Provider Portal for Healthcare MSO

Designed and built a full-stack HIPAA-compliant healthcare provider portal for ProCare MSO, a Medicare Advantage managed care organization managing 5,000+ patients across multiple IPA (Independent Physician Association) networks in Southern California.

The client had a single static HTML file with hardcoded demo data and no backend. I built the entire platform from scratch — backend API, database, AWS infrastructure, authentication, and data integration — then deployed it to production in under a week.

Key deliverables:

Healthcare Data Platform & Analytics

Ingested and normalized 60,000+ eligibility records, 125,000+ claims, and capitation data from QuickCap/Excel sources

Built real-time dashboards with KPI cards, trend charts, and drill-down views for PCP performance monitoring

Claims analytics engine with Part A (inpatient) and Part B (outpatient) cost breakdowns by member and specialty

Utilization analysis: ER visits, hospital admissions, readmission tracking, specialist utilization ranking

ICD-10 diagnosis lookup module (400+ codes) with human-readable descriptions across all views

Clinical Case Management System

9-tab clinical workflow for high-risk patient case management (Overview, Vitals, CCM Assessment, Care Plan, Notes, Tasks, Alerts, Concierge, MEAT Notes)

Auto-identification of 20 highest-risk patients using RAF scores, ER/IP utilization, and claims cost data

PHQ-2/PHQ-9 depression screening, ADL/IADL functional assessments, SDOH screening

MEAT (Monitor, Evaluate, Assess, Treat) progress notes with speech-to-text dictation

Care team coordination: task assignment, goal tracking, alert system, concierge activity logging

Text member feature with canned clinical message templates

Authorization & Referral Management

Prior authorization tracking with PCP-to-specialist and specialist-to-specialist pending workflow

Self-referral PCP review system matching the client's existing fax notification process

Upload/download for paper PA forms

In-network specialist directory (440+ specialists across 53 specialties)

HIPAA-Compliant Authentication & Security

JWT-based authentication with bcrypt password hashing

Role-based access control (RBAC) with 6 roles: Provider, Specialist, Case Manager, Nurse, Concierge, Admin

PCP-scoped data isolation — each provider sees only their assigned patient panel

Server-side session management with token-based API security

HIPAA-compliant infrastructure on AWS with plans for encryption at rest, audit logging, MFA in Phase 2

Medicare & Managed Care Specific Features

CMS V28 HCC risk adjustment coding with RAF weights for 130+ ICD-10 codes

Annual Wellness Exam (AWE) tracking with HEDIS MY 2026 measures and dollar tracking ($150/AWE)

Capitation reporting: monthly trends, PMPM calculations, health plan mix analysis

Eligibility management: active/termed member tracking across multiple health plans (HealthNet, Molina, Champion, Central Health, Imperial Health)

Technical Architecture

Backend: Node.js + Express API with 20+ route files and 50+ endpoints

Database: SQLite (better-sqlite3) with 15+ tables, optimized indexes

Frontend: Vanilla JavaScript single-page application with role-based rendering

Infrastructure: AWS EC2, Nginx reverse proxy, systemd service management

Data Pipeline: XLSX parser for automated import of claims, eligibility, capitation, and authorization data from QuickCap

Deployment: Automated SCP-based deployment to production