Hariharan R's Portfolio

The Insight Console

Enhancing the Payer Experience by 70%* via Self-Service Tool

01 . Introduction

From a Simple Ask to a Deeper Challenge

The payer product team approached me with what seemed like a straightforward request: an analytics dashboard to improve visibility into our organization tracked data. At first glance, the problem appeared clearly defined.

The organization provides payers with a solution for exchanging gap requests and provider responses.

View High-level Flow

02 . Problem Hypothesis

When Internal Signals Identify a Potential Problem

The "Service" is working but the "Experience" was failing. The Customer Success Team was stuck in a cycle of manual damage control.

CURRENT OPERATIONAL FRICTION MAP

INTERNAL SERVICE VIEW

"The API is sharing data"

Api driven identification of appointments validated against plan logic.

"The API is sharing data"

Api driven identification of appointments validated against plan logic.

STATIC SCREENSHOTS

"The data is a black box"

Payer receives high-level Tableau screenshots. Zero drill-down. No actionable insights. Low Transparency

"The data is a black box"

Payer receives high-level Tableau screenshots. Zero drill-down. No actionable insights. Low Transparency

The Payer Reality

THE ACCOUNTABILITY GAP

DATA DISCREPANCIES

Payer and Organization teams report different numbers, leading to monthly reconciliation disputes and trust erosion.

THE "BLACK BOX" PROBLEM

Services identifies a patient, but Payer cannot confirm if the provider actually viewed the gap in the EMR.

03 . Strategy

Structuring Discovery Before Designing Solutions

Ambiguity is the enemy of execution. I designed a discovery roadmap that balanced stakeholder requirements with user pain points.

RESEARCH OUTLINE

Defined the core discovery objectives and categorize what we needed to learn, which guided the conversation script:

Gap Data Importance
Stakeholders and Intent
Current state and pain points.

Defined the core discovery objectives and categorize what we needed to learn, which guided the conversation script:

Gap Data Importance
Stakeholders and Intent
Current state and pain points.

TEAM ALIGNMENT

Orchestrated cross-functional alignment across Research, Engineering, Legal, Product and Relationship teams. Scheduled bi-weekly stand-ups to address early architectural blockers and complex privacy constraints.

GOVERNANCE TUG-OF-WAR

Partnered with Legal and Compliance to resolve tension between Payer Transparency and Provider Privacy. We defined the exact threshold of "De-identified" vs "Actionable" data to ensure HIPAA compliance

PARALLEL ORCHESTRATION

While research was in-flight, I liaised between Legal, Platform, Product and Analytics team to audit shareable data and verify metric feasibility under HIPAA.

Design Road Map

View Task & Timeline Plan

04 . Research + Synthesis

DECODING THE PAYER MINDSET

DECODING PAYER MINDSET

Program Director

Quality Analyst

Field Agent

"I have to show value to leadership. I need better visibility into appointments and provider response."

CORE RESPONSIBILITIES

Financial Performance

Vendor Management

Risk adjustment flow

CRITICAL PAIN POINTS

High level metrics makes it hard to justify investment

Growth depends on invisible engagement

Internal teams spend time for any actionable insights

Program Director

Quality Analyst

Field Agent

"I have to show value to leadership. I need better visibility into appointments and provider response."

CORE RESPONSIBILITIES

Financial Performance

Vendor Management

Risk adjustment flow

CRITICAL PAIN POINTS

High level metrics makes it hard to justify investment

Growth depends on invisible engagement

Internal teams spend time for any actionable insights

Program Director

Quality Analyst

Field Agent

"I have to show value to leadership. I need better visibility into appointments and provider response."

CORE RESPONSIBILITIES

Financial Performance

Vendor Management

Risk adjustment flow

CRITICAL PAIN POINTS

High level metrics makes it hard to justify investment

Growth depends on invisible engagement

Internal teams spend time for any actionable insights

Program Director

Quality Analyst

Field Agent

"I have to show value to leadership. I need better visibility into appointments and provider response."

CORE RESPONSIBILITIES

Financial Performance

Vendor Management

Risk adjustment flow

CRITICAL PAIN POINTS

High level metrics makes it hard to justify investment

Growth depends on invisible engagement

Internal teams spend time for any actionable insights

THE MARKET REALITY - LEGACY FRICTION

Payers aren't a monolith. Many still rely on self-portals and manual rosters, viewing the "Organization Service" as another avenue for getting gap data responses rather than a solution due to the lack of visibility.

MANUAL ROSTERS

Spreadsheets shared via secure email or printed sheets. Prone to human error and version-control hell.

High Admin Waste: Data is Stale Instantly

ISOLATED PORTALS

Proprietary web tools that require providers to "Double Document" outside their EMR.

Tool Fatigue: Leading to Low Compliance

THE BLACK BOX

The "invisible" space between sharing a gap and confiming an action.

Discrepancy: No proof Clinical Data

DIFFERENTIATING VALUE ACROSS PAYER SEGMENTS

ENTERPRISE & MID-MARKET

Large payers often have established analytics teams or are in the process of building proprietary analytics tool.

THE STRATEGIC VERDICT

"Large payers may use the Insights Console as a Gut Check - validating their internal metrics against our source-of-truth exchange data."

EMERGING & SMALL-MARKET

Smaller entities rely heavily on manual Excel tracking, prone to human error and data staleness/inconsistency.

THE STRATEGIC VERDICT

"Mid and small payers may treat Insights Console as their Primary Engine - completely replacing manual reconciliation."

VERDICT: BUILD AN INSIGHTS TOOL GREEN-LIT

Payers don't lack data; they lack objective proof of gaps surfaced to provider and action taken as required by HEDIS Compliance and Star Ratings.

NAVIGATING CONCERNS TO SECURE BUY-IN

Discovery surfaced critical organizational risks that required a governance-first design approach to move from concept to development.

Visibility Vs. Efficacy

The risk that transparency might reveal service gaps rather than strengths. I advocated for data ownership as a driver for service iteration.

Provider Alert Fatigue

Payers and Product team noted concerns that overloading requests via digital outreach could lead to provider burnout and partnership friction.

The Final Guardrail

System governance of performance metrics with restrictions for payers from viewing direct contact details will ensure relationship while delivering insights.

VERDICT: BUILD AN INSIGHTS TOOL GREEN-LIT

Payers don't lack data; they lack objective proof of gaps surfaced to provider and action taken as required by HEDIS Compliance and Star Ratings.

NAVIGATING CONCERNS TO SECURE BUY-IN

Discovery surfaced critical organizational risks that required a governance-first design approach to move from concept to development.

Visibility Vs. Efficacy

The risk that transparency might reveal service gaps rather than strengths. I advocated for data ownership as a driver for service iteration.

Provider Alert Fatigue

Payers and Product team noted concerns that overloading requests via digital outreach could lead to provider burnout and partnership friction.

The Final Guardrail

System governance of performance metrics with restrictions for payers from viewing direct contact details will ensure relationship while delivering insights.

VERDICT: BUILD AN INSIGHTS TOOL GREEN-LIT

Payers don't lack data; they lack objective proof of gaps surfaced to provider and action taken as required by HEDIS Compliance and Star Ratings.

NAVIGATING CONCERNS TO SECURE BUY-IN

Discovery surfaced critical organizational risks that required a governance-first design approach to move from concept to development.

Visibility Vs. Efficacy

The risk that transparency might reveal service gaps rather than strengths. I advocated for data ownership as a driver for service iteration.

Provider Alert Fatigue

Payers and Product team noted concerns that overloading requests via digital outreach could lead to provider burnout and partnership friction.

The Final Guardrail

System governance of performance metrics with restrictions for payers from viewing direct contact details will ensure relationship while delivering insights.

VERDICT: BUILD AN INSIGHTS TOOL GREEN-LIT

Payers don't lack data; they lack objective proof of gaps surfaced to provider and action taken as required by HEDIS Compliance and Star Ratings.

NAVIGATING CONCERNS TO SECURE BUY-IN

Discovery surfaced critical organizational risks that required a governance-first design approach to move from concept to development.

Visibility Vs. Efficacy

The risk that transparency might reveal service gaps rather than strengths. I advocated for data ownership as a driver for service iteration.

Provider Alert Fatigue

Payers and Product team noted concerns that overloading requests via digital outreach could lead to provider burnout and partnership friction.

The Final Guardrail

System governance of performance metrics with restrictions for payers from viewing direct contact details will ensure relationship while delivering insights.

05 . Strategy Refinement & Target Definition

REDEFINING THE OBJECTIVE

NAVIGATING CONCERNS TO SECURE BUY-IN

REDEFINED PROBLEM STATEMENT

Payers don't lack data; they lack objective proof of gaps surfaced to provider and action taken as required by HEDIS Compliance and Star Ratings

VALUE STATEMENT

Provisioning a self-service analytics engine to transform complex integration data into immediate gap visibility. By automating accurate HEDIS/Star Rating reporting, we secure payer funding, ensure regulatory compliance, and unlock the identification of risk-adjustable conditions with minimal effort.

TARGET SUCCESS CRITERIA

> 70%

Analytics Adoption Rate

ACROSS ALL PAYER SEGMENTS WITHIN 6 MONTHS

Avg. 5 hrs/wk

Analyst Efficiency

REDUCTION IN MANUAL RECONCILIATION PER USER

< 5%

Data Discrepancy

TARGET REDUCTION FROM THE 20% LEGACY BASELINE

06 . Solution Evolution

PHASE 1 - CONCEPT IDEATION

SOLVING THE MULTI-APP FRACTURE

Early sketches focused on Accountability Checkpoints. I recognized that users were switching between four apps to verify a single clinical action.

STRATEGIC SHIFT

Shifted from "Data Volume" to "Ingestion Integrity" and "Provider Performance" - tracking exactly where visibility stopped in legacy channels

PHASE 2 - UI EXECUTION

ENGINEERED FOR CLARITY

I engineered the final interactive prototype using ChatGPT and Lovable.dev and Windsurf for React.jsx to demonstrate real-time ingestion models, showcasing the speed of "Time-to-Insight" reduction.

Concept Ideation

EXPERIENCE THE PROTOTYPE

07 . Project Conclusion

A SCALABLE FOUNDATION DELIVERED

Prior to resonance testing, I successfully secured a Strategic Green-Light for development. My exit was preceded by a comprehensive handoff designed to ensure the vision's integrity throughout the 2025 production cycle.

FULL TECHNICAL SPECS

Documented all interaction models and components used for the engineering team for their sprint planning.

STAKEHOLDER ALIGNMENT

Delivered a detailed resonance guide summarizing executive feedback for incoming design lead.

ECOSYSTEM ROADMAP

Defined platform's long-term roadmap influencing cross-vertical Product Owners to begin architecting for their stakeholders