CHALLENGE

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.

SOLUTION

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. 

 

• Trainers 
• Team Leaders 
• Processors 
• Managers 
• Quality Associates 
• Mentors 

 

Each of these overseers was brought in from similar Commercial Claims programs to ensure a smooth transition.

SOLUTION

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.

SOLUTION

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.