Instructional Design Restructure, A Case Study

BACKGROUND

A regional health care company that offers a broad spectrum of group and network-based health care products to over 3.6 million members.

CHALLENGES

The Instructional Design Team was under performing. The training material was outdated, the material lacked industry standard best practices and adult learning techniques and was often incomplete. The training resulted in contact center agents not being ready for their role.

ZELUS APPROACH

Zelus used their extensive knowledge of the health care industry, contact centers and instructional design skills to complete a needs analysis of all the contact center teams; and reviewed all the training material in the department. From the needs analysis Zelus re-imaged and updated all training material for new hire classes, gap training classes, new system training and the company’s product training.

RESULTS

  • Redesigned the training material for all lines of business, including Medicare and Medicare Advantage; over 750 documents.
  • Increased speed to market for new and revised material. The Zelus team worked 3x faster than the industry standard across the entire engagement.
  • Incorporated robust hands-on exercises in training that spanned multiple systems.
  • Built assessments to predict the capability of the trainee to do the job.
  • Established the use of state of the art web-based training as a best practice for delivering awareness training to agents.
  • Implemented a training approach that resulted in floor-ready trainees that met quality and productivity goals.
  • Launched new contact channels, more than 10 software applications, and Healthcare Reform and Medicare Products.

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Call Center Optimization & Technical Implementation, A Case Study

BACKGROUND

A nationally recognized and trusted consumer brand committed to helping members create and maintain a healthy lifestyle.

CHALLENGES

The company was preparing for a significant product change anticipating that membership would increase substantially. The contact center had long lacked the focus and attention required to infuse the brand experience across inbound calls, emails, and online chats. The contact center was preparing for a significant ramp up in volume while it lacked technology solutions to support its agents.

ZELUS APPROACH

  • Developed a road map to achieve short-term launch efficiencies and long-term operational vision for the contact center. Created an operational launch plan to handle a large customer increase without creating excessive costs.
  • Based on organizational decision to build a proprietary CRM system, the client used Zelus’ extensive contact center expertise and skilled staff to define business and functional requirements, manage prioritization, lead UAT efforts, train staff, and provide application deployment and launch support.
  • Developed comprehensive blended learning, virtual and classroom program with WBT at its core; resulting in a quick, accurate, and consistent training for over 400 agents.
  • Created RFI requests for contact center voice, chat and knowledge management solutions defining best practice needs within each channel. Key member of the selection process for all three solutions.
  • Created operational improvements to shift the nature of contact center contacts from largely administrative to a more value-added support model.
  • Comprehensively reviewed all content in organizational content management system to align to new system launches and reflect the brand

RESULTS

Since the effort started, the contact center:

  • Reduced contacts per member by 29%
  • Reduced cost per contact by more than 35%
  • Delivered more than $20M in savings to the organization
  • Achieved a 4-point gain in first contact resolution
  • Supported at 25% membership increase while improving performance

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Your Company’s Brand is heard in the Contact Center

Health insurance plans are more focused than ever on evaluating and maintaining their brand. Most plans are working to be more than simply a low-cost provider of healthcare or the plan with the biggest network.  For years now, we’ve seen that singularly focused strategies like that don’t work.  One of the biggest opportunities plans have is to emerge as the health plan of choice for members by choosing to deliver a personal connection in every member interaction.

This personal connection starts in your contact center.  What’s interesting though, is that the push for Artificial Intelligence (“AI”) to take over customer service entirely isn’t what members really want. Members want our Contact Centers to be MORE human! And for those humans to be enabled by technology. We’re seeing this desire for a human touch in every industry but especially in healthcare. It’s one of the main reasons we created a proprietary training program to assist health plan contact centers.  When Zelus trains contact center agents we always incorporate empathy, we use a simple, yet comprehensive, approach:

I’m looking forward to speaking more about this at the upcoming 9th Annual Medicare Market Innovations Forum in San Diego, CA. on a distinguished panel.  The panel will be focused building a year-round branding strategy that extends beyond Medicare’s Annual Enrollment Period (“AEP”).  Zelus will also be in the Exhibit Hall at the Conference, so stop by and see us.  We’d love to talk about your challenges and what’s working in your organization to deliver that consistent brand experience! If you need a push in the right direction talk to us about our PACE program.  We built a comprehensive healthcare contact center program to marry proficiency, accuracy, confidence, and empathy seamlessly. There is nothing like it in the marketplace.

We’re working on an upcoming webinar with Contact Center Week about connecting with customers on a human level, learn more and register here.

To learn more about our suite of services and the additional benefits of partnering with Zelus for your call center training needs, please contact us at (617) 821-1061 or info@zelusllc.com.

Jenny Graham, co-founder of Zelus LLC, is an expert in operational performance and excellence with over 15 years of experience developing and implementing innovative operational strategies to improve overall business performance and utilization. 

Call Center Reorganization, A Case Study

A regional health care company that offers a broad spectrum of group and network-based health care products to over 2.8 million customers.

CHALLENGES

The executive team was concerned about the level of service provided by multiple call centers across the organization.  Preliminary evaluations showed that the level of service was inconsistent and hurting their image in the marketplace.

ZELUS APPROACH

A detailed needs analysis by the Zelus team revealed that performance standards differed from call center to call center as did level of training between these groups.

It was also discovered that each group had different practices for handling exceptions and executing work that was not metrically measured but important to service level.

RESULTS

  • Consolidation of smaller call centers into a larger central team to improve key performance metrics by increasing the staff pool available.
  • Revised set of organizational effectiveness measures aimed at ensuring all aspects of the customer experience are viewed with equal importance.
  • Development of a comprehensive training curriculum for the call center that focuses on functional knowledge and expertise while creating a career path for representatives.
  • The team also executed a comprehensive and aggressive re-training plan addressing individual and department deficiencies without sacrificing overall performance
  • Execution of a rigorous quality program that monitored individual quality across three dimensions.
  • Creation of area specific performance standard expectations for each distinct work product including development of reporting automation, exception handling, and guidelines for non-measurable work in the department.
  • Development of a corresponding self-funding incentive plan and roll-out strategy to support the quality and performance measures.

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Process Improvement and Implementation, A Case Study

A large regional health insurer servicing over 3 million members was not meeting key performance targets.

CHALLENGES

The insurer was not meeting its key performance targets in the customer   service, claims, and correspondence areas including:

  • Inquiry Timeliness
  • Inquiry Accuracy
  • Average Speed to Answer
  • Abandonment Rate
  • Claims Timeliness
  • Claims Accuracy

ZELUS APPROACH

Zelus worked with the insurer to determine the root cause of the issues and implemented customized solutions including:

  • Designed and implemented workflow improvements resulting in removing 4 days from the claims cycle.
  • Designed and implemented a comprehensive skills assessment for all areas.
  • Developed a comprehensive Customer Service Training Program.
  • Developed a comprehensive Claims Training Program.
  • Developed a comprehensive Correspondence Training Program.
  • Assisted struggling trainers by delivering components of the training as needed, often with little to no notice.
  • Evaluated team leader and manager capabilities via Zelus-developed calibration process and developed coaching program that upgraded leadership skills significantly.

RESULTS

  • Improved performance score results by 17% in six months.
  • Improved performance score results by an additional 23% in the next 12 months.
  • Performance score improvement earned client significant incentive dollars.
  • Strategic plan led to national recognition for the insurer.

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