CASE STUDY
Optimity Mines Data ‘Gold’ to Connect Large Health Insurance Payer’s Contract Sales Trends
SERVICES
THE CHALLENGE
Limited visibility into contract agreement status and data discrepancies
Optimity was engaged by a large Blue Cross Blue Shield insurance payer to analyze, map and document Admin Service Contracted (ASC) product reporting & analytics requirements and initial design. This effort was driven by the business need to leverage ASC sales data for future product positioning and end-to-end process improvement insight.
Optimity and the client had recently implemented a new ASC customer agreement authoring & publishing system to operationalize and automate the ASC Group Renewal process. The client also needed an enterprise source-of-truth for all ASC product sales. However, the client still needed to address the root causes for many ASC product financial and operational impacts downstream of the sales agreement execution. This larger enterprise data challenge was plagued with data structure discrepancies and inconsistencies. The inability to track down end-to-end ASC agreement status from sale to invoice payment and GL posting was a major problem.
Optimity approached this engagement collaboratively and iteratively with the client to deliver key functional and technical findings, reporting requirements and conceptual analytics designs.
OUR SOLUTION
‘Art of the possible’ proof of concept models built on ASC data
Optimity approached this engagement collaboratively and iteratively with the client to deliver key functional and technical findings, reporting requirements and conceptual analytics designs.
After engaging stakeholders and users in multiple discovery interviews around ASC business data use, Optimity worked with the client to capture prioritized requirements and the “wish list” of insights. This assessment drove the data-mapping work to surface data sources and identify data gap areas – both fundamental for future state analytics and reporting design. The data mapping deliverable drove the “art of the possible” machine-learned Proof of Concept (POC) models built on existing ASC data.
The client described the final deliverables as “gold.”
TOOLKIT
Discovery Interviews
Proof-of-Concept Models
THE RESULTS
Machine learning-driven proof of concept gave the client the line of sight on data-driven tools they could use to better develop, recommend, sell and invoice the right products to the right customers at the most profitable price.
Surfaced & mapped actionable data sources previously hidden to client
Built foundation for client to create higher value ASC operational and financial reports
