone, has 6 medications, and his follow-up appointment is in 3 weeks. What's the highest-priority action?

Knowledge Check

Question 1 of 3

What is the primary goal of a care navigator at Belong?

💡 Reflection: How should Belong's AI platform decide which members a care navigator calls first each morning? What signals matter most?

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