Overview:

Integrated people, processes, and technology redesign solution for the Group Enrollment and Administration process at a Large Health Payer

Business Issue:

This Large, East Coast Healthcare Payer needed to improve its effectiveness at monitoring the open enrollment process, eliminate waste and improve the overall process efficiency. The client desired an integrated process, people, and technology strategy to address these needs in a short timeframe, in advance of the upcoming enrollment period. Familiar with our track record for success, the client asked us to create this strategy.

Actions:

• Developed and gained approval from the Executive team on a redesigned strategy for New and Renewal Group Implementation:
• Process, Technology, and Organization redesign
• Detailed Cost Benefit Analysis
• Prioritized Implementation Plan
• Led the definition of need and the selection process for the necessary supporting technologies
• Conducted training and rollout of the new process, roles, and technology for over 700 users
• Performed all Change Management to ensure success for the entire initiative by providing:
• Communication Strategy development and execution
• Executive reporting
• Issue management
• Cross-project risk mitigation
• Performed Process Assurance activities to ensure adoption of the new process and technology across the user base

Results:

• Reduced renewal data entry time by 50%, thus increasing staff capacity
• Streamlined workflow process, eliminated non-value added and redundant activities
• Created 100 visibility of to the status of all groups at all times for all functions
• Enhanced reporting for strategic planning, trend analysis, product development, and account profitability