Creating 'actionable outcomes,' across the care continuum - Collabera:

Creating ‘actionable outcomes,’ across the care continuum

Admin February 3, 2022

Choosing the right health insurance plan deeply impacts the quality and affordability of care options. Helping members choose the right plans for their health needs and supporting them in making the right care decisions could be a significant competitive differentiator for healthcare payers. For this leading health insurance provider in the U.S., relying on third-party providers for enrollment was proving costly – both in terms of profitability and customer experience. In addition, the lack of a unified customer relationship management (CRM) platform affected the ability of customer service representatives (CSR) to assist members. The Client needed a solution that could improve CSR effectiveness, reduce the cost of service, and improve the experience while helping consumers choose a plan with confidence and make the most of their benefits.

The Solution

Experience assured: Collabera partnered with the client to map the member’s journey and identify areas of improvement. 

Transformed the member experience with a new self-service portal. We created an intuitive, user-friendly member portal with comprehensive self-service capabilities for search health plans and benefits and customer support. 

We designed a decision support system for the CSR team. We also built an analytics and machine learning-led unified decision support system for the Customer Service Representatives with a 360 degree view of the customer information to offer personalized support and enable proactive outreaches to members if required.

Collabera co-engineered the member portal and CSR portal that now offer: 

  • Best-in-class UI design imbued with accessibility principles for universal access
  • Secured patient health information (PHI) with data encryption
  • Ease of quote retrieval for members via email with pre-filled customer-specific URLs
  • Appointment scheduling on prior consent to discuss a custom quotation
  • Detailed reporting based on user activity to understand crucial metrics such as bestseller plans, best target market, overall revenue, members enrolled, etc
  • Comprehensive plan search experience powered by seamless third-party integrations       
  • Scalability and ease of maintenance with logic from different consoles consolidated into a single module
  • Low-code capabilities with migration to Salesforce Flows and point and click configuration for the front-end coding needs 
  • Member data analytics across engagement channels that provides CSRs with the ‘actionable outcome’ recommendations 

These modules were custom-built for the client and developed and maintained in-house. For the ‘actionable outcome’ solution, the entire module was upgraded to Salesforce Lightning.

Tech Stack:

AutoRabit, GIT, LWC, Selenium, RTC, VS force with Salesforce CLI

The Results     

These platforms improved the user experience of Medicare plan members and enabled several benefits for the organization:

  • 6% reduction in overall healthcare costs for members with tailored and timely health and wellness information 
  • 12-13%  increase in CSR campaign output with more effective outreach
  • 9,000+  CSRs improved experience and productivity by with a consolidated customer 3600 views, ‘actionable outcome’ recommendations, and the ability proactively reach members
  • 30%  reduction average customer query handling time
  • 20%  reduction of targeted member healthcare cost

Additionally, outreach capabilities and campaign management were introduced to send reminders to members/non-members through SMS and e-mail based on member preferences. While member experience improved, the health solutions company leveraged Collabera’s expertise in digital platforms and experience engineering to create an asset that will strengthen the health insurer’s leadership in the Medicare space.  

Collabera has co-engineered and helped numerous organizations succeed in their digital transformation and experience efforts. Talk to us to learn more.

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