CASE STUDY
Modernization Roadmap for Healthcare Enrollment Center Boosts Customer Service and Development Efficiency
SERVICES
THE CHALLENGE
Outdated enrollment system hindered customer satisfaction, caused workflow delays
Our client, a large healthcare payer serving Federal employees, was tasked with modernizing their enrollment and customer service systems and processes. They needed a strategy roadmap to improve customer satisfaction and speed of response, and also lower costs. The roadmap, along with its supporting business cases, would enable proper executive support for project funding and scheduling.
However, the payer faced a critical challenge: Many of its legacy systems applications, data sources and integration points were dated, inflexible and poorly coded. This inhibited our client’s ability to fit business processes to customer needs, due to the long cycle of development and testing required to update supporting IT systems. The brittleness of the payer’s IT systems constrained its business process agility, which resulted in wasteful workflows with numerous manual process workarounds.
We generated a four-year roadmap projecting 33 projects across three primary improvement initiative groups: data, applications, and process and reengineering.
OUR SOLUTION
Architecting a roadmap and eliminating waste
To remedy the payer’s inefficient workflow, Optimity built an enrollment and customer service modernization strategy that included a future state conceptual application and data architecture. We generated a four-year roadmap projecting 33 projects across three primary improvement initiative groups: data, applications, and process and reengineering. Optimity extended the conceptual architecture into a Build vs. Buy assessment of architectural components, complemented by a buildout of detailed project plans to support task-level execution of each architectural component.
To safeguard against any undue IT development investment commitments, we performed a Lean Process Optimization assessment and design across all enrollment operations. This assessment identified areas where waste could be reduced or eliminated. A critical element of delivery consisted of enrollment process and UI simulation models, which provided a quantitative foundation for project funding prioritization and in turn fueled follow-on agile user stories and development sprints.
TOOLKIT
Enrollment & Customer Service Modernization Strategy Roadmap
Build vs. Buy assessment
Architectural component buildout plans
Lean Process Optimization assessment
UI simulation models
THE RESULTS
Strategy to modernizing the payer’s enrollment and customer service systems and processes, identifying areas for improvement of the human experience such as customer satisfaction, speed of response and cost reduction.
Four-year detailed roadmap across data, applications, and process & reengineering to ensure proper execution
Direct path to completion by performing a detailed Build vs. Buy analysis of each architectural component
Quantified and eliminated waste of time and money through Lean Process Optimization assessment and design
