Strategic Consulting and Process Optimization for Health Benefits Manager's Prior Auth and Product Roadmap
Overview.
The healthcare industry is evolving with advanced care management systems like Pega. Organizations face complex Prior Authorization processes, regulatory demands, and operational inefficiencies. Strategic consulting, robust product roadmaps, and technical support are essential for optimizing systems, enhancing patient care, and achieving long-term goals.
The customer’s initial installation of Pega Care Management did not fully align with the customer's operational needs, necessitating a comprehensive reconfiguration to optimize its functionality.
The existing Prior Authorization (Prior Auth) processes were inefficient, leading to delays and increased administrative burden.
Process Optimization: There was a critical need for strategic and process consulting to streamline and enhance the Prior Auth workflow.
Solution.
Coforge provided the client with a comprehensive strategic framework, enabling them to take control of their product roadmap with confidence and precision.
Delivered advanced tools and methodologies tailored to the client's unique needs, allowing them to effectively plan, manage, and adapt their product roadmap.
Conducted intensive training programs that equipped the client's team with essential skills and knowledge, transforming them into proficient product managers.
Facilitated hands-on workshops that offered practical experience and insights, ensuring the team could apply their new skills in real-world scenarios.
Provided ongoing mentorship and support, fostering a culture of continuous learning and development within the client's organization.
Ensured a seamless transition to the new system by guiding the client through each step of the process, from initial setup to full implementation.
The impact.
Secured funding and approval for the client's strategic roadmap, aligning technology investments with business goals.
Empowered the client with skills and knowledge to independently sustain and evolve their roadmap, ensuring long-term viability.
Streamlined processes and optimized workflows led to improved efficiency and resource utilization.
Positioned the client for sustained growth and innovation in healthcare management, leveraging optimized systems and strategic planning.
