Healthcare Client Story

Surpass Agent Learning & Performance KPIs to Boost Enrollments and Build Member Loyalty

One of the largest US healthcare plan providers reinvigorated agent training through the award winning RealPlay™ platform, a well-organized knowledgebase, and ongoing solution enhancements.

10% increase in

QA scores

59% increase in new

plan enrollments via phone

28% decrease in transfers,

indicating improved FCR

The challenge

One of the nation’s largest health plan providers needed to clean up its knowledgebase and streamline the processes and procedures necessary to develop a strong, well-informed, and self-reliant workforce to deliver positive member experiences that foster member loyalty.

For years, the prestigious health plan providers struggled with knowledgebase organization. Duplicate articles were rampant, making it difficult for each LOB to easily search and access content – and when agents did locate what they were seeking, the content was often unengaging and hard to consume.

Without a centralized LMS platform in place, the healthcare organization also struggled with effectively tracking curriculum completion and accreditation, implementing DL modules, managing agent training assignments, and running reports on various levels.

Our solution

Because of our proven track record of delivering impressive results in other aspects of the client’s business, the healthcare organization sought TTEC to tackle its knowledgebase and LMS challenges – the goal was to adequately prepare its agents to deliver consistent, high-quality member resolution results.

We sprang into action by re-thinking, re-envisioning, and re-organizing innovations to create a new custom learning experience, tailored specifically to the healthcare plan provider’s unique situation. Our teams outlined clear rules and responsibilities for each system, introducing new technology and functionality to improve consistency and workflow across all LOBs.

Using this approach, the TTEC team worked quickly to organize content and introduce innovative, digital, and asynchronous learning exercises. This includes a personalize, self-paced learning environment deployed through our RealPlay™ platform. Agents practice various call types as though they were handling real customers without compromising the production environment and customer accounts through the RealPlay Sandboxes. In addition, agents receive immediate feedback based on their interactions with the RealPlay BOT.

Additionally, we proactively partnered with Operations and Training to ensure smooth implementations, refreshed outdated training curriculum schedules, developed user-friendly training guides for both facilitators and learners, and introduced three delivery models – classroom, virtual, and a flexible, self-directed asynchronous learning environment. Our team also set up automatic protocols for tracking update requests, adding new content, and facilitating a timely content review process for ongoing program improvements.

The results

Within weeks of ironing out the kinks in the knowledgebase and LMS, quality assurance (QA) scores jumped 10% to 97%, well above the organization’s 85% Service Level Agreement (SLA) requirement. After our new learning and performance initiatives were introduced, the healthcare plan provider saw a 60% increase in telephone enrollments and a 28% decrease in call transfers – indicating agents felt more confident to manage consumer inquiries on their own. We also saw a significant increase (42%) in knowledgebase use and positive behavioral changes in the workforce.

In the future, TTEC plans to migrate knowledge content and integrate call flow scripts into a new customer relationship management system for all LOBs. Doing this will give all departments a single, shared view of every consumer/member and eliminate the need for agents to toggle back and forth between the call flow, knowledgebase, and the CRM system to process a call.


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