Author: AztuteYRCAdmin

Libertana ECM POC

Libertana ECM POC – Common Overview Guide

📘 What Is This POC About?

This Proof-of-Concept (POC) is a limited-time sandbox simulation of how Libertana staff can manage the Enhanced Care Management (ECM) member journey using Aztute’s platform.

This POC demonstrates:

How different roles interact with the system

What steps occur in the ECM member lifecycle

How role-based access reduces confusion and guides users to only what they need

What functions are available in the platform and how to access them

This guide should be reviewed first before accessing your role-specific user guide.

👥 Key Roles in the ECM POC

Role	Definition
DEO / Intake Coordinator	Responsible for entering new members into the system via forms (MIF) or bulk upload from MCPs
Supervising Case Manager (SCM)	Oversees assignments to Case Managers, reviews care progress, reassigns or inactivates members
Case Manager (CM)	Provides direct care tasks including outreach, enrollment, assessments, and care plan documentation
Admin (Claims/Content) (Later when there is data)	Manages system-level updates, claim reviews, and data or template corrections

You will be granted access to only the tools relevant to your role, reducing errors and making onboarding easier.

ACCESS AZTUTE SYSTEM

🔐 Accessing Aztute – App & Command Center

This standalone guide explains how to access both components of the Aztute platform:

1. The App – where Case Managers and Supervisors manage care workflows

2. The Command Center (Browser App) – where administrative and program management tasks are performed

🚀 Getting Started

Before using Aztute, make sure you have:

Your assigned Username and Password

A device with Chrome, Edge, or a mobile browser

Access to either your work email or phone for two-factor authentication (2FA)

🔐 2FA Note: In most cases, your 2FA is set up using your work email. However, your system administrator may have configured it to use your mobile phone instead—or both. Follow the login prompts accordingly.

📱 Accessing the App (Mobile)

The Aztute App is the care-facing interface used by Case Managers (CMs) and Supervising Case Managers (SCMs) to:

Conduct Outreach

Log Progress Notes

Conduct Basic Assessment

Communicate with your members and teams

To access the app:

1. Open your mobile browser or download the Aztute Public Health App from the App Store or Google Play

2. Launch the app

3. Enter your Username and Password

4. Complete Two-Factor Authentication (2FA) if prompted

> No need to select an organization – this step is preconfigured for Libertana users.

Click the link for Preview – Download the app

🖥️ Accessing the Command Center (Web)

The Command Center is used by:

DEOs / Intake Coordinators to perform member intake (manual or bulk)

SCMs to assign Case Managers and monitor dashboards

CMs to do Outreach, HRAs, Care Plans, Progress Notes (Encounters)

Admins to manage claims, content, and configurations

To access the Command Center:

1. Open a desktop browser (Chrome or Edge recommended)

2. Visit: https://app.aztute.com

3. Click the Switch icon in the top right

4. Type Libertana in the field and click Save

5. Enter your Username and Password

6. Complete 2FA as configured

> You are only given access to tools that apply to your role. This reduces confusion and ensures you stay within your lane.

If you are unsure which environment to use, refer to your Role-Based User Guide.

For technical support, contact: support@aztute.com

🧭 Member Journey Overview – Routine Tasks

Step	Action Owner	System Behavior / Trigger
Member Intake (MIF/File)	DEO	Member added to system
Assignment	SCM	CM notified, member status updated
Outreach + Enrollment	CM	Outreach triggers claim; enrollment triggers HRA
HRA	CM	Set to “In Progress” triggers Care Plan
Care Plan	CM	Submitted plan is visible to SCM
Progress Notes	CM	First monthly note triggers PMPM claim
Monitoring	SCM	Uses 360 View, Program Dashboards, CM Productivity

🔁 Ad Hoc / As-Needed Tasks

Task	Action Owner	Notes
Intake Edits / Fixes	DEO	Reopen and modify MIF entries if flagged
Reassign Case Manager	SCM	From All Member Status, reassign member to new CM
Mark Member Inactive	SCM	From All Member Status
Flag/Correct Data Issues	All roles → Admin	Admin handles all member-level data corrections
Update Content / Templates	Admin	Referral lists, dropdowns, and standardized form inputs
Claim Investigation	Admin	Review status, investigate missed or incorrect claims

🔄 Key Rules & Interdependencies

Action	Required Precondition
Outreach	Member assigned to CM by SCM
HRA	Outreach marked as Successful
Care Plan	HRA set to “In Progress”
Progress Notes	Requires a Care Plan to begin
Claim Generation	Triggered by Outreach + Progress Notes monthly

❓ Frequently Asked Questions

Q: Can I edit member demographic data?
Only Admins can make those changes. Others must flag issues via Support.

Q: Who can assign or reassign Case Managers?
Only SCMs through the Command Center.

Q: Can we do multiple HRAs or Care Plans?
Only one of each per member during the POC. Ongoing care is documented via Progress Notes.

📌 Role-Based Quick Summary

👩‍⚕️ Case Manager (CM)

Views assigned member via My Tasks

Completes Outreach + Enrollment

Completes HRA → sets status to In Progress

Submits Care Plan

Logs ongoing Progress Notes

Monitors care via Member 360

👩‍💼 Supervising Case Manager (SCM)

Assigns & reassigns members via Command Center

Receives enrollment/decline notifications

Marks members Inactive if needed

Uses 360 View, Program Dashboards, CM Productivity Dashboard to monitor care delivery

👩‍💻 DEO / Intake Coordinator

Creates member records using MIF or file upload from MCPs.

Ensures correct program, demographic, and contact info are entered

🛠️ Admin (Billing / Content)

Manages claim oversight and confirms generation from outreach + progress notes

Handles content updates, user roles, and demographic corrections

📊 Libertana ECM Member Journey

Routine Lifecycle Step	DEO / Intake Coordinator	Supervising Case Manager (SCM)	Case Manager (CM)	Admin (Claims & Content)
1. Intake Initiation	Intake member via MIF or MCP file
2. Member Assignment		Assign member to CM via Intake Sheet → Member Status tab	Receives Notification that a new member is assigned.
3. Outreach & Enrollment		Receives notification when enrolled/declined	Performs outreach → marks outcome + enrollment	Claim generated on successful outreach
4. HRA Creation & Completion			Completes HRA (created automatically)→ sets status = In Progress
5. Care Plan Development			Completes Care Plan (created automatically) form (goals, interventions)
6. Progress Notes			Logs notes → first monthly note triggers PMPM claim	Reviews claim via dashboard
7. Monitoring		Uses 360 View, Program Management & Productivity dashboards	Uses 360 View to check member status

🔁 Ad Hoc / As-Needed Activities

Ad Hoc Task	DEO / Intake Coordinator	Supervising Case Manager (SCM)	Case Manager (CM)	Admin (Claims & Content)
Edit Existing Intake	Update/correct member record if flagged
Reassign Case Manager		Reassign member via All Member Status
Mark Member Inactive		Mark inactive from All Member Status
Flag Data Issues	Report duplicates or errors to Admin	Flag data gaps to Admin	Make corrections to member demographics
Content / Template Updates				Update, forms, Notification, Content
Claim Audit				View Claims Data
Communications With the Libertana via Chat	X	X	X	X
Create Support Ticket	X	X	X	X

Now that you understand the end-to-end process and where your role fits in:

Documentation is already available inside the solution.

Open your Role-Based User Guide for step-by-step instructions

Join the Day 1 Kickoff Session to get your login, ask questions, and test access

Use your sandbox access to perform real workflow tasks with test members

Support Tickets can be created with the system

Welcome to the ECM POC — your role is critical to its success!

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Case Manager (CM) Guide

👤 Role Overview

As a Case Manager (CM), your role is to support members through their ECM journey by completing outreach, assessments, care planning, and regular follow-ups using Aztute’s App and Command Center.

✔  Pre-Conditions

Before starting, ensure that:

You have access to both App and Command Center

Your login and 2FA (via email or phone) are configured

Members have been assigned to you by the Supervising Case Manager (SCM)

🔐 You will only see members and tools relevant to your role.

🧭 Key Navigation Areas (App)

App Feature	Purpose
My Tasks	View all assigned member tasks by type and due date
Outreach	Initiate contact and capture member response
HRA	Document health, housing, behavioral, and risk factors
Care Plan	Create personalized goal-oriented plans for the member
Progress Notes	Record and sign off on monthly contact with the member
Member 360 View	See a full history of forms, notes, and engagement for any assigned member

🔁 Step-by-Step Workflow

🔹 Step 1: Access Assigned Member

Log into: https://app.aztute.com

Go to Manage → My Tasks

Look for any new tasks.

🔹 Step 2: Outreach

You can start from Home or from Manage → My Outreach → NEW

Indicate Outreach Attempt and Response:

Successful → Select Enrolled

Declined → Member refuses ECM services

Save your submission

✔  A claim is generated automatically if the outreach is successful.
✔  The SCM is notified whether the member enrolled or declined.

🔹 Step 3: Health Risk Assessment (HRA)

Once enrolled, a task and HRA form are created automatically.

Navigate to: Manage → My HRA

Select the Member → Actions → Edit

Click Start to change the HRA status to “In Progress”

Complete the following sections:

Member Health Conditions and History

Behavioral and Mental Health Needs

Housing and Living Situation

Social Determinants of Health

Support Network and Functional Needs

Risk Factors for Hospitalization or Institutionalization

Submit the HRA once finalized

✔  HRA status updates to In Progress and unlocks Care Plan

🔹 Step 4: Care Plan

The Care Plan becomes available once HRA is marked In Progress.

Go to: Manage → My Care Plans

Select the member → Click Action → Edit

Fill out each tab:

Goals: Define measurable objectives for the member

Barriers: Document obstacles the member faces in achieving goals

Interventions: Describe planned actions (internal or external) to help the member

Target Dates: Assign dates for follow-up and review

Save the Care Plan and mark as Completed

✔  Submitted Care Plans are visible to SCMs for monitoring and feedback

🔹 Step 5: Progress Notes

Navigate to: Manage → My Progress Notes → NEW

Fill in the note with:

Contact Date

Reason for Visit / Interaction

Updates on Goals or Interventions

Any Referrals or Follow-Up Plans

Sign the note to finalize submission

✔  The first monthly note triggers the PMPM claim
✔  Additional notes update the member file but do not generate new claims within the same month

📊 Monitoring Member Journey

Go to: Manage → My Members Status

Use Action → Member 360 to:

Review status of Outreach, HRA, Care Plan

View all completed forms

Track activity and engagement over time

🛠️ Tips for Success

✔  Do	✘ Don’t
Complete forms in correct sequence	Submit forms with missing required fields
Use Member 360 for overview before calls	Skip Progress Notes – this affects billing
Ask SCM if unsure or stuck	Edit submitted forms without permission

🔔 Notifications You Will Receive

Member assigned to you

Tasks due soon or overdue

Notes or Care Plans flagged by SCM

🧠 Common Use Cases

🔸 Outreach completed but HRA not visible? → Ensure Enrollment = Enrolled
🔸 HRA done but Care Plan isn’t opening? → Check HRA status = In Progress
🔸 Member info needs editing? → Flag it for Admin via SCM

📅 What to Expect During POC

Use test members to walk through the full workflow

Participate in daily support check-ins

Share any feedback on usability, navigation, or bottlenecks

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Supervising Case Manager (SCM) Guide

👤 Role: Supervising Case Manager (SCM)

🎯 Objective:

To oversee and support the full ECM member journey by managing member assignments, reviewing care progress, identifying gaps using dashboards, and guiding Case Managers. You do not complete direct care tasks but play a key role in ensuring timely, high-quality service delivery.

✔  Pre-Conditions

You must have Command Center access with SCM permissions

Member intake must be completed by the DEO / Intake Coordinator

Case Managers must be active in the system with appropriate role access

🧭 Key Areas of Access

Tool		Used For
Command Center → Manage → All Member Intake Sheets		Assigning Case Managers after intake
Command Center → Manage → All Member Status		Reassigning members, marking members as inactive
Command Center → Dashboard → Program Managemen		Tracking member progress by stage
Command Center → Dashboard → Case Manager Productivity		Evaluating performance metrics by CM
Command Center →Manage✔ All Membe Status-✔ Action-✔  Member 360 View		Deep dive into individual member history

🔁 Assign a Member to a Case Manager

Navigate to Manage → All Member Intake Sheets

Filter by Program = ECM and find members not assigned to any CM (you can see the filters by clicking on the Advanced Filters button in the top right corner)

Click Action → Edit on the member row

In the intake form, confirm details are complete

Go to Member Status tab → Select a Case Manager

Click Complete to finalize the assignment

✔  CM is notified and assigned the outreach task

🔁 Reassign or Mark Member Inactive

Navigate to Manage → All Member Status

Filter/search for the member

Use Action → Reassign CM or Mark Inactive

✔  Reassignment creates a task for the new CM
✔  Inactive members are paused from workflows

🔍 Monitor Member Progress

📌 1. Member 360 View

Go to All Member Status → search for the desired member → Action → 360 View

See full history including:

Intake details

Outreach status

HRA status

Care Plan progress

Progress Notes

All assigned tasks and completed tasks

✔  Use to prepare for case conferences or audits

📌 2. Program Management Dashboard

Go to Dashboard → Program Management for population-level monitoring:

Dashboard Chart	What It Shows	SCM Actions
Intake Status by Program	Members stuck in intake, active or inactive	Follow up with DEO for stuck intakes
Outreach Completion by CM	Outreach counts by Case Manager	Nudge CMs with low outreach volume
HRA Status Tracker	% of HRAs Not Started, In Progress, Completed	Identify and act on HRA delays
Care Plan Status Overview	Distribution of Care Plans by status	Push follow-up on pending Care Plans
Days Since Last Activity	Inactive members by days since engagement	Consider reassignment or outreach alerts

📌 3. Case Manager Productivity Dashboard

Go to Dashboard → Case Manager Productivity:

Metric	What It Means	SCM Use
Tasks Completed by CM	Counts of forms, notes, and activities	Support or recognize high/low performers
Form Turnaround Time	Avg days to complete Outreach, HRA, Care Plan	Address delay patterns
Member Engagement by CM	# of members each CM is actively working with	Reassign under-utilized members

🔔 Notifications SCMs Receive

When a CM enrolls or declines a member after outreach

When a member is reassigned or marked inactive

Optional dashboard alerts (e.g., inactivity, overdue forms)

🧠 Use Case Examples

🛠️ SCM Best Practices

✔  Do	✘ Don’t
Review intake status and assign promptly	Complete forms like Outreach or HRA
Use dashboards daily to track gaps	Change member demographics (Admin-only)
Support CMs through delays or confusion	Skip reassignment for unresponsive CMs
Coordinate with Admin for escalations	Ignore members with no recent activity

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Data Entry Operator Guide

DEO / Intake Coordinator Guide

👤 Role: Data Entry Operator (DEO) / Intake Coordinator

🎯 Objective:

To intake new ECM members into the system using either manual entry (via Member Intake Form – MIF) or by uploading bulk files received from MCPs. DEOs play a critical foundational role in initializing the member journey.

✔  Pre-Conditions

You must have Command Center access with DEO permissions

Member data must be available from:

A formatted Member Information File (MIF) from the MCP

Manual intake (walk-ins, referrals, phone interviews)

🧭 Key Navigation Areas (in Command Center)

Path	Function
Manage → Member Intake Sheets	Create or edit individual member records (MIF)
Data Management → Bulk Data Upload	Upload member data from MCP-provided files
Manage → All Member Status	Verify intake success and program assignment

🔁 Manual Member Intake (MIF)

Step 1: Open the Intake Form

Navigate to Manage → Member Intake Sheets

Click + New Member or use Action → Edit to modify an existing entry

Step 2: Enter Member Data

Fill out the required fields:

Member CIN (unique ID)

First Name, Last Name

Date of Birth, Gender, Race, Ethnicity

Contact Info (Phone, Address)

Preferred Language (Spoken and Written)

Select Program = ECM from the dropdown

✔  Click Save to complete. Member now appears in the system.

Note: After creating a new member, you must refresh the view to see the new member reflected in the view. To do this, follow these steps: Click on ‘Advanced Filters’ in the top right corner → Click ‘Refresh’ in the expanded panel.

🔁 Bulk Member Intake via File Upload

Sample File is located here: Anthem MIF File.xlsm

(You can download the file and change the MCIN (first column, member name, etc.)

Step 1: Navigate to Upload Screen

Go to Command Center → Data Management → Bulk Data Upload

Step 2: Prepare the Excel File

Use the ECM-specific template from your team

Complete the required fields:

CIN (must be unique) – if a duplicate CIN is detected, the row will be ignored

Name, DOB, Gender, Contact Info

Program = ECM must be selected

Step 3: Upload the File

Choose Type of Data = Members

Choose the Health Plan

Choose Health Program = ECM

Upload the file and click ‘Upload’

✔  A success message will confirm the upload. Members will now appear in:

All Member Status

Member Intake Sheets

🔍 Post-Intake Validation

After successful intake:

✔  Confirm each member shows Program = ECM in All Member Status

✔  Review uploaded fields for completeness

✔  Notify the Supervising Case Manager (SCM) to initiate assignment

You may:

Use Action → Edit in Intake Sheets to make corrections

Flag duplicate or bad records to Admin for cleanup

🛠️ Tips for DEO Success

✔  Do	✘ Don’t
Verify CINs are unique before upload	Upload outdated or misaligned templates
Confirm Program = ECM in each entry	Attempt to assign or enroll members
Use standard naming conventions	Skip fields marked as required
Flag issues to Admin or SCM early	Edit completed records without approval

📌 Common Intake Errors to Avoid

❗ Duplicate CIN – row will be skipped silently

❗ Program not selected – member won’t be connected to ECM

❗ Missing DOB or Contact Info – invalid entry

❗ MIFs saved in wrong format (e.g., .csv) – upload will fail

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Test

🧾 DEO / Intake Coordinator Guide – Libertana ECM POC (Comprehensive) – v3

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