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.


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.


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.


  • 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.


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 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.


  • 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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Learning Design For Technology Implementation, A Case Study

A State Agency was given a mandate to incorporate a new operating system.  In addition, new federal mandates needed to be incorporated into the system and new processes simultaneously to the implementation of the new system.  This group is a customer interfacing agency and is implementing the new system in two phases over a 3-year time frame.

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Don’t Forget the Learning Function in your Customer Experience Improvement Effort

Today, the customer experience is at the forefront of everyone’s mind. In many industries, it is an elusive goal.  Industries where this is most challenging have a lot in common.  Most importantly, the work of their contact center is often complex.  The transactions are no longer, and maybe never have been simple.  Think healthcare.

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Translating Industry Jargon in the Contact Center begins with Learning Design

Organizations work tirelessly to create and operate contact centers that provide an exceptional member experience.  That exceptional experience is the face of their brand.  It’s never easy.  And it can be particularly challenging when the contact center is supporting a complex good or service.  Complex contact centers and the agents that work in them are usually subjected to increased levels of industry and technical jargon.  Our agents are almost always new to the industry and the task of ingraining industry jargon in how they understand the work they do is even more difficult.  In reality, you rarely want your agents to use that jargon on the customer.  So, to the agents we say: “Learn the jargon, understand it completely, and then make it sound much simpler to customer”.  If memorization isn’t the answer, what is?

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