Selected Work / Operations Design
Designing Operational Visibility for Authorizations
A fictional workflow tool built to improve authorization visibility, track utilization risk, and surface operational breakdowns before they become downstream revenue problems.
This case study is based on Magnolia Pediatric Behavioral Health, a fictional pediatric behavioral health practice in Augusta, Georgia, with a realistic payer mix that includes Medicaid, BCBS, UnitedHealthcare, Aetna, Cigna, and Humana. The organization and data are fictional, but the workflow risks, operating logic, and intervention thinking are grounded in real-world revenue cycle work.
01
The setup
Authorization operations often fail quietly before they fail visibly. A team may not realize an authorization is nearing exhaustion, approaching expiration, or sitting too long in a vendor queue until the issue has already affected scheduling, reimbursement, or both.
This scenario centers on a fictional pediatric behavioral health practice where authorization work is shared across internal teams and outside vendors. That creates the kind of fragmented oversight that makes it easy for risk to hide in plain sight.
The challenge is not simply obtaining authorizations. It is building enough operational visibility to understand what is pending, what is vulnerable, and where follow-up is needed before service delivery or revenue is impacted.
02
What the dashboard is meant to do
The dashboard below simulates the kind of visibility a billing or revenue cycle team needs to manage prior authorizations before they become downstream problems.
Rather than functioning as a static list, the tool is designed to surface risk early and make action clearer. It helps answer practical operational questions: Which authorizations are active? Which patients are close to exhausting approved units? Which requests are stalled in a vendor queue? Which authorizations are approaching expiration? And where is work accumulating across the broader authorization pipeline?
The dashboard is organized into five views: Auth Summary for a snapshot of active authorizations, Unit Utilization for approved versus consumed units, Vendor Queue + SLA for pending requests at risk of delay, Expiration Risk for renewals and coverage exposure, and Workflow Status for a pipeline-level view of where each authorization sits in the process.
Interactive demo
Live dashboard
If the embedded demo does not load cleanly on your device, use the full-screen link below.
03
What this demonstrates
This piece is meant to show more than dashboard fluency. It is an example of how I think through operational control: where visibility tends to break down, how risk should be prioritized, and what teams need in order to intervene before issues become denials, write-offs, or care disruptions.
The intended takeaway is not just that I can build a tracker, but that I can translate messy operational risk into something visible, usable, and actionable. In a real environment, this kind of tool supports more than reimbursement. It protects scheduling reliability, staff decision-making, and the organization’s ability to scale without preventable leakage.
Bottom line
The goal is not tracking. It is control.
In a real operating environment, the value of an authorization tool is not the tracker itself. It is whether the tracker helps a team see the right risk clearly enough to act before care is disrupted or revenue is exposed.