Strategic Outsourcing Helps Health Plan Maintain Quality Data for Compliance and Customer Service During Peak Cycles

A national health plan needed adequate levels of trained resources to ensure Quality Control (QC) of critical data used as part of compliance and customer services. SDLC Partners created and implemented an optimized resource allocation strategy to provide flexible, highly-trained resources to meet fluctuating demand.

As a health plan of national renown, our client must maintain a high level of quality control to ensure that key customer data is properly coded and maintained in the appropriate systems. Inaccurate or improperly-documented data within the operational workflow impacts a health plan in four ways:

Their Quality Control (QC) struggled to ensure cohesive operation of the organization’s key customer support and related downstream systems were unburdened by missing, incomplete, or inaccurate information; all required to maintain compliance with federal mandates.

Maintaining and managing a knowledgeable, seasoned staff to perform this quality control function was difficult due to fluctuating demand, difficulty optimizing resource capacity, loss of domain knowledge, and ongoing training and development requirements.

SDLC Partners collaborated with the client to design and implement a flexible staffing plan that augments the client’s core staff. We utilized an improved resourcing model that managed demand and resource supply while optimizing existing resource utilization.

Our team developed and prepared resources in a flex team pool by capturing knowledge specific to the client, acting as a catalyst for change by creating and carrying out training and development programs, which minimized transition as the resource team expanded or contracted as QC demand fluctuated.

Working together, SDLC Partners was able to ensure long-term staffing solutions to ensure high-quality data maintenance and quality control achieved through a flexible resourcing plan.

The client realized additional benefits to a collaborative staffing arrangement:

Quality Control and Assurance are critical to maintaining mission-critical workflow, databases, and operational functions. Learn how SDLC Partners can supplement your talent pool as your organization needs evolve and grow.