CUSTOMER PROFILE
ABOUT
Founded in 1971, Medscheme is South Africa’s largest health risk management services provider and second largest medical aid administrator. The group reaches over three million people throughout South Africa.
LOCATION
Headquartered in Roodepoort, South Africa
AGENTS
1000+ representatives
GOALS
- Control costs, particularly unexplained rise in overtime
- Improve back-office efficiency
- Improve quality and CSAT
- Gain visibility into back-office employee practices and adherence
FEATURES
- Desktop Analytics integration with legacy core CRM solution
- Custom dashboard blending desktop analytics insights with CSAT, quality, and cost metrics 70%
01 THE BEFORE
An overdue back-office transformation
Medscheme had achieved some success with NICE solutions for call recording and optimization in the contact center. In the back office, where highly skilled workers are responsible for processes such as hospital pre-authorization, productivity improvements had remained largely unexplored for years.
02 DESIRE TO CHANGE
An unexplained bill
As an organization, Medscheme prizes opportunities to save money, improve efficiency, and bolster customer service in pursuit of better experiences for members. And like a savvy patient, Medscheme also watches its bills carefully.
Medscheme’s back office was working at least R3,000,000 (approximately $190,000) in overtime every month. Workloads weren’t rising enough to explain the need for these extra hours, which alerted analysts and management that productivity appeared to be falling.
After examining other performance metrics, the company realized that quality scores were also sliding. But the company had no systematic way to evaluate the change in work habits or otherwise identify a root cause. “These are highly skilled resources, most of these people have been with the company for a long time. So, it’s not that they don’t know the job,” said Ncumisa Hlapo, Medscheme business intelligence senior specialist. “But we had no way of unpacking what it was that they were doing or not doing.”
03 THE SOLUTION
Desktop analytics to dive deep into back-office practices
Motivated to deliver exceptional customer service, identify process blockages, and understand agent productivity, Medscheme selected NICE NEVA Discover with desktop work tracker, and engaged NICE Value Realization Services (VRS). NICE VRS assisted with the complex process of integrating the desktop analytics tools with Medscheme’s core legacy CRM system, and provided guidance on understanding data returned through desktop analytics reporting.
“The support from the NICE VRS team has been great, not just in showing us how the product works but in understanding how it can work best in our environment and suggesting valuable measurements,” Hlapo said. “And they took ownership of communication with NICE R&D team to solve technical challenges.”
04 THE RESULTS
Revelations from the back office
Implementing NICE NEVA Discover gives Medscheme insights and understanding into back-office practices which were previously hidden. Supervisors now understand not only when employees are active or idle, but know which applications they spend time in.
The first discovery was that many employees spent little of their time in the core CRM system. In some circumstances this indicates that the employee is handling more complex cases which require more external research, but in others it signals inefficiency or a lack of adherence. Medscheme established a baseline of 70%, meaning that employees are now directed and expected to spend at least seven of every 10 scheduled minutes working in the CRM screen.
With these baselines and expectations in place, Medscheme now denies overtime to agents not in schedule adherence. The improved productivity and new adherence figures are now widely published, consistent with Medscheme’s culture of promoting “co-opetition” between business units. “If the employee next door is getting 99-100% across the board in their scores, there’s no reason you can’t,” Hlapo said. “From the perspective of our decision-makers and managers, there’s a need to drive toward these numbers and make sure our people deliver.”
A custom dashboard blends performance data from desktop analytics with CSAT and quality scores along with overtime figures to provide a holistic view of back-office agents. This blended view helps leadership identify links between hours worked, overtime given, and team performance versus objective and subjective results.
Along with the new accountability comes new opportunities for supervisors to coach employees on skills which have been discovered to be comparatively weaker than peers. Medscheme is also using NICE NEVA Discover's desktop analytics to identify and publicize optimal workflows through complex processes, involving fewer clicks and delays.
05 THE FUTURE
On course for recovery
With new analytics and workflow monitoring tools in place, and reporting to identify opportunities for improvement, Medscheme is anticipating rapid return on these investments. Specifically, the solutions are expected to deliver:
- Reduced overtime expense
- Improved employee adherence
- Reduced case backlog
- Reduced overall operating cost
