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?