Overview:

Developed and Implemented a New Customer Service Delivery Model for a National Provider of Affordable, Comprehensive Health Plans

Business Issue:

This company was facing potentially static premium volumes, increased regulatory requirements, and heightened competitive pressure in the healthcare market. The organization needed to address its falling customer satisfaction score, then at 6 out of 10 points, placing it at the lowest level of satisfaction among individual carriers.

Actions:

• Conducted a comprehensive assessment of the Customer Service Delivery Model across 7 key areas: Breadth of Service, Responsiveness, Quality of Service, Consistency, Utilization of Staff, Expense of turnover, and Customer Satisfaction
• Implemented a formal tiered call handling methodology to more quickly and efficiently answer calls and achieve First Call Resolution
• Implemented predictable and repeatable process
• Identified accountability for every call at each point in the process
• Provided a universal, 360 degree View of the Customer
• Allowed for multi-channel support
• Created self-service options to be utilized by those Customers who were interested
• Implemented Call-Avoidance operational improvements to eliminate the need for the call in the first place

Results:

• Common understanding of divisional Value Proposition across Executive and Operational units
• A more consistent approach to Call Handling regardless of the  channel of entry or CSR
• Clear roles and responsibilities across the entire process
• Clear metrics and measures to support the intention of the model rather than unintended behavioral modifications