How to Build Healthcare Navigation Workflows in ClickUp
ClickUp can be configured to support healthcare navigation and advocacy workflows by combining tasks, custom fields, AI agents, and automations into a single, coordinated system. This guide walks you step by step through setting up an operational workspace that can help navigate insurance, coordinate care, and support patients or members end to end.
Plan Your Healthcare Process in ClickUp
Before building anything, outline the journey your team will support. A clear process ensures ClickUp reflects real work, not just abstract ideas.
Map the Navigation and Advocacy Stages
Identify the main stages a patient, member, or employee moves through when receiving support. Common examples include:
- Initial intake and eligibility check
- Benefits and coverage review
- Provider search and appointment scheduling
- Prior authorizations and referrals
- Ongoing care coordination
- Claims issues and appeals
- Follow-up and outcomes review
Document these stages in a simple outline. Each stage will map to statuses, views, and automation triggers in ClickUp.
Define the Data You Need to Track
Next, list the data points you must capture to successfully advocate for someone’s care. For example:
- Member ID, insurance plan, and group number
- Primary diagnosis and key conditions
- Preferred providers and networks
- Authorization numbers and expiration dates
- Case priority and risk level
- Communication preferences and key contacts
These fields will become custom fields on tasks in ClickUp, allowing AI agents and human teams to filter, sort, and triage effectively.
Create a Healthcare Navigation Space in ClickUp
With your process defined, you can create a dedicated structure in ClickUp to hold all navigation and advocacy work.
Step 1: Create a New Space
- In your workspace, create a new Space for healthcare navigation and advocacy.
- Name it clearly, such as “Healthcare Navigation” or “Member Advocacy.”
- Assign a color and icon to help teams quickly find it in ClickUp.
Within this Space, you can group Lists by population, product line, or region, depending on how your organization is structured.
Step 2: Set Up Core Lists
Create Lists to separate different types of navigation work, such as:
- New Intake & Triage
- Active Navigation Cases
- High-Risk or Complex Cases
- Claims & Billing Issues
- Completed & Archived Cases
Each List will hold tasks representing individual cases, members, or episodes of care. This structure gives teams a clear view of volume and status directly inside ClickUp.
Configure Custom Fields and Statuses in ClickUp
Accurate data is central to reliable navigation and advocacy. Configure your Lists with well-designed custom fields and statuses.
Step 3: Add Custom Fields for Healthcare Data
On your main case List in ClickUp, add custom fields such as:
- Member / Patient Name (text)
- Member ID (number or text)
- Plan Type (dropdown: HMO, PPO, EPO, etc.)
- Primary Condition (text or dropdown)
- Case Priority (dropdown: Low, Medium, High, Critical)
- Authorization Status (dropdown: Pending, Approved, Denied)
- Key Dates (date fields for intake, follow-up, and authorization expiry)
Use consistent naming across Lists to make reporting and AI analysis easier inside ClickUp.
Step 4: Design Case Statuses
Customize statuses in each List to reflect your real workflow, for example:
- New Intake
- In Review
- Awaiting Member Information
- Coordinating Care
- Awaiting Payer Response
- Resolved
- Closed
These statuses drive automations, views, and AI agent triggers so your navigation process is always up to date.
Build AI-Powered Views in ClickUp
Different teams need different perspectives. ClickUp views help care navigators, supervisors, and analysts focus on their specific tasks while AI agents assist with summarization and triage.
Step 5: Configure List and Board Views
For daily operations, create:
- A Board view grouped by status to see work moving through stages.
- A List view with key custom fields visible, filtered to open cases only.
- A Table view for bulk updates, reporting, and audit preparation.
Use filters for high-priority or at-risk cases so navigators can focus attention where it matters most.
Step 6: Add AI-Ready Fields and Notes
Include dedicated fields or sections in ClickUp tasks where AI can add value, such as:
- Summary of case history
- Key benefits or coverage details
- Recommended next actions
- Open questions for the payer or provider
AI agents can then generate or update these summaries based on activity, comments, or uploaded documents.
Use ClickUp Automations for Navigation Workflows
Automations help standardize navigation and advocacy steps so cases do not fall through the cracks.
Step 7: Trigger Tasks from Intakes
Set up automations in ClickUp so that new requests automatically become navigation cases. For example, you can:
- Create a task when a form is submitted.
- Assign it to an intake queue or specific navigator.
- Set an SLA due date based on the form type or urgency.
This ensures every new request is captured, triaged, and tracked without manual data entry.
Step 8: Automate Status and Ownership Changes
Configure additional ClickUp automations to handle routine updates:
- Change status to “In Review” when a navigator is assigned.
- Notify a supervisor if a task remains in “New Intake” beyond a set time.
- Move a case to “Claims & Billing” List when a specific field (like “Issue Type”) is set to “Billing.”
- Auto-assign follow-up tasks when a case moves to “Resolved.”
These automations keep the process consistent and give you reliable data for audits and analytics.
Leverage AI Agents in ClickUp for Healthcare Navigation
AI agents can accelerate case review, document analysis, and communication drafting within the ClickUp environment.
Step 9: Use AI to Summarize Case History
When notes, messages, and files accumulate, AI can generate concise summaries. You can configure AI agents to:
- Summarize all case comments into a current-state overview.
- Highlight recent payer or provider decisions.
- Extract key dates, coverage terms, or denials from uploaded documents.
This helps navigators quickly understand complex cases before contacting members or payers.
Step 10: Draft Communications with AI
Use AI in ClickUp to draft communication templates directly from case data, such as:
- Member outreach messages explaining benefits or next steps.
- Provider coordination emails summarizing history and requested actions.
- Payer follow-up messages that reference specific authorizations or claims.
Navigators can then review and personalize drafts while maintaining consistency and compliance with organizational guidelines.
Coordinate Teams and Reporting in ClickUp
Once your workflows and AI agents are in place, focus on collaboration and measurable outcomes.
Step 11: Standardize Collaboration
Within each case task in ClickUp:
- Use comments to document calls and decisions.
- Mention team members to capture approvals or insights.
- Attach EOBs, referrals, and other key documents.
- Use checklists for standard workflows like authorizations or appeals.
This creates a single source of truth for every navigation episode.
Step 12: Build Dashboards and Analytics
Set up dashboards to track the health of your navigation program, including:
- Volume of open and new cases.
- Average time in each status.
- Resolution time for authorizations, claims, and complex cases.
- Workload distribution across navigators.
Use this data to refine automations, staffing models, and AI agent prompts inside ClickUp.
Next Steps and Additional Resources
To deepen your operational design skills, you can explore healthcare workflow and AI content strategy guidance at Consultevo. For the original overview of healthcare navigation and advocacy AI agents, review the source material at ClickUp Healthcare Navigation and Advocacy.
By combining thoughtful process design with AI capabilities and structured data, your organization can turn ClickUp into a powerful hub for healthcare navigation and advocacy, improving member experiences while maintaining operational control and visibility.
Need Help With ClickUp?
If you want expert help building, automating, or scaling your ClickUp workspace, work with ConsultEvo — trusted ClickUp Solution Partners.
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