UPMC Health Plan - Front-Line Customer Service Team of the Year

Company: UPMC Health Plan, Pittsburgh, PA
Company Description: UPMC Health Plan, the second-largest health insurer in western Pennsylvania, is owned by UPMC , an integrated global health enterprise. Our products and services are utilized by nearly 2.3 million members. Our local provider network includes UPMC as well as community providers, totaling more than 125 hospitals and more than 11,500 physicians throughout Pennsylvania.
Nomination Category: Customer Service & Call Center Awards Team Categories
Nomination Sub Category: Front-Line Customer Service Team of the Year - All Other Industries

Nomination Title: UPMC Health Plan Front-Line Customer Service Team

From July 2019 to current, the team has assisted 93,000 UPMC Health Plan members with their insurance needs. These visits included finding participating providers, scheduling appointments, explaining coverage and benefits, accepting monthly premium payments, updating income information, filling out necessary forms, selecting coverage options and more. Additionally, the team engaged the community with monthly events providing free health screenings and education regarding health and wellness with over 10,000 participants and 6,742 free screenings provided. In March of 2020, to create a seamless experience for our consumers, the team deployed a customer-facing appointment scheduling system. When the COVID-19 pandemic required the state lockdown, our staff created a virtual meeting option allowing our customers to meet face-to-face through their computers or smart devices including an extensive telephonic outreach program. In late June, our stores reopened to the public with safety measures in place and our staff remained available extended hours to help concerned members with their many questions regarding their healthcare and the pandemic. The team provided peace of mind to many that lost their jobs and health insurance due to the pandemic by helping them find affordable healthcare options and navigating the complicated federally and state-funded exchanges. The team introduced and signed members up for UPMC Health Plan’s many virtual programs such as telehealth, virtual urgent care, test results, prescription refills and more. During a time where in-person atmospheres were less ideal, the Retail team saw a steady traffic flow because the face-to-face interaction this team provides is immeasurable.

Briefly describe the nominated team: its history and past performance (up to 200 words):

The UPMC Health Plan Retail Innovations Team was created to provide a friendly face, and strong community presence in the areas for which they serve. During a time when Health Insurance remains politically charged, extremely complicated, and incredibly needed; UPMC offers a safe, reliable, and convenient place to get all the answers you need regarding health care and insurance. Year over year, from the time of its inception in 2013, the Retail Innovations team saw on average over 43% growth in their total community interaction. UPMC offered a new and innovative approach to a Retail store that was unlike any other, combining the expertise of insurance sales and service agents, high quality healthcare, free health and wellness events and screenings, and healthcare education available to all. The team’s dedicated efforts to engage both current and prospective members have provided on average 19% increase in member interactions, 10% increase in sales and 40% engagement from the community year over year. In addition, the team has seen a customer satisfaction level of over 95% for five consecutive years. The department has grown from 4 stores locally to 9 across the entire state of Pennsylvania.

Outline the team's achievements since July 1 2019 that you wish to bring to the judges' attention (up to 250 words):

-The team’s dedicated efforts to engage both current and prospective members have provided on average 19% increase in member interactions, 10% increase in sales and 40% engagement from the community year over year.

-customer satisfaction level of over 95% for five consecutive years

-the team engaged the community with monthly events providing free health screenings and education regarding health and wellness with over 10,000 participants and 6,742 free screenings provided

Explain why the achievements you have highlighted are unique or significant. If possible compare the achievements to the performance of other players in your industry and/or to the team's past performance (up to 250 words):

The UPMC Health Plan Retail Innovation department is a unique and innovative offering in and of itself. Contrary to other Health Insurance Companies, UPMC offers their members and the community a permanent face-to-face customer service and sales location that is open 7 days a week, 12 hours a day for their convenience. The new scheduling system allows the customer-base to choose in-person or virtual appointments with a member of the Retail team that best fits the customer’s preference and availability. Our staff are extensively trained in all lines of business offered by UPMC Health Plan, providing them the ability to answer any question that may come their way. The Retail team engages the community assisting with health and wellness events, as well as virtual and in-person retention meetings. Our staff provides an additional level of care and assistance. Regardless of the circumstance, the Retail team’s number one goal is to remain available to the community and create a strong rapport and trust between the consumers and their Health Plan. We feel this level of connection is of the utmost importance. Whether this team is helping a worried member find the right health plan, reaching out to the vulnerable member population during quarantine, calling to welcome a new member to their health plan, or providing the community with free screenings, our courageous front-line employees use their passion to help people and create an incredible experience every day. The Retail team is the completion of the Integrated Health System’s full circle experience.