Transformation Examples Flashcards
Digital Transformation
At Elevance Health, I led a company-wide digital transformation to evolve us into a platform business. This meant not just digitizing existing operations but reimagining how our 10,000 employees worked.
My role was strategic AND hands-on. I developed a multi-year roadmap, prioritizing initiatives based on a clear framework that weighed potential impact, feasibility, and alignment with our overall strategic goals. This ensured we focused resources on the most impactful projects first, building momentum and demonstrating value quickly.
Getting Everyone On Board: To gain support from executives and employees throughout the company,
I used several strategies:
Executive Sponsorship: Getting clarity on which senior leader was to champion the transformation, helped remove obstacles, build excitement, and influence colleagues
Building Coalition of Cross-Functional Supporters: Actively listen and understand the business area’s priorities, definition, and measure of success and motivators to build shared purpose and responsibility. Identifying important stakeholders who can build conviction internally
Accomplished by
Workshops & Townhalls: To communicate transformation vision, gather feedback, explain the expectations and what we need for success, and co-create solutions with employees at all levels. Employees need to understand why they are being asked to change
Data-Driven Storytelling: Articulating the alignment to the enterprise strategy and business priorities, presenting a business case with clear data showcasing the potential return on investment, strategies for minimizing risks, and a phased approach that allows for flexibility.
Transparency & Communication: We maintained open and honest communication throughout the process, celebrating successes and addressing concerns quickly.
Leading the Change: Hands-On Implementation
Process Optimization: Mapped out our core processes, such as enrollment, claims processing, and clinical care, and redesigned them for a digital-first world, reducing redundancies and handoffs
Led to a 30% reduction in processing times for enrollment and claims, saving time and resources and reducing member complaints and inquiries
Automation: We automated manual tasks wherever possible, allowing employees to focus on more valuable work
Modernizing our billing system with self-service tools and reducing manual touch helped reduce billing cycle times by 25%, improving efficiency and improved customer satisfaction.
Digitization: Moved paper communications to digital, improved how we could personalize information that improved overall member experience and reduced print costs by $15M in 1 year
Creation of Digital Tools: Make work more efficient, improve member engagement, reducing FTE and manual interventions
Modernize Tech Infrastructure: Consider build, buy, and partner options for moving platforms to the cloud in phases; reduce admin costs by 10% for IT maintenance in year 1
Managing the Cultural Shift: Supporting Employees
Transparency: Regular updates, meetings, and Q&A sessions kept everyone informed about the reasons for and the progress of the transformation.
Training: We provided extensive training programs on new tools and processes, empowering employees to embrace the changes.
Identifying high-performers and giving them ownership of high-value initiatives
Provide resources for applying new skills through tools such as dashboards and project plans
Support: We established support channels to address concerns and foster a culture of continuous learning.
Results That Matter: Tangible Improvements
Our efforts paid off: we increased operational efficiency, improved customer satisfaction, and generated over $80 million in savings in year 1.
We successfully transitioned our workforce to a digital-first mindset, positioning us for continued growth and innovation.
Interim CX Performance Management System
The Challenge: Our Medicare business lacked a unified view of member experience performance, hindering our ability to make strategic decisions and drive operational improvements.
Align & Measure
Clear KPIs: Aligning performance metrics with strategic goals (Star Ratings, member satisfaction).
Actionable Dashboards: Equipping teams with real-time, actionable insights through strategic, operational, and analytical dashboards.
Strategic Dashboards: Provided executive leadership with high-level insights into long-term trends and goal attainment (e.g., year-over-year Star Rating improvements).
Operational Dashboards: Equipped frontline teams with real-time data on member inquiries, issues, grievances, appeals, and feedback from various sources (surveys, focus groups, etc.). This facilitated rapid response and proactive problem-solving.
Analytical Dashboards: Offered deep-dive capabilities for data scientists and analysts to uncover complex relationships, identify root causes, and model potential solutions (e.g., predictive analytics to identify at-risk members).
Accountability: Establishing clear ownership for every KPI across the organization, fostering a culture of responsibility and continuous improvement.
Technical Foundation: Recognizing the need for a robust data infrastructure, I oversaw the integration of disparate data sources and implemented near-real-time data processing. This enabled:
Data Integration: Orchestrated the integration of disparate data sources (e.g., member feedback, claims data, call center interactions, electronic health records) into a centralized data warehouse. This required overcoming challenges in data standardization, cleansing, and validation to ensure accuracy and reliability.
Advanced Analytics: Leveraged data science techniques (e.g., machine learning, natural language processing) to extract actionable insights from both structured and unstructured data. This included sentiment analysis of member feedback, predictive modeling for risk identification, and root cause analysis for issue resolution.
Agile Decision-Making: Empowering teams with up-to-date information for rapid response and proactive problem-solving.
Quantifiable Impact
X% increase in member satisfaction scores within 12 months.
Y-point improvement in overall Star Ratings.
Z% reduction in average call handle time.
Vision for the Future: Adaptive CX Performance System
This interim solution was a critical first step. I also spearheaded the investment request for a long-term, adaptive CX performance system, capable of:
Dynamically adjusting KPIs and targets based on real-time market conditions and member feedback.
Predicting and preventing member issues through advanced analytics and machine learning.
Personalizing the member experience at scale.
Key Takeaway:
By rapidly implementing an interim solution and championing the vision for an adaptive CX performance system, I demonstrated my ability to:
Deliver immediate value while building a foundation for long-term transformation.
Lead cross-functional teams to achieve measurable results.
Leverage data and technology to drive a superior member experience.
Member Recovery
Member Incentives
Context: At Elevance Health, we had multiple member incentive programs across various Medicare business areas (Stars, Quality, Sales, Product, etc.). This fragmentation led to member confusion, high costs, and low engagement. Local market leaders were resistant to change, preferring their customized programs.
Action: I led a cross-functional team to consolidate these programs into a unified platform with a single vendor, transitioning from a transactional model to a holistic rewards experience that fosters long-term loyalty.
Strategy:
- Customer-Centric Approach: We conducted extensive member research, including surveys, focus groups, and journey mapping, to understand their preferences and pain points
Competitive Analysis: Performed a competitive analysis to understand existing incentive programs in the market and identify gaps that our program could fill.
Value Proposition: We defined a clear value proposition for the new program: a simplified, personalized rewards experience that incentivizes healthy behaviors and long-term engagement with Elevance Health.
Minimum Viable Product (MVP): We prioritized features for the MVP that would deliver the most value quickly, such as a user-friendly interface, clear reward structures, and integration w/ communication channels.
Design and Development:
Agile Methodology: We adopted an agile development approach, working in short sprints to gather feedback and iterate on the platform design and features.
Prototyping: Developed prototypes of the incentive program, including digital interfaces and communication materials. Conducted usability testing with a small group of Medicare members to gather feedback and refine the design.
MVP Development: Focused on developing a Minimum Viable Product (MVP) that included essential features such as easy-to-understand incentives, a user-friendly digital platform, and seamless integration with existing health records.
Cross-Functional Collaboration: We involved stakeholders from various departments, including marketing, sales, IT, and clinical, to ensure the platform met diverse needs and aligned with broader business goals.
Implementation and Launch:
A
gile Methodology: Adopted agile methodologies to manage the implementation process. This involved sprint planning, QA testing, daily stand-ups, and regular retrospectives to ensure continuous improvement and goal alignment.
Phased Rollout: We launched the program in phases, starting with a pilot in select markets to test and refine the platform before scaling nationwide.
Change Management: We developed a comprehensive change management plan to address resistance from local market leaders, providing training and support to ensure a smooth transition.
Communication Strategy: We implemented a robust communication strategy to educate members about the new program and its benefits, utilizing various channels like email, direct mail, and portal.
Result: The consolidated member incentive program was a success, resulting in:
15% reduction in vendor costs due to consolidation and streamlined processes.
Improved member satisfaction with the program, as evidenced by a 25% decrease in customer service inquiries and complaints.
10% increase in preventive care utilization, contributing to improved health outcomes and Star rating
Changed the way member recover and service recovery were defined and executed
Modernize Billing Platform
Problem: Our billing system was outdated, inefficient, and frustrating for our members.
- Previous attempts at improvement were plagued by missed deadlines and budget overruns. It was my responsibility to change that narrative.
- Challenge: Secure a multi-year investment (which hasn’t been done) to overhaul a complex, outdated billing system with a history of failed projects.
Transformation Approach
- Gap Analysis & Root Cause Identification: I led a deep dive into the existing billing processes, utilizing data analysis, stakeholder interviews, and benchmarking against industry best practices. This uncovered key pain points, bottlenecks, and opportunities for automation and self-service.
- Data-Driven Vision: Armed with these insights, I developed a comprehensive business case, incorporating market research, financial modeling, and a detailed ROI analysis (3:1)
- Building Executive Alignment: I engaged key stakeholders early and often, tailoring my communication to their specific interests.
* - This included emphasizing cost savings for financial executives and highlighting the potential for improved member satisfaction for clinical leaders.
- Change Management & Controls:
Training programs to equip staff with new skills and knowledge.
Clear communication to build understanding and address concerns.
Rigorous governance with regular steering committee meetings and performance reviews to ensure accountability and progress tracking.
- Agile Methodology: To maintain momentum and flexibility, we adopted an agile approach, utilizing two-week sprints, daily stand-ups, and pilot programs to quickly test and refine solutions. This allowed us to demonstrate tangible progress early on and mitigate risks through iterative development.
Convincing the Funding Committee:
Successfully convinced the funding committee to commit to a multi-year investment.
Emphasized long-term benefits and the necessity of sustained funding for achieving goals.
Transformational Results:
$20 Million Investment: Secured the multi-year financial commitment necessary for a complete system overhaul.
Digitization and Self-Service: Delivered a modern, intuitive billing platform with enhanced self-service capabilities.
Reduced Inquiries by 25%: Streamlined processes and improved communication led to a significant decrease in call center volume.
20% Member Satisfaction Increase: Members experienced a more seamless, user-friendly billing process.
30% Reduction in Complaints: Proactive problem-solving and improved processes resulted in fewer member issues.
$60 Million in Savings: Operational efficiencies generated a substantial return on investment.
VBC Portfolio Management
M&A Integration
