Inside View: UPMC Health Plan

Inside View: UPMC Health Plan

/ Strategy, Customer Experience, People management
Inside View: UPMC Health Plan

Multiple award-winning contact center provides concierge-level service.

Guests of high-end hotels have come to expect over-the-top service from concierge staff. These well-trained individuals tap into their extensive knowledge of local services and providers to ensure that guests feel welcome and comfortable, and that their stay is memorable.

Imagine if you could get that same level of personalized attention in other areas of your life. In fact, that is the experience that the UPMC Health Plan Concierge Contact Center delivers to more than 1 million members navigating the complex world of health insurance.

The contact center’s mission to provide concierge-level service is part of a journey that began more than a decade ago, says Mary Beth Jenkins, Senior Vice President and Chief Operating Officer, UPMC Health Plan and UPMC WorkPartners. “We work hard every day to provide a different level of service to our members,” she says. “We have a culture of service excellence in which our goal is to exceed expectations on every call.”

It’s not merely an internal objective for staff—exceptional service is what differentiates the health insurer for its members. The organization’s success with its unique approach to the service experience has not gone unnoticed in the industry either. UPMC Health Plan has been recognized with industry awards year after year. In 2015 alone, the contact center was named a Gold Stevie Winner in the Contact Center of the Year category; was awarded the Global Call Center of the Year by ICMI; and, most recently, received a Call Center Week Excellence Award from IQPC for Best Large Contact Center of the Year. Jenkins also received a Call Center Week Excellence Award for Best Contact Center Leader of the Year.

Providing High-Touch, Proactive Support

What does concierge-level service consist of in a contact center environment? UPMC Health Plan concierges are trained and empowered to go beyond simply answering questions and meeting routine expectations.

“Our approach is to anticipate our members’ future questions and issues,” Jenkins explains. “We strive to be proactive and make outreach calls to our members to welcome them to our plan, educate them, remind them about appointments and preventive care needs, and to go above and beyond to help that member live a healthier life.”

Agent performance is not measured by how quickly they can get the member off the phone. Rather, concierges are trained and recognized for surpassing basic expectations to anticipate future questions and guide members through the changing healthcare landscape. Jenkins recalls a recent example in which a contact center concierge had called a member to remind her that she was due for a mammography. The member confided to the representative that she hadn’t been able to make an appointment because she was unable to find daycare for her children. The concierge quickly located a facility that had onsite daycare, scheduled an appointment for the member and her children, and called the member the day before the appointment to remind her.

The concierge’s determination to find a solution for the member is an example of the type of exceptional service that is delivered on a daily basis in the contact center. For this member, it turned out to be a life-saving service. The member later called back to thank the concierge and to tell her that the mammogram had revealed a lump. She admitted that she would not have had the screening if the concierge hadn’t made it possible through her proactive assistance. “That, to me, is why we do what we do,” Jenkins says.

Focusing on Quality Has Better ROI

At first glance, encouraging reps to spend more time on the phone and make outbound calls to members might sound like an expensive service model. Yet, as Jenkins points out, “We have found that, if you invest in the quality of the interaction, the number of individual calls will decrease. We have been able to demonstrate that our inbound calls at the member per thousand level has actually dropped. If you allow your service staff to have a higher quality conversation, they can be more thorough and cover the information in one call versus two additional calls.”

Service quality is measured by average speed of answer, first-call resolution and member satisfaction. Additional member feedback is collected via an after-call survey. Any survey responses which indicate that a member was not satisfied with the service they received or the response they were provided are automatically flagged and an alert is dispatched to the entire leadership team. “We are then able to provide immediate service recovery with an outbound call to the member,” Jenkins says. The management team regularly analyzes the survey data to identify process improvement opportunities and root causes, and then puts in place action plans to resolve issues.

While its voice of the customer process is a critical element of continuous improvement initiatives and member retention, UPMC Health Plan leaders place equal emphasis on listening to the voice of the employees. “Hands down, we attribute happy customers to happy, engaged employees,” says Jenkins.

A companywide employee engagement survey provides one method for collecting employee feedback. Participation is high; more than 93% of the contact center staff took part in the most recent survey earlier this year. The leadership team then reviews the survey feedback for opportunity areas. “We take them very seriously,” Jenkins stresses. As with customer feedback, the priority is on taking action. The management team breaks down improvement areas into projects and tasks with timelines to keep them moving forward, and importantly, communicates progress updates to the employees.

A Culture Built on Strong Values

In many companies, customer focus is a philosophy that resides primarily within the contact center. At UPMC Health Plan, a culture of service excellence permeates the entire organization.

“The culture—from the top down and bottom up—is very service-oriented,” Jenkins says. “There is a sense of ownership across departments. Everyone feels a sense of responsibility to customer service, and every function understands how what they do impacts the customer.”

At the foundation of UPMC Health Plan’s culture is a set of companywide values, known as PRIIDES Values, which stands for:

  • Partnership: We believe Positive Partnerships and Teamwork Improve Results.
  • Respect: We treat others as they want to be treated.
  • Integrity: We do what is right.
  • Innovation: We create products and services for current and future success.
  • Development: We invest in our staff members’ continued growth and satisfaction.
  • Excellence: We strive for “Best-in-Class” practices and outcomes.
  • Service: We view exceptional service to all customers as a critical differentiator.

Jenkins points out that, while the organization lives by all of these values, Service is considered the leading value.

Importantly, the contact center management team demonstrates the values on a daily basis through their actions and communication with their teams. In fact, UPMC Health Plan’s contact center is designed to encourage camaraderie and open communication. “We have an open-door culture,” Jenkins says. “The center has low-wall cubes, and offices have glass walls so that supervisors and managers are visible and not perceived as off limits.” Although, generally, she adds that supervisors and managers spend much of their time out on the floor with their teams.

Management by walking around is practiced daily by the center’s supervisors and managers. Senior leaders also build engagement through regular rounding in the contact center to meet with individual employees and get their input, while building trust and open communications. “As a leader, you have to be in touch and be visible,” Jenkins says. “We try to formally round and walk the floor to engage with the employees on a regular basis. It’s so important to connect with individual employees to ask, ‘What are we doing well,’ ‘What do we need to do more of,’ and even ‘What do we do that we don’t need to do anymore?’”

The leadership team also maintains constant communication with contact center staff through monthly team meetings, quarterly townhall meetings with Jenkins, and annual meetings with the CEO.

Hiring and Developing the Right People

What does it take to be a contact center concierge? UPMC Health Plan’s contact center leaders look for a special type of individual—someone with a proactive attitude who can anticipate customer needs and who has the drive to surpass routine requirements on every call.

In the early development stages of the contact center concierge position, the management team developed a hiring profile that was vastly different from the previous requirements. Rather than focusing on candidates who may have spent 10 or 15 years in the health insurance industry working in a competitor’s call center, they welcomed recent college graduates with minimal to no call center experience. “We were looking for the right attitude,” Jenkins says. “It’s incredibly important to have individuals on the phone who feel motivated to service their customers, and who come in every morning with an attitude of going above and beyond.”

To find the right individuals, candidates undergo an online skills assessment as well as a cultural assessment. Candidates with the right attitude and who are a cultural fit then come into the center for a round-robin type interview process in which candidates meet with at least two managers. “We want to get more than one manager’s input on every applicant,” she says, adding that this approach has proven highly successful in helping the center to identify and hire the best candidates.

Naturally, once the top candidates are on board, there needs to be a strategy in place for developing and retaining the best talent. Each supervisor and manager is responsible for meeting with the individuals on their teams every month to focus on their personal development plans. The contact center has a formal career path in which representatives can progress from entry level to management. After the first year, reps are provided with a promotional opportunity every six months if they meet certain milestones. And many do, as Jenkins points out. “Over 75% of my management team have been promoted from within,” she says. “To me, that is fabulous—that means the career path is working.”

Showing Appreciation for a Job Well Done

Jenkins believes that recognition is a critical element for driving service excellence. In the contact center, formal and informal recognition takes place on a regular basis. A companywide formal recognition program recognizes high-performers at a breakfast or luncheon, at which they receive a plaque and have a photo taken with the CEO. There are numerous department-level recognition programs, including a peer-to-peer award, a traveling trophy for those who go above and beyond, and departmentwide celebrations to recognize concierges who have received customer commendations.

The personal stories and accolades shared by members are perhaps the most impactful, and illustrate the critical role that the contact center concierge staff have played in their members’ lives. Take, for instance, a recent example the company shared from one very grateful member:

A longtime member who is blind and enrolled in a Special Needs health plan called the call center and, after a brief discussion, requested that her call be transferred to her doctor’s office. While Nicole (the UPMC Health Plan concierge who took the call) was talking to the member, she detected a change in the member’s voice. The member was suddenly slurring her words. Moments later the line went dead. Nicole called back, but there was no answer. Nicole then called “911” to see if someone could be sent to the member’s home to see if she were OK. A few minutes later, a 911 dispatcher called Nicole to tell her that the member had been life-flighted to the hospital.

Sharing stories like these not only recognizes individuals for a stellar performance, it provides a learning experience for others in the company about what great customer service looks like. Jenkins also includes them in her reports to the board of directors.

It Starts with the Right Culture

Remarkable customer testimonials, high member retention, strong employee engagement levels and numerous awards—for UPMC Health Plan, success comes in many forms. For Jenkins, it all comes down to the culture.

“When you start with the right culture, and you work hard to go above and beyond, accolades follow,” she says. “I’m proud that, within our contact center and across our organization, we embrace service excellence as an important part of our daily culture.”

Susan Hash

Susan Hash

Susan Hash served as Editorial Director of Contact Center Pipeline magazine and the Pipeline blog from 2009-2021. She is a veteran business journalist with over 30 years of specialized experience writing about customer care and contact centers.
Twitter: @susanhash

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