Review SpecialtyRx maintenance process to identify improvement opportunities, make recommendations

by admin on January 14, 2020

Client: Major Benefit Provider

Award-winning Fortune 50 provider of healthcare services for tens of millions of consumers through thousands of employer, government and union health plans.

Challenges

  • Client has been incurring on-going cost increases, challenges meeting Service Level Agreements (SLAs) specific to turn-around-time (TAT), to support changes and testing for Specialty drug prescription benefit changes
  • The timeframe was tight, with the project overseen at the highest executive level

RMK Solution

  • Facilitated Kaizen Events to identify process suppliers, inputs, process steps, outputs and customers
  • As a result of Kaizen Events utilized Lean Six Sigma methodology in the definition and documentation of the streamlined future state process including needed controls (metrics)
  • Future state process recommended decentralization where existing Subject Matter Experts (SMEs) in the organization would be leveraged

Results

  • Cost/benefit analysis resulted in a 62% reduction in effort cost to complete changes as well as a 60% reduction in turn-around-time (TAT)

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