Overview of the Company
The case study revolved around a large-scale Health Maintenance Organization operating across multiple counties in California. As they anticipated significant growth with approximately 2,700 new members expected by the end of the year, the organization aimed to expand into new service areas.
To manage this growth efficiently and avoid an increase in headcount, the organization initiated an RPA initiative. Accelirate was brought on board to support their ongoing RPA efforts and brought automation in healthcare solutions and new high ROI opportunities to address increasing bandwidth and reduce repetitive manual processes.
The healthcare organization faced several challenges in its growth journey:
- Expanding services into new areas while handling a surge in new members
- Avoiding the need for additional workforce despite increased workload
- Addressing repetitive manual processes and optimizing bandwidth for more critical tasks
- Identifying opportunities for automation in healthcare that align with RPA goals and key performance indicators
Accelirate approached the process discovery engagement in a structured manner:
- Structure Analysis: Understanding the enterprise’s structure and key stakeholders’ motivations, focusing on 6 Key Focus Areas and 17 Departments.
- Role Analysis: Conducting interviews with Subject Matter Experts (SMEs) to identify core tasks and transaction counts within each department.
- Task Analysis: Identifying key workflows and transactions within departments, particularly focusing on claim processing and customer grievance handling.
- Opportunity Analysis: Assessing candidates for healthcare workflow automation based on ROI, feasibility, and ease of implementation, aligning them with the organization’s RPA goals.
The results of the Discovery engagement were remarkable:
- 53 automation in healthcare Opportunities were identified, with 24 proposed as the Most Valuable Process (MVP) Automation Opportunities across the 4 Key Focus Areas.
- Potential savings of over $2.65 million per year and 99,000+ hours of efficiency gains per year if the automated processes are deployed.
- 59 identified FTE savings per year, showcasing the substantial impact of RPA implementation.