Managed Care
Case Study

Overview

Rapid growth in wellness management program services necessitated a restructuring of all aspects of the sales and implementation processes at a very large largest health benefits companies in the United States.
What was needed:
- A standardized sales and implementation process, including definitions, contracts, data elements, and processes steps from sales through deployment, involving over a dozen departments
- Management visibility to track progress and exceptions
- Quality, timely implementations
- Mechanisms for centralized communications, progress tracking methods, and conflict resolution
- An enterprise systems architecture and transition plan to migrate from existing systems to an appropriate future architecture

Created standardized definitions, processes, and data sets for sales and implementations
Created a web-based application supporting sales and implementations
- Data entry
- Workflow and tasking
- Exception management
- Reporting
Created an enterprise architecture diagram, systems development plan, and migration timeline

Increase in on-time client implementations
Increase in implementation quality
Increase in inter-departmental communications and collaboration to resolve issues in a timely manner to keep
implementations on schedule
Increase in management visibility into all aspects of the processes
Cost reduction per implementation due to new process and automation efficiencies
Cost reduction in client implementations due to less manual labor
Increased client satisfaction
Increased employee job satisfaction

Proven industry experience and familiarity with managed care and wellness management/disease state management
Rapid business process and application development methodology and technologies
Established ability to take paper- and spreadsheet-based processes and integrate them into fully-automated, integrated processes and systems
Experience with business-critical timelines where failure is not an option

TWHS consultants worked extensively with individuals and cross-department teams to understand objectives and needs. Using a process development approach supported by rapid application development methodologies and software tools, the team created functional prototype workflows and applications, solicited feedback, and iteratively resolved issues before on-time go-live.