Optum Consumer Sales and Services - Best Use of Technology in Customer Service



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Company: Optum Consumer Sales and Services, Horsham, PA
Company Description: Optum Consumer Sales and Service is the high value provider of contact center sales, service and retention in the healthcare industry. Our focus is to deliver an exceptional consumer experience, drive growth and loyalty for our clients’ brand and package that with the depth and breadth of products and services Optum has to offer.
Nomination Category: Customer Service & Call Center Awards Achievement Categories
Nomination Sub Category: Best Use of Technology in Customer Service

Nomination Title: Optum Consumer Sales and Service: Personalization of Consumer Interactions

Tell the story about how technology has improved your customer service initiatives since the beginning of July 2015 (up to 650 words). Focus on specific accomplishments, and relate these accomplishments to past performance or industry norms. Be sure to mention obstacles overcome, innovations or discoveries made, and outcomes: TEXT REDACTED FOR PUBLICATION

As a business handling millions of customer interactions annually and deeply grounded in key dynamics of the health care industry, we are uniquely positioned to drive strategies that will enable growth for our clients. In an environment of increased price sensitivity as consumers take on responsibility for their health care, further standardization of product offerings, and consumer need for a trusted source to navigate a complex system, we believe a differentiated service experience is a competitive advantage and the key to continued growth. We therefore developed and built our Personalization platform to evolve from transactional to relationship building interactions in order to differentiate our clients’ products in the marketplace.

Our patent pending solution design is a unique segmentation approach that matches caller profile to other data points to deliver cogent talking points to agents in order to drive the conversation with the right focus to increase satisfaction and first call resolution. This comprises a three tiered architecture, including a data layer, decision engine, and new user interface. The data layer is a flexible integration solution for retrieving data from various internal and external data sources. The decision engine evaluates treatment criteria and eligibility and prioritizes treatments at an individual customer level to be presented to staff. The new user interface is the view in the CRM system that staff accesses at the beginning of each call. This is a centralized view of customer demographics, recent activity, eligible treatment options, and engagement opportunities. As a whole, this design enables flexibility to adapt to customer and business needs across multiple dimensions, including:

• Treatments can be added, removed, or modified and evaluation rules can be changed within a short timeframe, outside of an enterprise systems release
• Scoring weights and treatment priority can be changed near real time, providing the ability to turn treatments off, either in part or as a whole, in response to high call volumes or system performance issues
• A customized suppression process that prevents the same treatment from being presented multiple times to the customer
• Integration to determine and promote treatments across channels and platforms longer term

At its core, our Personalization strategy represents a foundational change to the way we do business. In working to differentiate our service experience, a significant challenge was facilitating and scaling an organizational culture shift. We needed both agents and employees to understand and buy in to the change in order to successfully execute. To ensure success, we launched a change management “Make your service experience Stand Out” campaign to promote awareness and understanding of the business strategy and new system tools. Agents were further engaged through usability studies that delivered a user centric design that is easy and intuitive to use. Communication continued post launch through activities like identifying and cataloging exceptional calls for best practice sharing, and tracking and reporting of operational performance and customer outcome metrics.

The key objectives of our personalization strategy are to build strong relationships with customers, to drive employee engagement, and to deliver on client objectives. Following launch in June 2015, a few examples of results achieved include:

• High front line utilization rates and positive agent feedback demonstrated by the following example:
- “I love it, because it lets me be even more personable with our customers and set a different tone for the call. It doesn’t seem cold and computerized; the call somehow seems warmer and happier. You can actually hear the positive coming from the member when we are speaking and when we say goodbye.”

• Improved experience and business outcomes when interactions are personalized, including
- A 170 basis point lift in Top Box satisfaction
- A 270 basis point increase over industry scores for Top Box service experience
- 150-250 BPS lift in conversion/enrollment rates for personalized conversations pertaining to sales and value added services
- 36% reduction in repeat calls and a 20% reduction in escalations