Using BPM to Stabilize the Processes in a New Managed Healthcare Provider

Background

A two year old managed healthcare provider has gone through a rapid standup growth phase. Membership has stabilized and management has observed that the processes they started with are now out of date and in some cases out of control. Departments were very insular with no end to end process measurement or ownership. The CEO and COO want to breakdown departmental barriers and define core processes and process owners.

Solution

Starting with a pilot project in contracting, the organization gained confidence in a basic process management approach, implementing process ownership, and process metrics. The next work was focused on Medical Management and Claims. On going, we will be building capability in the organization to improve performance of the organization’s core processes.

Results

The original contracting process reduced cycle time by 20%, with the potential of reducing it by an additional 20% with corporate involvement. Visual management boards have been designed and implemented for Medical Management. Many personnel have developed new skills in process management, measurement, and control and implemented these in their area.

Want to see results like this at your company? Contact our team to learn more.

Newsletter

Innovative insights delivered to your inbox once a month



We hate spam and will never share your information. You can unsubscribe at any time.

Newsletter Sample

Operations

Operations Consulting

We have consulting experience with engagements as diverse as mergers and acquisitions, operations strategy, supply chain acceleration, shop-floor process improvements, and call center efficiency improvement.

Assessments

Assessments

Assessments are customized to meet your goals, leveraging our frameworks and knowledge of best practices from years of industry experience. Recent work has been in financial services, insurance, healthcare, manufacturing, and supply chain.

ASQ Lean and Six Sigma Conference 2019

ASQ Lean and Six Sigma Conference 2019

March 4 - 5, 2019
Phoenix, AZ

Lisa Custer, PhD presents "Data Visualizations: In the Realm of Big Data"