Proxi GUIDE manual
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Canonical identity spine

One roster. Tasks do not become roles.

A real employment or credential role may perform many tasks across the SOPs. A task name, procedure occurrence, participation basis, or software function never creates another role. The selected step links the task back to the same canonical role and states its entry trigger. The directory contains 13 internal human categories in total: ten routine service/support categories and three rare clinical or legal escalation authorities. Procedure steps and trace rows are coverage evidence, not additional roles. For example, assessment review and medication review are different tasks under the same U.S. clinician category when the named clinician's license, scope, beneficiary location, and assignment permit both acts.

10 routine service/support categories3 rare escalation authorities4 nonstaff participant/outside categories5 software services

Role → task family → procedure

U.S. LCSW or behavioral clinician

68 linked procedure steps. Every step shows its exact task; neither a step nor a task creates a different role.

U.S. LCSW or behavioral clinicianOne canonical job role
Eight-pillar episode systemAssessment → Care Plan → distinct service work → Ongoing return7 procedure steps
  • SOP taskEstablish an attributable baseline

    Reviews the prepared behavioral, psychosocial, distress, and safeguarding domains, performs the assigned assessment, documents findings and the behavioral disposition, and escalates any immediate or higher-authority concern.

    Enters when: Only when an assigned behavioral, psychosocial, distress, or safeguarding domain requires this profession.Open exact procedure step →
  • SOP taskConvert accepted choices into owned actions

    Reviews the prepared behavioral or psychosocial option question, documents the recommended safeguard, limitation, or correction, and returns it to planning.

    Enters when: Only when the accepted action depends on this professional scope.Open exact procedure step →
  • SOP taskOffer the configured Proxi companion interaction

    Reviews the prepared distress, behavioral, psychosocial, or safeguarding concern, performs the within-scope assessment, documents the immediate disposition and protective action, and escalates when required.

    Enters when: Only when the prepared report contains a named behavioral, distress, psychosocial, abuse, neglect, or safeguarding question within this profession's authority.Open exact procedure step →
  • SOP taskFurnish the distinct service

    Reviews the prepared behavioral, psychosocial, distress, or safeguarding question, performs the assigned assessment or intervention, documents the disposition and immediate action, and escalates when required.

    Enters when: Only when the distinct obligation requires an L3 behavioral, psychosocial, distress, or safeguarding act.Open exact procedure step →
  • SOP taskReturn the result and the next useful action

    Answers a new behavioral, psychosocial, distress, or safeguarding question within scope.

    Enters when: Only when triggered.Open exact procedure step →
  • SOP taskEnter laterally through 24/7

    Receives a behavioral, psychosocial, distress, or safeguarding question.

    Enters when: Only when indicated.Open exact procedure step →
  • SOP taskRespond to caregiver exhaustion or possible breakdown

    Reviews the prepared caregiver-distress or safeguarding report, assesses the concern within scope, documents the immediate disposition and protective action, communicates the next step, and escalates any emergency or higher-authority issue.

    Enters when: Only when the concern requires this clinical authority.Open exact procedure step →
Eight-pillar episode systemHandoff and truthful-completion ladder3 procedure steps
  • SOP taskAccept custody and start the right work

    Reviews the prepared behavioral or psychosocial assignment, accepts or declines it within scope, and records the first clinical action and due time.

    Enters when: Only when the obligation requires that scope.Open exact procedure step →
  • SOP taskProduce and return the local SOP result

    Produces the assigned L3-Behavioral result.

    Enters when: Only for L3-Behavioral work.Open exact procedure step →
  • SOP taskRepair failure without dropping the obligation

    Corrects an L3-Behavioral contribution within scope.

    Enters when: Only when applicable.Open exact procedure step →
Eight-pillar episode systemSame-interaction service attribution and count-once labor2 procedure steps
  • SOP taskRecord the interaction and each human act once

    Records L3-Behavioral participation and active minutes once.

    Enters when: Only if L3-Behavioral actually participated.Open exact procedure step →
  • SOP taskOpen only the unfinished remainder

    Accepts only the unfinished behavioral or psychosocial question, performs the within-scope assessment, and returns the clinical disposition.

    Enters when: When applicable.Open exact procedure step →
Eight-pillar episode systemWorked episode: “My mother will not bathe”2 procedure steps
  • SOP taskUse the direct protected route if indicated

    Reviews the prepared behavioral or safeguarding concern, performs the within-scope assessment, documents the immediate disposition and protective action, and escalates when required.

    Enters when: When applicable.Open exact procedure step →
  • SOP taskOpen only the needed follow-on services

    Receives an L3-Behavioral follow-on question.

    Enters when: Only when separately triggered.Open exact procedure step →
Eight-pillar episode systemWorked episode: caregiver exhaustion or possible breakdown2 procedure steps
  • SOP taskRoute protected or immediate concerns directly

    Reviews the prepared caregiver-exhaustion or safeguarding report, assesses distress and risk within scope, documents the immediate disposition and protective action, communicates the next step, and escalates any emergency or higher-authority issue.

    Enters when: When applicable.Open exact procedure step →
  • SOP taskUpdate only affected contingencies and safeguards

    Answers an affected behavioral, psychosocial, distress, or safeguarding question within scope.

    Enters when: Only when separately triggered.Open exact procedure step →
Eight-pillar episode systemDaily Companion and caregiver pulse2 procedure steps
  • SOP taskRoute to the real performer

    Assesses the prepared distress, behavioral, psychosocial, or safeguarding concern; documents findings, immediate action, and any escalation.

    Enters when: Only when that protected act is required.Open exact procedure step →
  • SOP taskComplete the routed work and return a disposition

    Reviews the prepared distress, behavioral, psychosocial, or safeguarding concern, performs the within-scope assessment, documents the immediate disposition and protective action, and escalates when required.

    Enters when: Only when routed to L3-Behavioral.Open exact procedure step →
Comprehensive Assessment procedure mapFrom assessment occasion to attributable handoff5 procedure steps
  • SOP taskConfirm people, access, modality, schedule, and packet

    Accepts the behavioral/psychosocial domains assigned within scope.

    Enters when: Only when applicable.Open exact procedure step →
  • SOP taskScreen behavioral health, safety, environment, and social needs

    Reviews the prepared depression, anxiety, substance-use, suicidal-ideation, distress, behavioral, and safeguarding inputs, conducts the assigned assessment, documents findings and the immediate disposition, and escalates when required.

    Enters when: No narrower actor-specific condition is recorded; this assignment applies only when the selected procedure step is active.Open exact procedure step →
  • SOP taskAssess caregiver capacity—or use the no-caregiver branch

    Reviews the prepared caregiver-distress, behavioral-health, or safeguarding report, performs the within-scope assessment, documents the disposition and protective action, communicates the next step, and escalates when required.

    Enters when: Only when the caregiver findings create this clinical question.Open exact procedure step →
  • SOP taskDetermine and complete the residence work

    Performs an in-scope behavioral or safeguarding home-context act.

    Enters when: Only when applicable.Open exact procedure step →
  • SOP taskSynthesize, discuss, hand off, and document completion

    Reconciles the attributed behavioral, psychosocial, distress, and safeguarding findings, records the behavioral conclusion, safeguards, conflicts, and unresolved questions, and returns the signed contribution for baseline completion.

    Enters when: Only when this profession contributed.Open exact procedure step →
Comprehensive Assessment procedure mapAssessment finding: continue, pause a dependency, or route immediately3 procedure steps
  • SOP taskPreserve the exact response and source

    Captures and interprets a behavioral or psychosocial response within scope.

    Enters when: When the item is within L3-Behavioral scope.Open exact procedure step →
  • SOP taskUse the immediate protected route when required

    Reviews the prepared urgent behavioral, suicide, distress, or safeguarding report, performs the immediate within-scope assessment, records the protective disposition and instruction, and transfers any emergency or higher-authority question without delay.

    Enters when: When the concern fits L3-Behavioral scope.Open exact procedure step →
  • SOP taskPause only work that depends on the missing fact

    Resolves a missing behavioral or psychosocial fact within scope.

    Enters when: Only when applicable.Open exact procedure step →
Person-Centered Care Plan procedure mapFrom current facts and beneficiary direction to owned action5 procedure steps
  • SOP taskAssemble the current source packet

    Supplies or receives an exact behavioral or psychosocial question.

    Enters when: Only when applicable.Open exact procedure step →
  • SOP taskPrepare options and obtain actual decisions

    Evaluates the behavioral and psychosocial implications and documents the recommended option or required safeguard.

    Enters when: Only when triggered.Open exact procedure step →
  • SOP taskDraft, content-check, and make the plan accessible

    Supplies or validates only the assigned behavioral/psychosocial plan element.

    Enters when: Only when that element exists.Open exact procedure step →
  • SOP taskReview and revise; hold finalization until authority is settled

    Compares the affected behavioral and psychosocial Care Plan content with current attributed findings, records pass, required safeguard, correction, limitation, or escalation, and returns the disposition to the plan facilitator.

    Enters when: Only when applicable.Open exact procedure step →
  • SOP taskSend actions, confirm custody, follow results, and revise

    Performs the assigned behavioral, psychosocial, or safeguarding intervention, documents the disposition, and returns the result to the Care Plan tracker.

    Enters when: Only when applicable.Open exact procedure step →
Person-Centered Care Plan procedure mapAccepted action to real result and affected-plan return3 procedure steps
  • SOP taskConfirm receipt and custody

    Accepts an L3-Behavioral action.

    Enters when: Only when applicable.Open exact procedure step →
  • SOP taskFollow the goal and actual service result

    Supplies or reviews an L3-Behavioral result and new within-scope question.

    Enters when: Only when applicable.Open exact procedure step →
  • SOP taskRevise only when needed or requested

    Reviews only affected behavioral/psychosocial content within scope.

    Enters when: Only when applicable.Open exact procedure step →
Ongoing Monitoring and Support procedure mapFrom relationship and cadence to a useful return2 procedure steps
  • SOP taskAct only on the applicable unmet need or concern

    Reviews behavioral, psychosocial, caregiver-distress, or safeguarding concerns within license and scope.

    Enters when: When the reported need requires behavioral or psychosocial judgment.Open exact procedure step →
  • SOP taskAgree, document, count, recover, and complete promised work

    Reviews behavioral, psychosocial, caregiver-distress, or safeguarding concerns.

    Enters when: When follow-through exposes that issue.Open exact procedure step →
Ongoing Monitoring and Support procedure mapUseful contact and material-change branch2 procedure steps
  • SOP taskCheck plan fit only when the conversation makes it relevant

    Reviews a behavioral, psychosocial, or caregiver-distress recommendation.

    Enters when: Only when the affected plan element contains that question.Open exact procedure step →
  • SOP taskRoute only the real need

    Receives behavioral, psychosocial, caregiver-distress, or safeguarding questions.

    Enters when: When triggered.Open exact procedure step →
24/7 Access procedure mapFrom continuously available human access to truthful follow-through5 procedure steps
  • SOP taskMaintain a usable, continuously human-covered route

    Provides behavioral, psychosocial, caregiver-distress, or safeguarding escalation within scope.

    Enters when: When the configured route requires behavioral availability.Open exact procedure step →
  • SOP taskAnswer, recover, and capture the need without clinical triage

    Assesses behavioral, psychosocial, caregiver-distress, or safeguarding concerns.

    Enters when: When the captured concern triggers this route.Open exact procedure step →
  • SOP taskUse the correct live help route

    Reviews the source-faithful live-call report, performs the within-scope behavioral, crisis, distress, or safeguarding assessment, documents the immediate disposition and caller instruction, remains connected when required, and escalates any emergency or higher-authority issue.

    Enters when: When that issue requires it.Open exact procedure step →
  • SOP taskRecord, share, confirm custody, call back, and carry forward

    Reviews and follows behavioral, caregiver-distress, psychosocial, or safeguarding content.

    Enters when: When the call created that issue.Open exact procedure step →
  • SOP taskRecover outages and learn from repeated calls

    Reviews recurring behavioral, caregiver-distress, psychosocial, or safeguarding reports.

    Enters when: When that pattern is present.Open exact procedure step →
24/7 Access procedure mapLive 24/7 call routing3 procedure steps
  • SOP taskInvoke the approved emergency route

    Performs behavioral-health, crisis, caregiver-distress, or safeguarding assessment within scope.

    Enters when: When the issue is behavioral or psychosocial.Open exact procedure step →
  • SOP taskConnect a clinical issue directly

    Performs behavioral, psychosocial, caregiver-distress, crisis, or safeguarding assessment.

    Enters when: When that is the clinical issue.Open exact procedure step →
  • SOP taskFurnish or hand off the applicable GUIDE support

    Handles caregiver distress, behavioral challenges, psychosocial issues, crisis, or safeguarding judgment.

    Enters when: When that issue is present.Open exact procedure step →
Care Coordination and Transitional Care procedure mapChoose the exact coordination route and close on a returned result4 procedure steps
  • SOP taskCoordinate with an outside PCP

    Reviews returned behavioral, psychosocial, caregiver-distress, or safeguarding information.

    Enters when: When that question is present.Open exact procedure step →
  • SOP taskRun the specialist referral and return loop

    Defines or reviews a behavioral-health, psychosocial, caregiver-distress, or safeguarding referral within scope.

    Enters when: When the referral is behavioral or psychosocial.Open exact procedure step →
  • SOP taskCoordinate a care-setting transition

    Reviews behavioral, psychosocial, caregiver-distress, safeguarding, or adjustment needs.

    Enters when: When those needs arise.Open exact procedure step →
  • SOP taskWork another exact clinical coordination dependency

    Reviews behavioral, psychosocial, caregiver-distress, or safeguarding questions.

    Enters when: When that question is present.Open exact procedure step →
Care Coordination and Transitional Care procedure mapSpecialist referral: clinical need to returned recommendation4 procedure steps
  • SOP taskDefine the clinical need and purpose

    Determines a behavioral-health or psychosocial referral need within scope.

    Enters when: When the referral question is behavioral or psychosocial.Open exact procedure step →
  • SOP taskPrepare factual options and support beneficiary choice

    Resolves uncertain clinical capability for a behavioral or psychosocial referral.

    Enters when: When within behavioral scope.Open exact procedure step →
  • SOP taskObtain the visit result and recommendation

    Receives returned behavioral or psychosocial material for review.

    Enters when: When the referral is behavioral or psychosocial.Open exact procedure step →
  • SOP taskReview, explain, and carry forward the result

    Reviews and explains returned behavioral or psychosocial material within scope.

    Enters when: When applicable.Open exact procedure step →
Care Coordination and Transitional Care procedure mapCare-setting transition return loop2 procedure steps
  • SOP taskOpen distinct affected work in parallel

    Accepts behavioral, psychosocial, caregiver-distress, or safeguarding work.

    Enters when: When triggered.Open exact procedure step →
  • SOP taskReinforce approved instructions and return reviewed results

    Reviews and explains behavioral, psychosocial, caregiver-distress, or safeguarding recommendations.

    Enters when: When applicable.Open exact procedure step →
Referral and Services Supports procedure mapIndividual referral: need to actual service result1 procedure step
  • SOP taskDefine the need and desired result

    Reviews the prepared behavioral-health, distress, abuse, neglect, and safeguarding facts, determines within-scope clinical need, suitability, and urgency, documents the referral recommendation or protective disposition, and returns the permitted route.

    Enters when: When the stated need contains a behavioral or safeguarding concern.Open exact procedure step →
Medication Management and Reconciliation procedure mapFrom a real trigger to an authorized regimen result and real-world use1 procedure step
  • SOP taskUse the medication-safety bypass

    Reviews the prepared behavioral-health or safeguarding concern associated with medication use, performs the within-scope assessment, documents the immediate disposition and protective action, and escalates any prescribing or emergency question.

    Enters when: When the medication concern includes behavioral crisis, suicidality, abuse, neglect, or another behavioral/safeguarding question.Open exact procedure step →
Caregiver Education and Support procedure mapFrom caregiver applicability to a human-owned useful result6 procedure steps
  • SOP taskReview assessment, priorities, plan, and available services

    Reviews the prepared caregiver-distress, behavioral-health, abuse, neglect, or safeguarding question, performs the within-scope assessment, documents the disposition and protective action, and communicates the next step.

    Enters when: When the assessment or conversation produces a named behavioral or safeguarding trigger.Open exact procedure step →
  • SOP taskFurnish skills training and confirm practical application

    Reviews the behavioral, distress, treatment, or safeguarding issue raised during training, performs the within-scope assessment, documents the instruction, safeguard, or stop disposition, and escalates when required.

    Enters when: When the training reveals a behavioral-health or safeguarding concern.Open exact procedure step →
  • SOP taskOffer, arrange, and facilitate support-group participation

    Moves the distress, abuse, neglect, behavioral, or safeguarding concern out of the group setting, performs the private within-scope assessment, documents the disposition and protective action, and escalates when required.

    Enters when: When the group interaction creates a protected behavioral or safeguarding concern.Open exact procedure step →
  • SOP taskFurnish substantive one-to-one support and escalate protected concerns

    Reviews the prepared behavioral-health, suicidality, abuse, neglect, distress, or safeguarding concern, performs the within-scope assessment or intervention, documents the disposition and protective action, and escalates when required.

    Enters when: When the caregiver concern creates a behavioral or safeguarding trigger.Open exact procedure step →
  • SOP taskOffer optional support, role coaching, resources, and counseling referral

    Performs clinical behavioral-health assessment or counseling-referral judgment within authority.

    Enters when: When symptoms, treatment needs, or urgency make the route clinical rather than a clean caregiver self-request.Open exact procedure step →
  • SOP taskReassess caregiver need and update support

    Reviews the caregiver's reported use, distress, behavioral response, and safeguarding facts, performs the within-scope reassessment, documents improved, unchanged, worsened, or unresolved status, and returns the next intervention or escalation.

    Enters when: When reassessment produces a named behavioral or safeguarding trigger.Open exact procedure step →
Caregiver Education and Support procedure mapCaregiver skills training: automated content plus human application3 procedure steps
  • SOP taskFurnish the applicable skill content

    Receives a behavioral-health, distress, treatment, abuse, neglect, or safeguarding question.

    Enters when: When the lesson reaches a behavioral or safeguarding boundary.Open exact procedure step →
  • SOP taskRoute individualized clinical or safety judgment

    Reviews the protected distress, treatment, abuse, neglect, or safeguarding question, performs the within-scope assessment, documents the disposition and protective action, and returns only the permitted instruction to the caregiver and training record.

    Enters when: For behavioral or safeguarding questions.Open exact procedure step →
  • SOP taskConfirm practical understanding and intended use

    Reviews the behavioral or safeguarding concern revealed during attempted application, assesses it within scope, documents the safe modification, stop, or escalation disposition, and communicates the next action.

    Enters when: When the application check identifies a behavioral or safeguarding issue.Open exact procedure step →
Caregiver Education and Support procedure mapNo-caregiver branch: stop caregiver services, continue beneficiary safeguards1 procedure step
  • SOP taskOpen and follow the added beneficiary safeguards

    Reviews the prepared abuse, neglect, behavioral, social-work, and safeguarding facts, performs the within-scope assessment, documents the protective action and follow-up disposition, and escalates when required.

    Enters when: When the safeguard includes a behavioral or safeguarding concern.Open exact procedure step →

People and accountable organizations

Canonical actor roster

Each selected diagram step shows the exact task and entry condition under the same canonical role; the linked SOP carries the full procedure.

People who furnish or support GUIDE services

L1

Philippine 24/7 and coordination support

Proxi's Philippines-based human first-answer and administrative support team.

$5.50/hour planning assumption · July 14, 2026

Functions this category may perform
  • 24/7 human first answer, identity and callback capture, and warm transfer
  • Scheduling, record pursuit, endpoint verification, structured intake, and failed-route recovery
  • Source-faithful documentation and permitted administrative follow-through
Authority
Performs approved nonclinical first-answer and administrative acts.
Hard boundary
Not a GUIDE navigator contact and never clinical triage, medication reconciliation, treatment, or U.S.-licensed work. A Philippine RN credential does not expand this lane.
82 linked procedure steps across 26 procedure maps

Each step lists the exact task performed by this same job role. The steps are not additional roles or capacities.

Browse this role's SOP tasks
L2

Puerto Rico GUIDE navigator

Puerto Rico-based nonclinical dementia care navigator with current Alzheimer’s Association® essentiALZ® certification for dementia care navigation.

$22/hour all-inclusive planning assumption · July 14, 2026

Functions this category may perform
  • Primary relationship, required GUIDE contact, and beneficiary-led care-plan facilitation
  • Nonclinical assessment contribution, caregiver support, community coordination, and warm introductions
  • Caregiver-training tasks only when the named navigator's verified competency covers the subject
  • Human clarification for ambiguity, disagreement, distress, accessibility failure, or requested relationship help
Authority
Performs the specifically required or valuable nonclinical human GUIDE task after preparation. A training task requires verified subject-specific competency; it does not create a separate trainer job category.
Hard boundary
No clinical or medical work, even if an individual also holds an RN or other professional credential. A topic outside the navigator's verified training competency routes to the applicable U.S. clinician or an approved outside training provider. Not the default fact collector, option builder, or gateway to a clinician.
113 linked procedure steps across 26 procedure maps

Each step lists the exact task performed by this same job role. The steps are not additional roles or capacities.

Browse this role's SOP tasks
L3-RN

U.S. clinical support RN

A separate beneficiary-location-authorized U.S. registered nurse working within actual license, scope, and organizational authority.

$64/hour blended L3 planning assumption · July 14, 2026

Functions this category may perform
  • Clinical assessment and pre-review
  • Scoped physical-health, symptom, function, transition, medication-use, and safety judgment
  • Clinical follow-up that is within RN authority
Authority
Exercises nursing judgment only for acts covered by the nurse's license, beneficiary location, and scope.
Hard boundary
Does not inherit prescribing, diagnosis, or Part B E/M authority and is not Puerto Rico navigator labor.
75 linked procedure steps across 24 procedure maps

Each step lists the exact task performed by this same job role. The steps are not additional roles or capacities.

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L3-Behavioral

U.S. LCSW or behavioral clinician

A separate beneficiary-location-authorized U.S. LCSW or other behavioral clinician working within actual professional scope.

$64/hour blended L3 planning assumption · July 14, 2026

Functions this category may perform
  • Psychosocial and behavioral assessment or intervention
  • Caregiver-distress, safeguarding, abuse/neglect, and behavioral-health judgment
  • Protected behavioral or social-work contribution to a prepared episode
Authority
Exercises the protected behavioral or social-work judgment covered by the professional's credential and jurisdiction.
Hard boundary
Does not prescribe, diagnose outside scope, or act as a generic reviewer for clean nonclinical work.
68 linked procedure steps across 22 procedure maps

Each step lists the exact task performed by this same job role. The steps are not additional roles or capacities.

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L4

U.S. prescribing or Part B E/M clinician

A dementia-proficient NP, PA, CNS, physician, or other exact prescribing/E/M professional authorized for the beneficiary location and act.

$140/hour planning assumption · July 14, 2026

Functions this category may perform
  • Required examination and clinically necessary history
  • Diagnosis, staging, treatment, medication reconciliation, prescribing, and medical orders
  • Higher-authority clinical contribution to assessment, care planning, transitions, and follow-up
Authority
Exercises only the medical and prescribing authority actually held by the named professional.
Hard boundary
Receives a prepared source-linked packet; routine record hunting, form population, scheduling, and administrative chasing occur before this role enters.
89 linked procedure steps across 25 procedure maps

Each step lists the exact task performed by this same job role. The steps are not additional roles or capacities.

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Corporate enabling departments

These departments enter only for their concrete technical, claim, Medicaid, or workforce work. They are not routine beneficiary-case reviewers.

Corporate enabling

System administrator

The person responsible for approved production configuration, access, telephony and integration operations, permissions, and service restoration.

Concrete work
  • Restore approved access, configuration, routing, permissions, or environment operation
  • Diagnose whether an incident is configuration, vendor, connectivity, or software-defect work
  • Preserve incident timing, affected routes, actions, and recovery evidence
Authority
May restore and operate approved systems; may not change business, privacy, billing, or clinical policy.
Hard boundary
Enters an operational incident, not a routine beneficiary episode. A product defect routes to software engineering.
2 linked procedure steps across 2 procedure maps

Each step lists the exact task performed by this same job role. The steps are not additional roles or capacities.

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Corporate enabling

Software engineering and debugging team

The product engineers who correct defects, missing automation, and data-model failures after the approved rule is defined.

Concrete work
  • Reproduce and correct incorrect deterministic behavior
  • Implement approved automation and data-model changes under change control
  • Identify affected records and supply validation and recovery evidence
Authority
May implement an approved rule; may not invent or adjudicate the underlying policy.
Hard boundary
Not an IT helpdesk, care-delivery role, clinical reviewer, or policy owner.
2 linked procedure steps across 2 procedure maps

Each step lists the exact task performed by this same job role. The steps are not additional roles or capacities.

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Corporate enabling

Billing and revenue-cycle specialist

The administrative professional responsible for claim construction, coding, release, denial correction, and payment records under approved policy.

Concrete work
  • Correct a claim or payment artifact
  • Work a payer denial or manual claim condition
  • Record claim hold, release, correction, denial, or payment disposition
Authority
Performs revenue-cycle work under approved claim rules.
Hard boundary
Does not decide clinical appropriateness, fabricate service evidence, or interpret Medicaid program authority outside billing scope.
No routine procedure task

This job enters through a concrete failure or escalation route, not as a standing reviewer.

See its entry route
Corporate enabling

Medicaid program specialist

The administrative subject-matter professional for state Medicaid benefits, waivers, coverage authorities, eligibility interfaces, and Medicaid responsibility questions.

Concrete work
  • Resolve a bounded Medicaid program or coverage-authority question
  • Identify the authoritative state, plan, waiver, payer, or agency source
  • Separate Medicaid responsibility from GUIDE and claim-processing work
Authority
Interprets the approved Medicaid program materials within assigned administrative scope.
Hard boundary
Not a clinician, navigator, eligibility adjudicator beyond delegated authority, or second revenue-cycle queue.
No routine procedure task

This job enters through a concrete failure or escalation route, not as a standing reviewer.

See its entry route
Corporate enabling

HR and workforce administration

The workforce function responsible for hiring administration, credential files, schedules, leave, roster capacity, and approved coverage plans.

Concrete work
  • Repair an uncovered shift or roster-capacity gap
  • Maintain required personnel and credential-file evidence
  • Escalate when the approved staffing plan cannot supply coverage
Authority
May administer employment, roster, and credential-file controls under approved policy.
Hard boundary
Portfolio and workforce work only; HR does not become the owner of a beneficiary case or decide professional scope.
1 linked procedure step across 1 procedure map

Each step lists the exact task performed by this same job role. The steps are not additional roles or capacities.

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Clinical and legal escalation authorities

These leaders enter only for the issue inside their actual authority. They do not bless routine work.

Escalation authority

Head of nursing and clinical operations

The U.S. nursing leader accountable for nursing-practice quality, RN clinical operations, and escalations beyond the original nurse or first-line clinical supervisor.

Concrete work
  • Review a serious or repeated RN-practice issue
  • Set and correct nursing-practice and clinical-operations standards
  • Assign the responsible nursing correction and verify recovery
Authority
Exercises nursing leadership within actual organizational, licensure, and jurisdictional authority.
Hard boundary
Not a reviewer for administrative, navigator, billing, privacy, software, or physician-quality work.
1 linked procedure step across 1 procedure map

Each step lists the exact task performed by this same job role. The steps are not additional roles or capacities.

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Escalation authority

Chief Medical Officer

The physician executive used for physician/medical quality, high-level medical judgment review, and medical-staff accountability when the issue exceeds the original clinician.

Concrete work
  • Review a serious physician or medical-quality issue
  • Resolve high-level medical-practice escalation within actual authority
  • Assign the responsible medical correction and verify its disposition
Authority
Exercises physician medical leadership within the CMO's actual organizational and professional authority.
Hard boundary
Not a rubber stamp for routine care plans, RN work, missed callbacks, staffing gaps, or administrative failures.
No routine procedure task

This job enters through a concrete failure or escalation route, not as a standing reviewer.

See its entry route

Participant, people served, and outside parties

Participant authority

GUIDE Participant accountable authority

The named person or body inside the GUIDE Participant that retains a nondelegable approval, signature, attestation, or organizational accountability act.

Functions
  • Participant-retained approval, attestation, signature, or final accountability
  • Assignment and oversight required by the Participation Agreement or approved policy
Reviewer-visible subtype or participation basis
  • Exact retained Participant body
  • Exact retained approval, release, signature, attestation, or accountability act
Authority
Performs only the exact act that cannot be delegated or that the Participant has expressly retained.
Boundary
Not automatically the navigator or clinician and not a universal approver. Exact unresolved authority remains an open decision rather than a placeholder role.
No routine procedure task

This job enters through a concrete failure or escalation route, not as a standing reviewer.

See its entry route
People served

Beneficiary

The person receiving GUIDE services.

Functions
  • Supplies lived facts, goals, priorities, choices, consent or refusal, and reported outcomes
  • Leads the person-centered Care Plan and participates through accessible routes
Authority
Owns personal choices except where a valid, decision-specific representative authority applies.
Boundary
A source report establishes what the beneficiary reported, not a clinical diagnosis, external result, or professional judgment.
96 linked procedure steps across 25 procedure maps

These are participation or outside-party touchpoints. They are not Proxi employment roles.

Browse linked procedure touchpoints
People served

Caregiver or authorized representative

A caregiver, potential caregiver, or decision-specific authorized representative, with each status and permission recorded separately.

Functions
  • Supplies caregiver-owned facts, needs, preferences, participation, and reported outcomes
  • Receives permitted education/support and may perform an authorized representative act within scope
Reviewer-visible subtype or participation basis
  • Caregiver
  • Potential caregiver whose participation is not yet established
  • Decision-specific authorized representative
  • A person who holds both statuses, recorded separately
Authority
Authority depends on current beneficiary permission or valid decision-specific representative evidence.
Boundary
Family relationship, emergency-contact status, shared address, or portal access does not itself confer representative or disclosure authority.
107 linked procedure steps across 26 procedure maps

These are participation or outside-party touchpoints. They are not Proxi employment roles.

Browse linked procedure touchpoints
L5

External provider, service, or authority

The typed outside endpoint that controls an external act: PCP, specialist, pharmacy, hospital/facility, emergency service, payer, community organization, Medicaid/AAA/Tribal Aging Program, or contracted field professional.

Functions
  • Co-management, concurrence, direct treatment, dispense, coverage/intake decision, emergency response, or real-world service delivery
  • Returns source-native evidence of the outside result or truthful non-success
Reviewer-visible subtype or participation basis
  • PCP or primary care practice
  • Specialist, prescribing clinician, diagnostic provider, or laboratory
  • Pharmacy, supplier, hospital, facility, home-health, or hospice organization
  • Emergency, crisis, poison-control, or protective-service responder
  • Payer, Medicaid HCBS program, AAA, or Tribal Aging Program
  • Community service, caregiver support, training, transportation, interpreter, accessibility, or communications provider
Authority
Controls only the external decision or performance within that party's real role.
Boundary
Proxi may prepare, connect, pursue, and report; it cannot manufacture the external result from a send, appointment, claim, or acknowledgement. An external system is channel metadata for the typed endpoint, not a person or a Proxi software surface.
89 linked procedure steps across 26 procedure maps

These are participation or outside-party touchpoints. They are not Proxi employment roles.

Browse linked procedure touchpoints

Procedure tasks are not job titles

Route each task to one of the real categories.

Each linked task opens its definition, permitted job categories, and controlling procedure instead of creating a phantom role.

Task-routing rule

Assessment team or owner

The people accountable for the particular assessment act, not one standing job title.

How the exact person is selected
Resolve each task to the Puerto Rico navigator, exact U.S. RN, behavioral clinician, medical clinician, beneficiary/caregiver, or outside source shown in that assessment step.
Open the controlling procedure →

Task-routing rule

Care Plan owner

The canonical person assigned the particular Care Plan action or protected contribution.

How the exact person is selected
The beneficiary leads choices; the navigator facilitates and owns nonclinical follow-through; an exact U.S. clinician owns protected clinical judgment; outside or Participant acts stay with those parties.
Open the controlling procedure →

Task-routing rule

Caregiver-service owner

The canonical performer of the applicable caregiver education, support, training, or protected clinical contribution.

How the exact person is selected
Relationship and application work resolves to the Puerto Rico navigator. A training task may be assigned to a navigator only when that named navigator's verified competency covers the subject; protected clinical content resolves to the exact U.S. clinician, and approved contracted training may resolve to an outside provider.
Open the controlling procedure →

Task-routing rule

Prescribing clinician

A function requiring actual prescribing authority for the beneficiary location and act.

How the exact person is selected
It resolves to Proxi's exact U.S. L4 clinician only when Proxi supplies that clinician; otherwise it resolves to the typed outside prescribing clinician.
Open the controlling procedure →

Task-routing rule

Transition source

The external hospital, facility, home-health, hospice, practice, or other endpoint supplying the transition event or source-native record.

How the exact person is selected
Resolve it to the exact outside organization in the event; Proxi may pursue and coordinate but cannot manufacture the outside result.
May be performed by
External party
Open the controlling procedure →

Failure and exception routing

Route the work to a real job, not a specialist pool.

There is no runtime state in which an unnamed human may perform undefined work.

Start with the worker who owns the real task. Add another department only for its concrete work.

Repeated failure — supervisory task in the same job lane

An approved senior Philippine L1 worker or Puerto Rico GUIDE navigator performs the specific reassignment or recovery task after the owning SOP's repeat-failure trigger. This is a task and seniority assignment inside the same job category, not a new role. Nursing-quality or physician-quality questions enter the separate Head of nursing or CMO authority only when their protected judgment is actually required.

Protected escalation — exact authority

Nursing quality goes to the Head of nursing, physician or medical quality to the CMO, and a genuine uncovered legal question to healthcare counsel. The affected act remains held.

  1. Run the approved software rule and keep the original worker responsible for ordinary completion or correction.
  2. If human recovery is needed, use that worker's named lane lead before creating work for another department.
  3. Classify the remaining issue by the observable work: system operation, software defect, claim, Medicaid, workforce, nursing quality, medical quality, or legal interpretation.
  4. Assign one named rostered person from the matching real job category and state the exact input, act, output, due time, and return recipient.
  5. Keep portfolio work outside the beneficiary episode. HR roster repair, system incidents, and QA sampling do not become furnished GUIDE services.
  6. If no real role has the required authority, hold only the affected act and resolve the policy or organizational gap before field use.

Routine work correction

Canonical job category
The original worker; then that worker's Philippine, Puerto Rico, or clinical lane lead
Person enters when
A handoff, callback, service record, or assigned action remains incomplete after the approved automated retry
Work
Correct the original work inside the same lane; the lead enters only after the defined repeat-failure or dispute threshold.
Output
Corrected work, named next action, due time, and recovery evidence.
Episode boundary
Beneficiary episode. Quality is a responsibility of the applicable lane lead, not a separate case specialist.

System operation

Canonical job category
System administrator
Person enters when
The approved workflow cannot run because of access, configuration, telephony, integration availability, permissions, or environment failure
Work
Restore the approved configuration or service without changing the business or clinical rule.
Output
Restored service, incident evidence, affected interval, and escalation if the fault is a software defect.
Episode boundary
Operational incident. The administrator does not rewrite policy or clinical logic.

Software defect

Canonical job category
Software engineering and debugging team
Person enters when
The implemented rule is wrong, required automation is missing, or the data model cannot express the approved policy
Work
Diagnose and correct the product defect under change control; preserve the failed result and affected cases for repair.
Output
Defect record, corrected release, validation evidence, and affected-work recovery list.
Episode boundary
Product incident. Engineering does not decide what the policy should be.

Claim or payment work

Canonical job category
Billing and revenue-cycle specialist
Person enters when
A claim, coding, payment, denial, or claim-release artifact requires manual revenue-cycle work under an approved rule
Work
Correct the claim artifact or document the payer disposition without deciding whether a service was clinically appropriate.
Output
Released, corrected, held, or denied claim record with reason and next action.
Episode boundary
Beneficiary-linked financial work; not service delivery or clinical review.

Medicaid program question

Canonical job category
Medicaid program specialist
Person enters when
A state Medicaid benefit, waiver, coverage authority, eligibility interface, or Medicaid responsibility question cannot be resolved from the approved rule and verified facts
Work
Resolve the bounded Medicaid program question or identify the authoritative outside source needed.
Output
Cited Medicaid disposition, missing source, or external referral; no GUIDE clinical decision.
Episode boundary
Program expertise. This is not a second billing queue.

Workforce and credential administration

Canonical job category
HR and workforce administration
Person enters when
A roster, shift, onboarding, credential-file, leave, or capacity gap cannot be filled from the approved workforce plan
Work
Repair staffing and credential-file coverage outside the beneficiary episode.
Output
Accepted coverage, corrected workforce record, or documented capacity gap and escalation.
Episode boundary
Portfolio/workforce work. HR does not become a beneficiary-case owner.

Clinical quality or medical escalation

Canonical job category
Head of nursing/clinical operations for nursing practice; Chief Medical Officer for physician or medical judgment
Person enters when
A repeated or serious clinical-practice issue exceeds the original clinician and first-line clinical supervisor
Work
Review only the nursing-practice or physician/medical issue inside the leader's actual authority.
Output
Clinical leadership disposition, corrective action, and responsible clinical owner.
Episode boundary
Rare clinical escalation. Missed administrative work never routes here.

Legal interpretation

Canonical job category
Internal or retained healthcare legal counsel
Person enters when
Complete verified facts expose a genuine legal question that the approved policy does not answer
Work
Answer the bounded legal question while the affected act remains held.
Output
Legal disposition, restriction, or need for external authority.
Episode boundary
Rare held-act escalation. Counsel does not perform outreach, navigation, education, scheduling, or clinical work.

Return rule: the enabling or escalation role returns its result to the service worker responsible for the affected action. It does not take over the beneficiary relationship.

Open the controlling role procedure →

Nonhuman layer

Proxi software surfaces

Preparation and orchestration are visible, but they never borrow human authority.

01

Proxi Daily Companion

Configurable daily beneficiary interaction, approved information, reminders, action help, source-attributed self-report, and a direct request for a person.

Boundary

Not a qualifying navigator contact, 24/7 human first answer, clinical monitor, diagnosis, urgency decision, or service-completion event. Silence stays unknown.

02

Caregiver Companion View

Permission-scoped, source-dated last-confirmed beneficiary information, open actions, explicit unknowns, a fresh-check request, and an optional caregiver pulse.

Boundary

Does not expose unauthorized information, convert caregiver observation into beneficiary fact, score distress, or present synthetic clinical status. Silence, stale data, and conflict remain unknown and never become reassurance.

03

Staff Preparation and AI Workspace

Retrieval, source links, contradictions, unknowns, prior promises, approved explanations, options, summaries, and the exact unresolved question.

Boundary

Prepares and advises within approved content; it does not resolve the question, choose for the person, or prove human review.

04

Deterministic Routing and Takeover

Approved routing, no-repeat context transfer, retries, failed-handoff recovery, and preservation of the original issue.

Boundary

AI cannot select clinical urgency, authority, disclosure, service credit, or closure.

05

Action and Result Tracker

Promises, owners, deadlines, external responses, receiving acceptance, due work, returned results, corrections, and affected-pillar feeds.

Boundary

A send, alert, appointment, handoff, named owner, or dashboard state is not completion.

Proxi product layer · not a ninth pillar

Daily companion and caregiver pulse

Daily availability feeds the right service; it does not manufacture one.

  1. Verify identity and permission.Use the person's current scope, not family relationship or old access.
  2. Show the last confirmed picture.Every material item carries its source and as-of time; unknown stays unknown.
  3. Offer a beneficiary interaction.The beneficiary may participate, defer, decline, or ask for a person.
  4. Ask the optional caregiver pulse.Capture how the caregiver is holding up and whether help is wanted as caregiver-owned information.
  5. Prepare; do not decide.Proxi retrieves context, preserves exact reports, and raises configured stop candidates.
  6. Route to the real performer.L1, L2, the exact L3/L4 professional, a concrete enabling department or escalation authority, or the outside endpoint completes the named work and returns a disposition or source-native evidence.
  7. Return one action plan.State what happened, which canonical actor is assigned each action, what remains unknown, and when the result is expected.

No response is not stability. Companion activity alone is not a human GUIDE contact, 24/7 human answer, caregiver assessment or support call, clinical assessment, or service credit.

Mechanical reviewer check

If a name does not resolve here, it is a phantom actor.

A diagram links concrete work and an entry condition to a canonical person. It may state a credential or seniority condition on the task, participation basis, or outside-party type. It may not create a new role from a task, combine software and a human into one label, or put a ledger, packet, calendar, route, or work queue in the actor lane.

A linked task phrase in a source manual returns here when the exact performer depends on the episode or an open authority decision. The selected diagram step must resolve that task to the applicable canonical actor and state the work performed; the task link itself never claims a new person.

Inspect the normalized sequence atlas →