The AI in Business Podcast Transforming Care Management and Disease Management Workflows with Agentic AI - with Raheel Retiwalla of Productive Edge
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Jul 3, 2025 Raheel Retiwalla, Chief Strategy Officer at Productive Edge, dives into the transformative power of Agentic AI in healthcare. He discusses how AI shifts care management from reactive to proactive, using real-time data for better patient outcomes. Raheel shares practical use cases, such as AI monitoring for care disruptions and identifying behavioral health risks through appointment patterns. He emphasizes the potential of AI to optimize resource allocation in chronic disease management, stressing its importance for healthcare leaders in improving workflows without additional staffing.
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Care Management Pressures Spark AI
- Care management faces rising pressures from financial risk, staffing challenges, and complex chronic conditions.
- Agentic AI helps shift workflows from reactive to proactive, boosting efficiency and reducing manual fragmentation.
AI Tracks Authorization Utilization
- A U.S. payer uses agentic AI to track benefit authorization utilization in real time to avoid care disruptions.
- AI nudges care teams, members, and providers to stay within authorized limits, improving care continuity.
International AI Use Flags Disease Risk
- An international health plan uses AI to mine clinical notes for rising chronic disease risks to prioritize outreach.
- AI enables proactive engagement by flagging risks early and reprioritizing care manager workloads.