Case Study: Engaging Solutions

CUSTOMER PROFILE

THE CHALLENGE

Working with Medicaid managed care entities and other governmental agencies can necessitate reaching out to large populations, often in a very short time frame, to perform various activities, including customer education, payment reminders and health screenings. The company’s contact center agents, ranging from 100 to 175 — scaling up or down as needed — make both inbound and outbound calls in a blended environment.

Call Center Director Christina Sparks says that campaigns often begin with a big “data dump” from a state agency that includes outdated or inaccurate contact information.

“In addition to timing requirements, data integrity is a big pain point for a lot of our clients,” she says. Business process improvements, data mining and integration with client systems (proprietary, on-premise systems, or cloud hybrids) are all important components of the services Engaging Solutions provides.

Case in point: A Medicaid Managed Care plan requested that Engaging Solutions process thousands of plan members within a 90-day eligibility window. Data quality was poor, and the client’s own proprietary system was slowing the entire process down.

THE SOLUTION

A collaborative, customized solution with NICE CXone and SpiceCSM enabled Engaging Solutions to bypass the client’s system, do the necessary data mining and complete the extensive outreach assignment within the required timeline.

“After a data gathering session, we started building scripts inside NICE CXone Studio…where member information would be managed and delivered to agents on the front end as well as in our SpiceCSM system,” Christina says. “Together we built an automated process and captured required data points as agents walked through the call script. Once we tested and fully implemented that scripting, we saw increased efficiencies on all levels, including call handle time. This allowed us to eliminate the client’s entire system from the flow.”

“Prior to working with NICE CXone and SpiceCSM, we had systems that only allowed for limited integration and data mining, and they were often incompatible with our client systems,” she continues. “Now we are able to build scripts in the background for both SpiceCSM and NICE CXone with enhanced documentation and automation.”

Automation drives efficiency and productivity gains

“Average call handle times can be tough to manage when agents are doing health assessments with plan members over the phone,” Christina points out.

“We were looking at around an average handle time of 35 to 45 minutes,” she says. “And that’s without a translator, which extends the call even more — up to a good hour and 30 minutes per call. It’s very difficult to get through the number of members we need to get through within the time frame.”

But automating the process had a major, positive impact. “Once we were able to eliminate the client’s system completely, we reduced average handle time to about 20 to 25 minutes,” Christina says. “In many cases, that was a 50 % improvement or more!”

Christina says that automating the process had another huge benefit: improved agent morale. Agents simply felt better about the work they were doing.

“It wasn’t as taxing to get through calls, and the audit scores were better,” she says. “With NICE CXone, we could set up automation behind the scenes. This way, we were able capture some of the data that the client wanted, so our agents would not have to collect and enter it manually.”

“We were definitely able to increase morale and productivity,” she continues. “We could move through these member lists quicker than before. We could also report information back to the client on a weekly basis. Previously we reported monthly due to the effort required to compile all the data.”

Automating the process provided a variety of benefits — to the client and the company

Christina says there are other tools in the NICE CXone platform she’d like to leverage with future clients. Remote and work-from-home agents, for example, would add flexibility geographically and could potentially help meet a broader variety of client requirements.

Additionally, Engaging Solutions would like to move to a true omnichannel environment. “We definitely want to take advantage of the other channels that are part of the NICE CXone platform, like SMS messaging, chat and email,” Christina says. “A lot of the plan members we reach out to are younger, and text messaging is all they do!”

In the meantime, Christina incorporates the benefits of NICE CXone into her pitches with prospective clients — the lack of downtime, the reliability and most of all, the flexibility of being able to customize.

“I use the successes of the Medicaid Managed Care plan as an example and tell them to ‘dream big,’ because we will customize their solutions the way they want it,” she says. “We tell them that all of our technology is fully customizable, so however they want their process to flow, we will build their solutions in alignment with that.”

Christina says she also likes the way NICE CXone and SpiceCSM products work together, like a family.

“I like the relationship between the two,” she says. “They integrate seamlessly, and it’s translated into a very user-friendly approach that has made it easy for us to learn and build solutions.”