Achieving 400% Scale to Support Group and IFP Business
A prominent health plan partner successfully tackled the change of their health plan insurance claims by entrusting us with executing a seamless transition and significant expansion of their Group and Individual Family Plans (IFP) claims business, drawn by Sagility’s reliable legacy platform for Commercial claims.
Transition and Expansion
Transitioning health plan insurance claims can be timely and difficult. Harder still is making the transition when you’re on a time crunch, and rapid scale-up is crucial. This was the case recently for one longstanding health plan partner who wanted to transition their Group, and IFP claims business.
Their goal was to transition these claims and to significantly scale up without disrupting their business in any way. To achieve this daunting task, the health plan partner decided to transition their claims business to Sagility. The allure of Sagility’s Commercial claims business on legacy platforms was enough to earn the trust of this leading health plan partner.
Identifying Staffing Needs
To identify the client’s staffing needs, Sagility engaged its experienced Workforce Management Team. Based on the initial projections for the task, the Workforce Management Team determined that a significant increase in FTEs was needed. These FTEs were employed across two separate locations, Bangalore and Coimbatore so that the teams could absorb the new increase of volumes. Our Talent Acquisition team acted quickly to work through the staffing process, sourcing and hiring the most qualified candidates within the client’s short time window.
In order for any new operation to succeed, however, it needs talented and experienced leaders to oversee the process. Therefore, in addition to ramping up to 400 FTEs, Sagility also developed and promoted a team of overseers that included the following.
- Team Leaders
- Quality Associates
Each of these overseers was brought in from similar Commercial Claims programs to ensure a smooth transition.
Dividing the Workforce
To ensure that neither location would get overwehelmed with their workload, 40% of the headcount was determined to operate out of the Coimbatore branch. The remaining 60% would work from the Bangalore branch. Splitting the workforce was done for risk management workforce absorption purposes.
Sagility meticulously outlined our process in a Gantt chart to keep that the client remained in the loop. We then shared this chart with our client on a bi-weekly basis for transparency. Our report included details related to hiring, training, batch planning, reporting and governance planning.
Training and Mentoring New Staff
With the plan in place, the final phase of the transition was to train and mentor all the new hires. The initial pilot batch of trainees were trained and mentored remotely by the client. All other new employees were trained and mentored by staff who received Sagility training. To ensure quality control of personnel, buffers were added via an external Quality Auditing Program.
The results that Sagility was able to achieve were even better than hoped for. With a simple combination of identifying staffing needs, workforce division, and properly training and mentoring the new staff, the transition of the Group and IFP claims business was smooth, fast and didn’t disrupt the claims business.
In Claims Capacity
With Client’s Proposed Transition Plan
Transitioned Over 8 Months