Overview:

Process Redesign and implementation of new contract processing and large group enrollment for a Large, Chicago-based Health Insurance Company

Business Issue:

This payor had substantial opportunities to improve its level of customer service. Of 19 competitors, this payor was ranked last in the amount of time it took to complete a new group enrollment before revamping the group membership system, this organization needed assistance to review the existing business processes, identify the changes required to achieve dramatic improvements in customer service, and substantially reduce the cost of the new group enrollment process.

Actions:

• Adjusted the current design for the New Membership System (NMS) to leverage a portable, intelligent, and easy-to-use automated checklist to guide team members through the account setup
• Reviewed the current hardware and software platform, systems development methodology, and project organization structure to identify a new membership system solution
• Restructured teams to process all enrollment-related work, including proposal and renewal work

Results:

• Implemented improved business processes
• Implemented work teams to process group enrollment
• Reduced time required and cost of the new group enrollment process
• Enabled the development of supporting information systems in 2.5 years for half the cost