Transforming Case Management
Physical to Digital
Seamless communication and collaboration through Papyrus ACM established a powerful digital-era business application
WellCare Health Plans, headquartered in Tampa, FL, provides government-sponsored managed care services in all 50 U.S. states. The company serves about 3.9 million members, partners with 417,000 contracted health care providers and employes 7,600 associates nationwide. The company covers 10 different brands and carries more than 40 lines of businesses.
The company’s Creative Services Team provides all marketing and regulated materials for external and internal use, which adds up to a repertoire of more than 60 media types in 30 different languages. The work of the Creative Services Team was 90 percent paper-based, with documents gathered in physical case folders containing mostly written information. This system of case management was both time consuming and inefficient. Workflows were handled manually and case files moved physically between different groups, often creating bottlenecks. Proofs and deliverables had to be printed then added to the case file.
The company already utilized Papyrus to extract data from traditional forms of communication, such as paper and fax, and wanted to integrate e-mail extraction capabilities with this existing capture workflow.
An Enterprise Content Management System (ECMS) based on the Papyrus Adaptive Case Management (ACM) framework brings WellCare a unified case management platform in which the Creative Services Team can handle workflow and content digitally, preserving work time and material resources.
The Papyrus ACM solution provides adaptive goal-oriented workflows where administrators can react to unforeseen situations with real-time changes, such as adding goals or content. The Creative Services Team can govern its processes without involving IT departments.
The new system has reporting and tracking features that provide management with detailed operational performance numbers of the Creative Services Team. Administrators use integrated quality assurance measures, such as predefined checklists and approval cycles, to continuously improve workflow quality.
Standardized Case Handling and Workflow
Work requests for the Creative Services Team are standardized online request forms that use dynamic fields to gather required information. Every request form opens a case that specialists then triage to make a judgement on whether to move forward with the request. The Project Management Team reviews each request and assembles workflows based on available goal templates. Project Managers can create new case templates based on proven workflows to enhance the ACM library.
Validation, Verification and Approvals
Previously, a comprehensive checklist was used at the end of the creative lifecycle to validate and verify the deliverables. If there were any errors, the folder would return to the beginning of the process for corrections.
With the Papyrus ACM solution, the checks and validations occur throughout the lifecycle of each piece, not just at the end. Approval cycles are integrated in the workflow templates using voting tasks, with options for approval or disapproval. Approval will advance the process to the next task or goal, while disapproval will reroute the workflow back with meaningful comments for improvement and resubmission. Iteration tracking informs management of accumulated denials, which enables targeted examination and fosters improvements.
Monitoring Case Execution
Each case participant can monitor their own work with the My Tasks queue and the tasks waiting to be accepted with the Work Requests queue. High-priority and ‘rush’ jobs are listed first.
Managers have access to reporting dashboards that show lists of active and completed tasks or jobs. These lists allow monitoring of how long tasks perform, how long tasks wait to be accepted, how many tasks are sitting idle, etc. Project and team managers can analyze data for individual or team performance metrics, while also identifying bottlenecks and process inefficiencies.
Business Benefits of Papyrus ACM Framework
Cost Savings, Time Reductions
WellCare experienced a 75% reduction in printing, paper and physical file storage costs, along with a 20% reduction of rework due to quality measures. Job lifecycle time savings are at least 20% due to eliminating the human hand-off bottlenecks and adding ad-hoc goals that trigger predefined workflows.
WellCare is currently expanding at a pace of more than 2% per year, with increasing needs for materials. The ability to expand the overall material creation capacity enables the entire company to expand and meet its growing needs.
Improved quality with explicit, in-process quality checks throughout the project lifecycle reduces the risk of late or inaccurate materials and related regulatory fines.