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Benefits Processing Innovation Strategy

 

Benefits Processing Innovation Strategy

The United States’ largest benefits organization receives upwards of 6 million applications per year. For just one of these benefits, at any given point there are 500,000-750,000 cases pending with an average processing time of 700 days. With multiple offices across the country servicing this benefit, it was difficult for our client to know exactly what was happening office to office, let alone pose a solution to address the growing backlog. To solve for this, we explored the question:

How might we harness and scale innovation across offices to drive efficiencies and promote a consistent experience across the end to end process while maintaining a high level of integrity and eliminating fraud?

 

My Role

I was part of a 4 person made up of a Service Designer, an Interaction Designer, a Visual Designer and a Business Designer (myself). I was responsible for leading and executing all strategic design activities including the development of a Productivity Model and Business Model framework, identifying existing quantitative data to complement qualitative insights, drafting all interview guides, conducting ethnographic research, providing oversight to the entire synthesis process and giving weekly updates to the director of the department.

*Due to confidentiality terms, client names and strategic recommendations have been intentionally omitted.

Approach

Design

  • Mapped the Business Models of each individual location

  • Synthesized ~160 interviews to understand the perceptions around the current state challenges

  • Created an Office Productivity Model and Business Model Framework for each location and identified areas of opportunity for data collection pilots

  • Designed Future State Process Blueprint and Implementation Roadmap

  • Prioritized top 5 concepts with client and made Now, Next, and Later recommendations

Discover

  • Reviewed existing product manuals, organizational reports and media coverage to garner baseline understanding of the problem

  • Conducted ethnographic research (site visits, intercepts, and shadowing) in 8 cities in a 2-month period to capture how individual offices were operating

  • Conducted remote stakeholder interviews for all additional locations

  • Collected individual office performance and staffing data as additional input

  • Recruited employees across the organization to participate in a 2-day design workshop resulting in 20+ concepts for process and operational improvement

Key Insight

While the organization had one unified mission, each office was executing on the mission in extremely different ways. Because each location was given autonomy to determine what resources they needed to complete the work, each location, over time, had developed entirely different business models, cultures and union agreements. Before we could harness and scale the local innovations at an organizational level, we needed to identify all of the variables contributing to lack of throughput and minimize as many as possible.

Outcome

To highlight these variables, I mapped the business model for each location. Using quantitative data from reports and systems and qualitative data from stakeholder interviews, I identified gaps in data collection and areas for organizational improvement, as well as began benchmarking success for the organization as a whole. The strategic recommendations are currently being vetted for implementation, and as a result, we have been awarded a follow on engagement to create a unified strategy and holistic approach to process improvement and innovation across the entire organization.