UPMC Health Plan - Best Use of Technology in Customer

Company: UPMC Health Plan, Pittsburgh, PA
Company Description: UPMC Health Plan, headquartered in Pittsburgh, Pennsylvania, is among the nation's fastest-growing health plans. It is owned by the University of Pittsburgh Medical Center (UPMC), a world-renowned health care provider. As part of an integrated health care delivery system we provide services to more than 4 million members.
Nomination Category: Customer Service & Call Center Awards Achievement Categories
Nomination Sub Category: Best Use of Technology in Customer Service - Other Service Industries

Nomination Title: UPMC Health Plan Best use of Technology

We strive to deliver a World Class Experience on every call. Previously, our Quality Audit (QA) Team audited a few calls weekly. Our Concierges received a quality score, based on this small sample. While this approach was helpful, it left us with opportunities and unknowns. While focusing on continuous improvement, we considered the advantages of being able to quickly know what was happening on all interactions. With this opportunity in mind, we implemented a Speech Analytics Tool. The Speech Analytics Tool has been a game changer, but not without the hard work and dedication of our team. The team spent countless hours creating specialized syntax to ensure concierges would be scored fairly, allowing 100% of their calls to be scored based on the member experience. This was no small feat in the complex world of healthcare. Our “World Class Call Score” provides Concierges with a comprehensive view of their performance on the metrics we have determined most important in creating a meaningful experience for our members. This has completely changed the way we coach and recognize our team! But we didn’t stop there, we have found many other ways to bring value to the organization through this tool. We are quickly able to identify trends and then work to correct through service recovery and put plans in place to prevent any reoccurrence. We can assure we are meeting strict compliance requirements for our government programs. We identify and reward positive behavior and find areas where additional training may be needed.

UPMC Health Plan, headquartered in Pittsburgh, Pennsylvania, is owned by the University of Pittsburgh Medical Center (UPMC), a world-renowned health care provider. As part of an integrated health care delivery system, we are committed to providing our members better health, more financial security, and the peace of mind they deserve. Our provider network includes UPMC as well as community providers, totaling more than 140 hospitals and more than 29,000 physicians, serving over 4 million members. Our Member Services Team has been recognized with numerous awards for offering a remarkable and welcoming member experience. We focus on delivering World Class Service by providing first call resolution and a concierge level of service. We bring the voice of the customer to the entire organization and drive improvements across the enterprise. While we have enjoyed year over year growth throughout the history of the organization, we understand that continuous improvement is the key to success. We focus on our people, processes, and technology to keep us moving forward. The implementation of Speech Analytics has helped us move to the next level in identifying opportunities for improvement as well as recognizing our team for a job well done.

While this may sound like we just implemented a speech analytics tool, we have gone far beyond an out of the box approach to create a unique, personalized, unbiased way to score every call. This allows us to create a memorable experience for our members, and it doesn’t just stop there! It allows us to look at our people, processes and technologies and drive improvement across the organization.

Identify both positive and negative (holds, transfers, etc.) behaviors for coaching or recognition
Identify call reasons and recognize trends to drive improvements
Ensure compliance
Increase FCR and reduce repeat callers
Identify training improvement opportunities
Comprehensive dashboard to compare performance and monitor progress over time
Create “Insights” – personalized messages automatically sent to coaches and Concierges for positive or coachable moments
Teams can own their progress and quality of work provideWorld Class Service for our members

What does that mean to the organization?
During implementation period, reduced volume by 231,949calls, savings$1,315,150
Reduced Resource Unit Calls by 9,122 in 2021 for a savings of $51,721.74
We came in9.73% under budget for 2021 contributing tooverall savings of $2.4M
Voice of the Member- Dec 2021
Overall Satisfaction 4.9/5.0
Agent Helpfulness 98.9
FCR 96.6%
Repeat Caller 1.3

What makes us unique with this technology is our focus on not settling for the basics but going above and beyond finding innovative, creative ways to improve the member and employee experience.

Our document breaks down outstanding accomplishments we’ve achieved by implementing our Speech Analytics System. We are proud to be a World Class Team Delivering World Class Service! You’ll learn about Speech Analytics and the hard work that went into building out our World Class Score. We explain the vast difference in our past coaching process versus the amazing dashboard we have today! Slides 17-25 provides you with screenshots of the system, along with definitions to explain how we use each tab. You will learn how our quality of coaching has improved and even get to read some testimonials from our concierges and coaches that use the system every day! You’ll be able to see that it really simplifies the way the coaches pull calls, review statistics and allows you to pinpoint what parts of the member experience to focus on. Slides 28-39 truly paints a picture of the hard work we have put in to make the system successful! It also takes you through the different reporting we have created with the system to further enhance our World Class Service. You can see the tool allows us to report out things we discover in a variety of ways! Slides 40-47 walks you through all the ways we openly communicate and encourage our concierges to ensure their experience in the system is a good one too! We are proud of the enhancements and process improvements we have made and can’t wait to see where it takes us!