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 deliverable.

Solution.

Coforge guided teh 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.

The Impact.

• Enrollment operation: Immediate impact on the quality and turnaround of the enrollment operations.
• Improved CSAT: Improved customer satisfaction and higher star ratings for the plans.
• Implemented corrective actions: Identified core areas of errors and implemented corrective actions for other vendors involved in the process.
• Reduced risk: Reduced risk of operational disruption.