Creating a Seamless Healthcare Customer Experience

Cognizant Softvision optimizes operations with easy, responsive and flexible solution

Our client is a leading health benefits company dedicated to improving lives and communities, and making healthcare simpler by providing pharmacy benefit management services to payers. They focus on delivering a member-first solution so members get the benefits they need in a way that is simple, seamless and lowers member, employer and plan costs.

At a glance:

  • Serves customers of parent company affiliated health plans and non-customers
  • Along with parent company, the client serves more than 100 million people
  • Created to help manage costs as pharmacy care affects total healthcare costs

The Challenge

With an outdated interface our client needed to rethink the overall digital customer experience. However, antiquated processes that involved manual intervention, a platform that was out-of-date and inefficient integrations with external systems would redefine how the new digital solution would be engineered. 

Our Approach

The project follows our core Discover, Design, Deliver, Iterate model, using Scaled Agile Framework (SAFe). The Core Delivery team is in Romania, made up of four Pods with one supplemental Pod from the client. Cognizant Softvision owns full delivery. 

Throughout the Discovery Phase, client SMEs collaborated with our Healthcare SMEs and the teams to put together a comprehensive set of milestones, measured in Program Increments (PI). Each PI allows teams to align on and adjust priorities and work efforts, measured in Story Points. Team velocity is measured by Sprint as a foundation for PI Planning. Our teams’ capacities have increased over the first three PI’s – high 300’s to mid 400’s to nearly 600 story points per PI.

Monthly executive demos were held for senior stakeholders and were supplemented by Sprint Demos. During these processes, Cognizant Softvision teams consistently received high praise for our expertise, quality, performance, and understanding of our client’s needs and pain points.

Through a series of planning sessions, our team of experts began to reimagine the platform by leveraging the technology and architects that makes the complexity of the technology appear easier. Implementing Java and Angular in addition to an AWS technology stack, which included, EC2, S3, EKS, and Lamba, the back-end got an immediate uplift, which would allow for the ability to scale in the future.  

MySQL and Oracle were used to store benefits and related data, while Talend, a Data Extraction, Transformation and Load (ETL) tool, was used to allow users to automate data mapping and loading. This expedited the ingestion and processing of benefits from providers and ensured data integrity. 

Our experts also worked alongside the client internal IT team for extensive integration work that would help expedite the enrollment process when a new customer signs up for the pharmacy benefit. 

Using our agile development process, we included experts from our guilds to build this high-performing team, called a pod, which would enable quick delivery for the solution. 

The pod offered technical expertise and consulting to help build an efficient and robust platform that would easily scale.

To ensure the engineered outcome included a cohesive, unified platform, our product and design teams used KPIs that measured velocity, quality, product impact, and autonomy to ensure a seamless transition upon rollout.

Each guild is a world-class community of talented engineers within each area of expertise. The following guilds and communities contributed to the program’s success: 

  • Web
  • Enterprise Coffee (Java)
  • Cloud & DevOps
  • QA
  • PMO
  • Big Data & Analytics

The Results

We created a single source of truth for all benefit information, which is a defining approach in the healthcare industry as many use disparate systems that are hard to understand. The new solution created a seamless experience that is easy, responsive and flexible in its ability to handle the complexity of benefit structures. 

The platform also optimizes operations by delivering insights and automation, removing fragmented and manual steps, which saves in both time and manual effort. Additionally, by automating, the room for potential human error drastically decreases. 

With a completely updated UI, both our client and customers have found the platform to be a standout amongst competition. The client CIO commented that the partnership between Cognizant Softvision and the wonderful collaboration that has been established between the two teams has been wonderful so far. He also noted that the solution is a good example of the type of platform development he expects from his organization.

The new solution is expected to launch in 2021. 

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