Diagnose · Trace the mandate to the work
Turn healthcare mandates into executable, auditable operational change.
In 3–4 weeks, I follow one approved mandate or platform transition through Policy → Obligation → Capability → Workflow → System → Control → Owner → Evidence → Outcome. You receive the obligation register, cross-system impact map, gap and ownership matrix, implementation backlog, and a readiness readout showing what is proven and what still needs a decision.
3–4 weeks
$15,000 fixed · 3–4 weeks
One principal · Scope agreed in writing
Inspect the deliverables
See the register, impact map, backlog, and sponsor readout.
Follow one fictional healthcare change across five connected sample deliverables. The package shows how the sprint turns an approved obligation into an explicit readiness decision.
Who it’s for
When this is the right step.
For health plan COOs, CIOs, VPs of Operations, VPs of Transformation, and regulatory-program sponsors facing CMS-0057-F, state prior-authorization mandates, or core platform migrations.
- A regulatory deadline (such as CMS-0057-F or state PA rules) has created multiple projects but no single readiness view.
- Compliance, operations, technology, product, and vendors have each interpreted the mandate differently.
- A prior-authorization, interoperability, or policy change looks technically on track but operationally unclear.
- Leadership needs an independent answer before declaring readiness, funding more work, or escalating a vendor.
- Testing is planned at the application level, but no one has defined the end-to-end operational scenarios and evidence that matter.
Outputs
What you get.
- Obligation Register & Impact Map: traceable from policy to capability, workflow, system, control, owner, evidence, and outcome
- Gap, Dependency, and Accountable Ownership Assessment across operations, IT, and delegated vendors
- Executable Implementation Backlog with explicit business rules, exceptions, and acceptance criteria
- Executive Readiness Scorecard showing what is proven, what remains open, and what needs a leadership decision
- Sponsor readout with accountable workstream owners and a baseline plan for activation, rework, exceptions, and downstream fallout
Week 1
Map Obligations & Authorities
Translate the approved mandate into concrete obligations across member eligibility, benefits, clinical policy, provider programs, UM orchestration, and claims controls.
Week 2
Inspect Systems & Handoffs
Walk through the operational and technology handoffs with workstream leads and vendors. Find where unmodeled exceptions and hidden manual workarounds exist.
Week 3–4
Structure Backlog & Executive Scorecard
Deliver the prioritized gap and ownership matrix, the executable backlog, and the executive readiness scorecard with a sponsor readout.
Pricing
$15,000 fixed for one agreed mandate, program surface, or platform transition over 3–4 weeks. The fee covers the assessment deliverables and sponsor readout; implementation and optional Execution Assurance are separately scoped.
Scope, system boundaries, required interviews, source access, acceptance criteria, and sponsor availability are agreed before kickoff. A delayed prerequisite or additional workstream requires an agreed change to timing or scope.
Boundaries
The fine print, up front.
Stated before any contract, so scope and expectations are clear.
- Grounded in operational and technical architecture; not legal, clinical, actuarial, or regulatory advice.
- Does not replace accountable client executives, compliance owners, architects, or delivery teams.
- Not a generic PMO status report, software implementation, or formal compliance certification.
- Bounded to one defined mandate, program surface, or platform transition. The sprint begins once approved interpretations, system walkthroughs, and accountable owners are available.
What comes next: Client delivery teams execute the backlog. Optional Execution Assurance follows one named workstream through evidence reviews, dependency resolution, acceptance reviews, and sponsor decisions. Its cadence, capacity, term, and fee are agreed separately after the sprint.
After the sprint · separately scoped
Execution Assurance
Keep the readiness backlog connected to the evidence your sponsor needs to accept the change.
A proposed 90-day engagement, reviewed in three monthly cycles. Each cycle covers one named workstream, two evidence reviews, and one sponsor decision readout.
- An updated obligation-to-evidence register and acceptance status
- A dependency and decision log with accountable owners and agreed review dates
- Reviews of missing authority, failed handoffs, and exception evidence
- A sponsor readout stating what can be accepted, what remains open, and who must act
- An end-of-term handoff and recommendation to close, continue, or scope a separate delivery phase
Your teams deliver the backlog; your sponsor accepts the release. This scope does not supply a PMO, software implementation team, legal opinion, compliance certification, or continuous on-call coverage.
Fixed fee agreed after the sprint, before continuation. The proposal states monthly capacity, meeting cadence, review turnaround, and escalation rules. Additional workstreams or implementation receive a separate scope. No automatic renewal.
Discuss Sprint and ContinuationTypical work
What this usually involves.
Does this replace our legal counsel or compliance team?+
No. Your compliance and legal teams interpret the rule. The sprint takes their approved interpretation and translates it into operational behavior, system controls, and evidence.
What systems and workflows do you inspect?+
Intake channels, UM platforms, clinical rules engines, claims adjudication, provider data, and partner APIs across the end-to-end operational path.
How does this differ from our internal PMO status reports?+
A PMO collects reported status from workstreams. The readiness sprint tests whether the links between policy, workflow, and systems actually connect with demonstrable evidence.
The other steps
Start with the smallest step that answers the question.
One principal · Priced up front
Tell me what's stuck.
Bring one healthcare mandate, platform transition, or client workflow that needs a clear path to delivery. In 30 minutes, I will talk through the decisions, systems, and dependencies with you, then identify the right scope and next step.