Growth Partner for a Fortune 50 Managed Care Organization

Challenges.

The managed care organization faced some very challenging issues:

• Complexity of the enrollment process leading to delays in coverage, errors in paperwork, and ultimately, dissatisfied customers
• High penalties due to delay in application process and customer complaints, with impact on Star ratings as well
• Complicated electronic load process and need for additional staffing in short time period
• Low quality of deliverables, with high rework effort

Solution.

Coforge guided the client with a series of steps designed to seamlessly solve their issues:

• Onboarded a team of industry experienced subject matter experts to streamline current processes.
• Well defined inventory management for efficient queue management, with a view of expedited and escalated cases.
• Cross trained staff to enable dynamic load balancing during peak seasons, ensuring service levels and clients expectations are met.
• Robust training plan and audit processes.