A network management agentic workforce, live in three weeks

The problem we took

The client provides behavioral health care to residents of nursing and assisted living facilities in New Jersey, New York, Pennsylvania and Maryland. After a 2024 private equity investment it added two companies and ran as three legacy entities, each with its own payer contracts across Medicaid, Medicare Advantage and commercial lines. Contracts, amendments and fee schedules sat in shared folders in many formats, some held by an outside vendor, and nobody kept a structured record.

Leadership could not see which contracts were in force, when notice windows fell, what each payer paid across entities and states, or which documents were missing. That capped the upside on the current book, left the operations team without the resources to work it, and blocked the growth plan: the company wanted to expand as Medicare Advantage grew in its markets, and it needed a clear view of its payer book first.

What the client already had

The payer book itself: 1,000+ agreements across drives, boxes and laptops. Revenue cycle, operations and finance set the priorities, with SharePoint as the primary repository. The client keeps the repository, the renewal matrix and the final say at every checkpoint.

What we built

A network management agentic workforce on Claude: a commercial contracting engine built from a standing start. In health plan terms, payer contracting is network management, so the design was modeled on how a regional health plan runs its contracting shop.

Extraction agents in Claude Cowork read every contract, amendment and fee schedule and normalized each one into a 42-field record with dates, signers and CPT-level rates, held in the client’s own AWS environment. 3Pillars reviewed the extractions; a human audit found Medicare Advantage rate language missed in 9 contracts, and re-extraction raised Medicare-indexed contracts from 6 to 15 of 51. Analysis agents in Claude Code then queried the database through MCP and wrote seven briefs: renewal risk, payer mix, rates against the book and 2026 Medicare, rate-increase terms, value-based terms and entity differences.

The engine reads vertically inside a single payer relationship and horizontally across payers, entities and states, so three sets of tax IDs, service names and rates could be compared like with like. 3Pillars sent payer document requests and presented a readout with 13 ranked initiatives.

What it returned

A $7M opportunity identified across the full contract book. Contract operations down from 40+ hours a month to 8, with no added contracting staff. Renewal visibility 12+ months forward where there had been none: the renewal matrix found 3 contracts already past their notice deadline, closed 12 renewal-date gaps and sourced 15+ missing contracts and fee schedules.

Live in three weeks: one repository, three entities reconciled, and a contracting function the company had never had.

Models: Claude Opus 4.6 and Opus 4.7 (1M context) for the agents, Claude Sonnet for extraction review. No payer names, contract rates or terms appear in this story. The client has not been asked to be named publicly.