Improving member–provider matching with AI

Leveraging UX research to recommend ethical, human-centered AI solutions.

Company
Salesforce

Position
UX Researcher (Contract)

Term
Jan ‘25 - Apr ‘25

Summary

Healthcare referrals are often slow, inefficient, and frustrating for members, providers, and contact centers alike. As a contractor for Salesforce, I conducted mixed-methods research to uncover pain points in provider matching and identify where AI could quietly enhance workflows without eroding trust.

Our recommendations focused on embedding AI in the background, automating verification, surfacing context for agents, and streamlining provider matching, so that care feels more connected, efficient, and human.

Context

Fragmented systems and outdated referral processes increase administrative burden, delay care, and frustrate patients. Salesforce aimed to explore how AI could support contact centers in reducing burnout while improving member satisfaction and provider alignment.

Research

Landscape Review

Analyzed 20+ sources (forums, blogs, journals) for real user frustrations.

Online Survey n=16

Gathered perspectives from members, providers, and a contact center agent.

Interviews n=6

Uncovered emotional stories across members, providers, and contact center workers.

Affinity Mapping

Visualized pain points and opportunity clusters across the care journey.

Insights

Members

75% couldn’t find a provider in under a week; 86% distrusted AI handling their health data.

Providers

Burned out by admin work; saw AI as useful only for low-stakes, repetitive tasks.

Contact Centers

Open to AI co-pilots (auto-matching, typing support) but emphasized transparency.

Our three strategic recommendations

Automate Verification & Eligibility

→ Shrink referral time from days to seconds, reducing redundant handoffs.

Embed AI in Back-End Workflows

→ Let AI quietly assist agents, suggesting matches and surfacing context, without removing the human touch.

Integrate AI into EHR Systems

→ Give providers richer, context-aware patient snapshots that streamline care delivery.

Projected impact

Impact

These design directions position Salesforce to deliver a member-provider matching experience that is faster, more transparent, and less taxing for all stakeholders.

Business benefits

Reduced Operational Costs

Shorter referral times and less agent burnout.

Enhanced Trust & Adoption

Ethical AI integration reduces member skepticism.

Improved Provider Productivity

Less admin overhead, more focus on patients.

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