The largest U.S. non-profit health insurer improves operational performance


  • $1.25 Million

    Increased utilization and capacity by 3.5%, saving more than $1.25 million over 12 months

  • 16% Increase

    Improved productivity by 16% or almost 800 hours per week

  • $70,000

    Eliminated close to $70,000 of incorrectly paid overtime

Opportunity: Improve Operational Performance

One of the largest non-profit health insurance plans in the U.S., with over five million members, set out to improve operational performance and enable its leaders company-wide to focus on enhancing the customer experience.

With Verint Quality Management, Verint Workforce Management, and Verint Enterprise Feedback Management deployed across its contact centers, the health insurer saw an opportunity to apply similar tools and methodologies within its back-office operations.

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The Challenge of Disparate Data and Manual Processes

With a staff of roughly 900 employees handling enrollment, billing, claims processing, and membership and patient accounts, the company’s back-office operations relied on numerous disparate data sources and a myriad of manual processes.

Because of this, leadership lacked visibility into exactly how employees were spending their time and, in turn, had little actionable data on the cause and effect of proposed changes to improve efficiency, quality, and operational effectiveness.

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Solution: Start with Workforce Management

The health insurer took a phased approach to addressing the specific challenges in its back-office areas.

It started with attendance management, where team leaders’ main complaint was the amount of time needed to manage time off requests, schedules, and administrative reporting.

The company tackled attendance management by deploying key functionality from Verint Enterprise Workforce Management.

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A Phased Approach

First, it installed Verint Time Off Manager to create a single source for all attendance-related data, automate routine requests, and reduce both employee and manager administrative time.

Second, it implemented Verint My Time, a tool enabling employees to self-report work activities. This data is compared with the health insurer’s human resources data to verify employees are accurately paid for time worked.

Next, the company created a standardized framework for managing employee productivity by deploying functionality from a variety of Verint solutions, including Verint Applications Visualizer, to capture employee activity directly from the desktop, delivering insight into time spent in production and non-production applications, as well as idle or non-system-related time.

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Identifying Opportunities for Improvement

This data is then fed into Verint Performance Management to generate key performance metrics. Subsequently, the health insurer’s employees and managers can view how they are performing against their productivity goals in near real-time, enabling them to quickly identify opportunities for improvement.

Verint Operations Visualizer is a QuickStart offering specifically designed for back-office operations that combines Application Visualizer, My Time and Performance Management scorecards into a easy to deploy, fast to ROI solution.

The health insurer can now flag claims by member, group, product, and business segment.

In conjunction with capturing production processing times, this has enabled the company to perform deep dive analyses and create cost-to-serve reports by category—giving it a better understanding of cost drivers and robust group-level reporting to more accurately allocate costs and prioritize opportunities for process and system improvements.

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Benefits: Actionable Insights

For the first time within its back-office operations, the company was able to measure how employees were spending their time and capture true production processing times by activity. This allowed leadership to challenge employees to process tasks at a higher standard, helping to close the gap between top and bottom performers.

In addition, by comparing employees’ My Time data with their desktop data, leaders were able to accurately determine how much employee time was spent in an idle state versus on valid away-from-the-desk activities such as training and meetings. From this abundance of actionable insights, the company identified latent capacity that it could recapture.

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Benefits: Increased Utilization and Capacity

Overall, the health insurer increased utilization and capacity by three and a half percent, saving more than $1.25 million over a 12-month period. It improved productivity by 16 percent or almost 800 hours a week, helping it more consistently achieve its service delivery goals.

In addition, the data generated by the Verint software quickly uncovered a need to change a human resources policy related to the calculation and payment of overtime.

In essence, when employees worked past the scheduled end time of their shifts, they were paid overtime, even if they failed to work the full shift. By addressing this issue, the company eliminated close to $70,000 of incorrectly paid overtime on an annual basis.

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