The challenge

In today’s always-on world, consumers demand convenience and rapid responses. Those expectations are no different in the health insurance space. A leading health insurer realized the trend and wanted to meet changing member interaction expectations. Additionally, regulatory changes under the Affordable Care Act introduced an influx of new members and contact center volume. It wanted to improve new member onboarding support and other types of membership assistance.

The health insurer looked to an outsource model to help it succeed at scale. It needed an experienced partner who could train and prepare associates to provide fast and accurate responses, as well as engage members as if they were internal employees.

Our solutions

Our efficiencies in strategy, technology, and customer management allowed us to deliver the quality associates that the client was looking for. First, we analyzed calls to the client’s contact center to understand why members were calling and what they were struggling with. We used that information to create customized training programs that were tailored to help our associates anticipate the questions members may ask and provide the right information.

Additionally, it was important that associates had a solid understanding of the company’s culture, products, and services. The client wanted to create conversations with members that did not feel scripted, except for required statements, such as referencing HIPAA regulations. We coached our associates on the importance of being conversational in their interactions with callers.

We also hosted information sessions and townhall meetings at our contact centers to educate associates about the client’s company culture and its membership base. During these sessions, we showed videos that highlighted the company’s mission and emphasized the value it places on excellent customer service. And to further help associates feel that they are part of the client’s team, we invited them to join weekly process improvement calls with the client and bring their questions and recommendations to the table.

The client let us know that our efforts to help outsourced associates assimilate and meet its members’ needs were greatly appreciated. According to the client, what also differentiated our service was our hands-on approach. Our directors were on site with the managers and associates and to quickly troubleshoot issues, unlike other vendors whose executives were not as familiar with day-to-day activities. These efforts helped associates quickly become experts in the client’s services and processes to deliver superior member experiences.

The results

Compared to nearly 30 other vendor partners, we received the highest overall performance rating on the client’s vendor performance scorecard. The scorecard included categories that our associates and leadership team excel in, such as operational performance, service excellence, economic value add, and thought leadership.

Also, the client noticed our associates’ high performance level and entrusted them with more responsibilities. The initial agreement was for 150 associates to support health providers, which eventually included other lines of business. For example, the client asked for additional associates to handle claims review, which was previously handled only by in-house staff.

Since then our partnership with the client has greatly expanded. We entered the partnership supporting only one line of business, but today we’re providing the client with about 800 employees across various lines of business and are in discussions to take on additional responsibilities.