CHALLENGES

The organization was looking to transform the patient experience at their 23 primary care offices in the Bronx, New York. They wanted to identify and prioritize the roadmap of initiatives and implement them based on priority.

ZELUS APPROACH

Conducted an assessment across the organization and developed a roadmap of initiatives that would positively impact the patient experience across all 23 primary care offices. The client engaged Zelus to implement three prioritized initiatives valued at over $3 million in financial benefits.

RESULTS

• Zelus worked with the client to:
  • Improve the CAHPS survey scores regarding timely communication of lab results
  • Implement a Shared Services team to centralize back-office administrative work to unburden the patient-facing staff
  • Improve the patient experience by aligning the right work with the right staff resulting in removing unnecessary administrative work from both clinical and non-clinical personnel.
• To significantly increase patient satisfaction and the financial incentives received due to higher satisfaction CAHPS scores, conducted a comprehensive assessment of how (communication vehicle) and how often patients are advised of their lab results within 7 days:
  • Observed the current process; and engineered an improved process to communicate patient lab results that reduced physician review time by 75%.
  • Analyzed and developed business requirements to the EPIC application to automate the process.
  • Identified vendor print distribution solution and developed business requirements to automate the end-to-end process to print 500,000+ letters annually.
• Conducted an operational assessment of administrative work at 23 primary care centers to identify non-patient-facing work, (e.g.: rescheduling appointments) to move from the sites to a central support team allowing sites to focus on the patient in person. Created the role and responsibilities for a dedicated central team, as well as standard policies and procedures to drive the delivery of exceptional patient experience across the organization. Developed and conducted planning and delivery of communications, training, and go-live support to drive adoption of this transition of work.
• Conducted an operational assessment of the major patient-facing functions of the primary care facilities (e.g.: Referrals, Sick Appointments, Lab Results, Prescriptions Requests, Appointment Access) to align the right work with the right people. Streamlined the processes, aligned the use of the technology; and developed the communication and training plans for each role. Improved the patient experience through operational excellence.

CHALLENGES

The client manages enrollment and premium billing functions for several key voluntary benefits held by Federal Employees. Annually, the client prepares for a significant increase in volume to support both benefit program changes and open enrollment. The organization hires and onboards as many as 2000 seasonal agents annually.

ZELUS APPROACH

Zelus has partnered with the organization since 2016 to deploy a 20-38 person team (depending on need) of learning delivery experts to train and ramp the seasonal agents.

ANNUAL RESULTS

• Hire and certify instructors annually to ensure they are well equipped to deliver a fast-paced curriculum with consistency and high retention of agents across the program.
• In 2020, certified trainers in remote learning technologies to support virtual learning during open enrollment.

QUALITY MONITORING AND IMPROVEMENT RAPID RESPONSE

Special enrollment period. Preparation and reality didn’t match so the Zelus team engaged in a rapid response initiative to shift the team to align more closely with customer expectations.

• Evaluated call center interactions between the call center and the customer to identify root causes through quality monitoring.
• Identified a significant gap in the ability to articulate the empathy the agents did feel.
• Developed a remediation session for all agents that leveraged actual customer interactions, reinforced prior learning and outlined techniques to delivery empathy to the callers.
• Created a safe environment to practice the delivery of empathy and a model that addresses possible answers to commonly expressed customer issues.

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.