Healthcare Provider Optimizes Call Center by Using CRM Solution, Improves Service

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1 Microsoft Dynamics Customer Solution Case Study Healthcare Provider Optimizes Call Center by Using CRM Solution, Improves Service Overview Country or Region: United States Industry: Healthcare providers Customer Profile Centene Corporation is a healthcare solutions provider in the United States. The company has more than 5,000 employees and is based in St. Louis, Missouri. Business Situation Centene is growing rapidly and needed to provide its call center staff with better tools to more effectively perform their jobs and increase first-call resolution and overall customer satisfaction. Solution Centene deployed Microsoft Dynamics CRM and tailored the solution to the needs of its call center. Benefits Improve call center productivity by 10 percent Ease adoption, save thousands per CSR training session Adapt to changing business requirements Enable business insight With functionally comparable competing solutions, the planning and initial implementation would have been a massive upfront undertaking. Microsoft Dynamics CRM, on the other hand, provided a rapid time-to-value, thus lowering overall cost and risk. Glen Schuster, CTO, Centene Corporation Centene Corporation provides managed care and specialty healthcare in the United States. Coinciding with recent expansion, company leaders at Centene wanted to drive operational efficiencies and achieve new levels of business insight through IT. To do so, the company replaced its legacy call center solution used primarily for call documentation with the more robust and flexible Microsoft Dynamics CRM. With the new solution in place, the company can support all member and provider service activities while collecting data related to those activities in a single database, helping to manage customer expectations and proactive outreach, thus improving overall customer service. In addition, the company has improved productivity in expansion call centers by 10 percent, reduced training time by 30 percent, become more agile, and gained business insight into the distinct needs of its customers.

2 By using Microsoft Dynamic CRM, we have been able to redesign our new-hire training program. Enhancements in system navigation, process flow design, and screen consolidation reduced the length of new-hire training by 30 percent. That translates into savings of thousands per new-hire class. Jennifer Weigand, Vice President of Member and Provider Solutions, Centene Corporation Situation Founded as a single health plan in 1984, Centene Corporation has since grown into a national leader in healthcare, with headquarters in St. Louis, Missouri. Today, the company has more than 5,000 employees and operations in 14 states in the Midwest and Southeast regions of the United States. With year-over-year revenue growth around 20 percent, Centene has recently expanded operations to Kentucky. Along with this growth, company leadership decided it was time to drive further operational efficiencies and business insight through IT. For years, Centene had relied on a legacy call center system, but that system had only minimal functionality and lacked integration with the company s other systems, including those for member and provider data. Often, customer service representatives (CSRs) would have to access multiple systems to locate information, which increased the overall talk time per call. And with CSRs acting as the company s face to customers, the call center seemed a logical place to begin the company s IT transformation. According to Bala Vanukuru, Director of IT for Centene, Our legacy system was really only for call documentation. And what we wanted to do, first and foremost, was to provide our call center representatives with all the functionality and information they needed within one application so that they could achieve first-call resolution and ultimately meet and even exceed customer expectations. Beyond first-call resolution, Centene also had a range of other objectives to achieve with a new call center system, including: Easing adoption both for existing employees and for new employees as Centene grew nationwide. Allowing for a decentralized business model wherein regional operations can benefit from a tailored solution while still using the same system as all other Centene Health Plan providers. Enabling Centene staff to draw on member and provider information to handle campaign management internally a process once outsourced to a costly, third-party vendor. In addition, Centene sought to use its ability to run campaigns as a means to proactively address customer concerns and reduce call volume overall. Easing integration with other IT systems so that employees can gain business insight, improve reporting, and provide a consistent and informed customer experience. Simplifying customization so that Centene can meet the needs of regional operations and maintain business agility. Reflecting on the company s decision to look for a new call center solution, Don Imholz, CIO of Centene, says, As we sought to deliver increasing business value to the organization through IT, we realized that what we really needed to provide call center agents with was a robust and flexible solution that would also ease reporting. That meant avoiding another point solution and providing them with a customer relationship management package. Solution After considering customer relationship management (CRM) solutions, including all Gartner Magic Quadrant and Forrester Wave leaders, Centene Corporation chose Microsoft Dynamics CRM. Glen Schuster, CTO of Centene Corporation, states, We were very impressed by the robust capabilities of Microsoft Dynamics CRM and its ability to grow with us. We could implement the solution rapidly at a single call center, tailor it to meet our needs, and then roll it out across the company. With functionally comparable competing solutions, the planning and initial implementation would have been a massive upfront undertaking, requiring us to

3 By choosing Microsoft Dynamics CRM, we were able to deliver the solution we set out to deliver and that really speaks for itself. Don Imholz, CIO, Centene Corporation implement a complex infrastructure such as those from other market-leading systems and then incur the associated resource needs and cost of such solutions. Microsoft Dynamics CRM, on the other hand, provided a rapid time-to-value, thus lowering overall cost and risk. Working closely with Microsoft Services, Centene deployed an initial rollout of Microsoft Dynamics CRM to a test group in only three months. The two teams also rolled out the Customer Care Accelerator (CCA) a preconfigured call center template for Microsoft Dynamics CRM. CCA provided functionality to support call flow, reduce clicks, and autocomplete fields when employees access the organization s other systems with the goal of providing a single view with all capabilities that employees need. Currently, 890 Centene staff members use the solution a number that is expected to grow to 1,800 within one year after the initial deployment. Of these staff members, 300 work in call centers and 590 span departments including member services, provider services, case management, claims, quality improvement, enrollment, and provider field relations. Jennifer Weigand, Vice President of Member and Provider Solutions for Centene, says, Because Microsoft Dynamics CRM worked and looked similar to Microsoft Outlook, which employees were already familiar with, and we could provide access to all of all the information they needed in one application, we were able to achieve widespread adoption. CRM for the Call Center Within the Centene call centers, Microsoft Dynamics CRM supports both member and provider services. For member services, CSRs can use the solution for a range of tasks, including helping members change their primary care provider, understand their eligibility and benefits, identify opportunities for preventative services, and track complaints. When a member calls a Centene Health Plan CSR, that CSR can use Microsoft Dynamics CRM to first verify that person s identity through information such as his or her customer ID and then document the entire call process itself. From within a single screen, CSRs can look up a range of member information and even see information from other systems, such as provider information from the company s enterprise data warehouse or benefits information from a portal based on Microsoft SharePoint Server. For provider services, CSRs use Microsoft Dynamics CRM to provide insight into the status of a claim or, as is often the case, a series of claims and all of the activities, such as field visits, with Centene overall. Much like with customers, CSRs can use the system to handle providers requests for information and updates to practice information and panel rosters. CSRs can also identify the provider by checking their TIN or NPI through Microsoft Dynamics CRM and then document the call. For calls that CSRs are unable to address, they can route those cases via Microsoft Dynamics CRM to other departments within the company. This can include the company s claims, medical management, provider data management teams, or even the company s 24-hour nurse hotline. Says Weigand, Regardless of the channel in which customers choose to contact us, we have a complete view of their cases in Microsoft Dynamics CRM, which enables us to provide them with a consistent, qualityfocused experience. Beyond the Call Center Centene is beginning to use Microsoft Dynamics CRM to manage its networkprospecting pipeline. Accessing the solution via mobile devices, Centene s Network Contracting team, for example, can input information about prospective or

4 With the implementation of Microsoft Dynamics CRM and integration with our outbound dialer, we were able to migrate our monthly member redetermination mailings to automated calls. Because of this change, we expect an annualized savings of $91,000 for one outreach program. Bill Kruegel, Vice President of Operations for Sunshine Health Plan, Centene Corporation new healthcare providers and physicians into the system when it meets with them in the field. Centene s Medical Management department can also use the solution to establish regular reminders to customers about the need for specific services, such as an annual checkup or mammogram. Says Vanukuru, By drawing on a centralized source of customer information, we can proactively address customer concerns. For instance, we can identify people who haven t had an annual checkup with their doctor and then send them a reminder. In the end, this lets us provide better service and reduces our call volume and costs. Looking back on the deployment, Imholz notes that, By choosing Microsoft Dynamics CRM, we were able to deliver the solution we set out to deliver and that really speaks for itself. Benefits By switching from a stand-alone call center application to a more robust and flexible solution, Centene has seen significant results. Specifically, the company has eased adoption, improved productivity in recently launched call centers by 10 percent, reduced training time by 30 percent, driven business agility, and gained business insight. Additionally, the company now has a 360-degree view of member data, allowing for more effective customer service. Says Vanukuru, Compared to our legacy call center solution, the cost of Microsoft Dynamics CRM is about the same, but with Microsoft Dynamics CRM, we got a comprehensive solution that we could then customize and take even further. Improve Call Center Productivity by 10 Percent With Microsoft Dynamics CRM, Centene has been able to staff its new call centers more efficiently. Says Weigand, We budgeted a 10 percent increase in calls per CSR for our new call center in Kentucky, and by using Microsoft Dynamics CRM, we are on target to achieve that goal. Ease Adoption, Save Thousands Per CSR Training Session Because Microsoft Dynamics CRM has an interface similar to Outlook and has comprehensive capabilities that limit application switching, Centene has seen considerable improvements in adoption and training, specifically in the call center. Says Weigand, One of the ways that we measure our success of adoption is by monitoring the average talk time per call for our CSRs as they migrate from the legacy solution to Microsoft Dynamics CRM. What we found is that the number stayed relatively flat at first, but then, as the staff became more comfortable, they could take additional calls. In addition, they are able to incorporate customer reminders for tasks such as preventative screenings and covered services. In terms of training, Weigand notes that, By using Microsoft Dynamic CRM, we have been able to redesign our new-hire training program. Enhancements in system navigation, process flow design, and screen consolidation reduced the length of newhire training by 30 percent. That translates into savings of thousands per new-hire class. Adapt to Changing Business Requirements Although Centene initially planned to use Microsoft Dynamics CRM for the call center, the company realized it could quickly adapt the solution to meet other business needs as well. For instance, the company deployed it to support network-contracting efforts and has even managed to eliminate the need for a third-party campaign vendor a process now handled by only one staff member for a cost savings of

5 more than U.S.$90,000 per year. Says Bill Kruegel, Vice President of Operations for Sunshine Health Plan, a part of Centene Corporation, With the implementation of Microsoft Dynamics CRM and integration with our outbound dialer, we were able to migrate our monthly member redetermination mailings to automated calls. Because of this change, we expect an annualized savings of $91,000 for one outreach program. This savings includes direct-mailing costs and reduction of fulltime employee costs associated with return-mail research. Says Vanukuru, Because the solution is robust and highly customizable, we have been able to rapidly meet new needs across our organization when they come up. As a high-growth organization, the ability to remain agile to meet our emerging and changing needs has been critical and Microsoft Dynamics CRM has helped us do just that. Enable Business Insight Because Microsoft Dynamics CRM works with Centene s other systems and all staff can work from the same application, the company has dramatically improved business insight. Says Weigand, Switching to Microsoft Dynamics CRM has been enlightening. Now that we have a central source of service center information, we can gain insight into emerging marketing trends and customer expectations. We now have the ability to expand our customer view to include inbound inquires, outbound education, care gaps, outreach, and field visits. And better yet, all our teams can see, through a single solution, all the points of contact that a customer has made with us so that we can be more effective and streamlined at meeting their needs. Adds Weigand, It s really remarkable and we re really only beginning to just scratch the surface of what we can do with Microsoft Dynamics CRM.

6 For More Information For more information about Microsoft products and services, call the Microsoft Sales Information Center at (800) In Canada, call the Microsoft Canada Information Centre at (877) Customers in the United States and Canada who are deaf or hard-of-hearing can reach Microsoft text telephone (TTY/TDD) services at (800) Outside the 50 United States and Canada, please contact your local Microsoft subsidiary. To access information using the World Wide Web, go to: For more information about Centene Corporation products and services, call (314) or visit the website at: Microsoft Dynamics Microsoft Dynamics is a line of integrated, adaptable business management solutions that enables you and your people to make business decisions with greater confidence. Microsoft Dynamics works like familiar Microsoft software such as Microsoft Office, which means less of a learning curve for your people, so they can get up and running quickly and focus on what s most important. And because it is from Microsoft, it easily works with the systems that your organization already has implemented. By automating and streamlining financial, constituent relationship, and procurement processes, Microsoft Dynamics brings together people, processes, and technologies, increasing the productivity and effectiveness of your business, and helping you drive business success. For more information about Microsoft Dynamics, go to: Software and Services Microsoft Dynamics Microsoft Dynamics CRM Partners Microsoft Services This case study is for informational purposes only. MICROSOFT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, IN THIS SUMMARY. Document published January 2012