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Healthcare Payor
Operational Risk Consulting Services

Client Situation

Client had recently brought up a new product line, which caused problems with claims inventory and service levels agreements fell below acceptable standards. Recent staffing turnover in key positions also complicated existing processes. Finally the gathering of Key performance metrics were manual, not secure and allowed easy manipulation. Workflow's and work assignments needing to be reviewed and adjusted accordingly.

Approach

• Placed an Azilon lead consultant in the role of interim manager of the department to resolve operating insufficiencies.
• Operational Assessment was also conducted to identify key gaps in the workflow's and processes
• Adjustments to work assignment process were designed and implemented
• Adjustments to policies and procedures to bring the customer to industry best practice was executed.
• A Dashboard reporting service was setup to provide monitoring of KPI so that trend analysis could occur.
• Automation of process controls was then able to be performed.