Abstract

A national leader in consumer driven health benefit programs needed to address marketplace developments while modernizing the technical architecture across several administrative systems and functional areas. SDLC Partners assisted this client with closing the gap toward achieving the targeted list of new capabilities.

The Challenge

With competitors investing in new strategies to improve speed to market, pricing pressures across accounts, and efforts to meet national marketplace challenges of next generation products and services, executives considered several approaches to evolving their existing legacy environment. Specific challenges included:

  • Enhancing core administrative systems to support new products and capabilities, while striving to reduce related costs
  • Modernizing the technical architecture to improve flexibility and speed to market
  • Updating the claim system in order to enable real-time adjudication

The Solution

The client decided to build upon the strengths of current assets while incorporating new capabilities such as real-time processing, member level processing, dynamic benefits, and seamless integration across other systems and subsidiaries. SDLC specialists joined the client on this multi-year engagement in a variety of roles from Business Analyst to Technical Architect. They were able to assist the client to componentize, restructure, and consolidate the targeted applications so data could support different business rules and redundant databases could be retired. One SDLC technical expert was selected to lead the phase associated with the critical new capability of real-time claim processing. SDLC Partners was also able to relieve some financial burden from the client by providing them an aggregate rate for services.

The Results

This client once again turned to SDLC Partners to fill specific gaps across areas of their organization. The Firm assisted them in achieving several desired capabilities such as enhanced user experience among internal customers, improved service tools, and expanded data availability. These new capabilities will enable them to respond appropriately to marketplace developments.

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