As consumers, we have certain expectations for the engagements we have with a company or provider. Whether we’re engaging our cable provider, the bank holding our mortgage or our health plan, we expect the person on the other end of the conversation to be responsive, knowledgeable and vested in addressing our questions or alleviating concerns.
Health plans face certain challenges in managing member engagements. Onboarding new members while retaining existing ones can be expensive and labor intensive. Meeting the evolving demands of members, who want to be more responsible for their health care, requires understanding of members and technology systems, and the capabilities to offer multiple touch points, channels and self-service tools. Throughout all of these processes, plans must maintain transparency with regulatory and compliance requirements.
Contact centers are a critical asset for health plans when it comes to solving these challenges, serving as the foundation of consumer engagement and driving sales, service and retention. Contact centers have evolved to meet new technologies, transitioning from phone-only call centers to offer multichannel support that now includes web, email, and chat.
To meet the needs of both the health plan and its members, a contact center should provide:
- Exceptional customer experience
- Innovation and value
- Reliable and secure operational delivery
As the health care system continues to evolve to meet demands of members and requirements brought about by the Affordable Care Act (ACA), many health plans have chosen to outsource their contact centers. Outsourcing is a cost-effective and efficient solution to member services, claims resolution and sales. Health plans looking to take this approach should partner with companies that:
- Offer the technology, talent and experience that is so unique to this space
- Have proven success in meeting both financial-based and outcomes-based KPIs
- Function as a partner to the health plan, working to evaluate practices and member feedback to improve processes and outcomes
Optum: Achieving award-winning excellence as outsourcing provider
Understanding that each contact is a relationship building opportunity, not simply an objective, Optum® offers insights on how to better serve and retain members and providers. The result is a more effective approach that meets consumer-driven demand, and helps our clients reduce administrative costs while improving quality scores through higher value clinical performance.
In recognition of continuous innovation, Optum was recently awarded the Best Outsourcing Provider by the International Customer Management Institute (ICMI). Optum received this recognition during ICMI’s 2016 Top Ranking Performers Awards, which attracted more than 1,500 entries from over 50 nations.
About the author:
Linda is responsible for the product development and direction of Optum Distribution’s call centers. She designs the contact center solutions and capabilities offered to clients to drive customer acquisition, loyalty and retention. Linda and her team drive contact center solutions across the continuum of people, process and technology in the health care arena based on industry best practices, client strategies and Optum innovations.