Case Studies for Industry, Processes, and Technologies

Project Background

A major provider of health insurance – member of a national association of health care plans. The company delivers individual and group health plans and third party administration services to large clients

Business Challenge

Sales and enrollment process was overly complex, didn’t meet different needs of different customer segments

Project Approach Two person project team worked with cross-functional team of client staff, departmental management, and executive management over six months to:
  • Determine client expectations and appropriate metrics for the process
  • Map core activities and develop “as-is” process maps
  • Review process disconnects and design new “to-be” process maps
  • Develop system requirements necessary to support re-designed process
  • Create new roles, position descriptions, and organization charts for affected departments
  • Develop implementation plan and business case for required investment
Business Benefits
  • Client implemented recommendations in Marketing, Underwriting, and Customer Service departments to improve service and reduce cycle time
  • Customer Service recommendations reduced abandon rates from 12% to 2% and improved service levels without hiring staff
  • Process analysis and business case justified necessary staffing increases and new positions in Marketing and Sales
  • System requirements incorporated in RFP for new system by client’s IT department

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