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Transforming Contact Centres for a Top 3 US health plan with over 10 million members

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Overview.

Streamlined processes and practices across government and commercial business, allowing for a single capability to serve both LOBs.

Challenges

The customer had an old Pega customer service solution that needed upgrading with better processes, a better UI, integration of systems, and support of benefit inquiries the # 1 reason people called in. The new system created a better experience for members and agents and was recognized across the industry.

Solution

The Coforge team was part of the solution team as employees of the health plan. They led the internal implementation team.

  • Strategic and process consulting on call center design; migration of MA individual and Medicare supplement contact centers from legacy to Pega
  • Full call center implementation and support
  • Implemented Pega Knowledge Management
  • Strategic Architecture - Common & Shared Components
  • A transformational application for the contact center that unifies call centers and drives customer experience.
  • A plan with 4 pillars:
    • Product Discipline
    • Personalized Components Across Business Lines
    • Staff Enablement
    • Agile Best Practices w/in-line, automated testing & DevOps

The Impact

  • Delivered over $20M Annual ROI
  • Increased CSR and Customer retention
  • Successfully migrated 500 agents
  • Slashed Time for Production updates
  • Reduction of AHT and improvement in 1st call resolution
  • Implemented AI solution to process benefits inquiries using NLP.
  • Beat TCO savings estimates.
  • Improved CSAT and NPS scores by 15%
  • Cut Training Time by over 30%.

Bring us your challenge.

Let’s Coforge your next success story.

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