Challenge

The managed healthcare company is a $1B division of the largest health insurance company in the USA. The Chief Experience Officer CxO team retained us to analyze their current processes, lead joint application (systems) development sessions, and orchestrate the development and implementation of a new software solution serving as the core workflow system for the business that services many of the largest employers in the country.

At the start of the project, the management team did not know how many core processes they had but knew each department was operating inefficiently. Management also believed any new system would not be successful unless they evaluated current workflows and defined ways to improve the processes.

At the start of the project, the leaders and subject matter experts believed they had four core workflows that ran the business and delivered services to each customer. The first phase of our four-phased methodology is Discovery where we discover and map what is going on internally. The discovery phase revealed that the client had 13 core processes critical to the business.

The client was under an extremely tight timeline and budget because they had spent a small fortune with IBM to get this work done. When IBM failed to produce deliverables of sufficient quality and thoroughness, the client called us. We had to work rapidly under C-level visibility and with limited internal manpower. The executive team was relying on us because this project was visible at the highest levels of the corporation (the board of directors).

Approach

• Rapidly evaluate the complexities and impacts of current processes that were using a legacy software system.
• Collaborate with subject matter experts and key stakeholders to document and assess all core processes that made this business operate.
• Work with key employees to identify opportunities for improvement, and how it could be better improved and more efficient.

Below is a sample of one of the process maps delivered at the end of “Phase 1 – Discovery.”

When we began, management thought the business followed four core processes. What we found were 13 core processes that coordinated the many services it delivers to its customer.

Results

Our team rapidly mapped current workflows, documented previously unknown procedures, and formulated critical system requirements that selected and customized a new system to automate key business workflows.