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Healthcare Payor

Major U.S. Healthcare Payor Drives Analytics Transformation Through Cloud Data Warehouse

 

 

About Client:

Industry:
Healthcare
 
Location:
Dallas, TX
 
What Client Does:

Provides a full portfolio of healthcare insurance plans tailoring  health coverage to a client's specific needs. 

Solution Focus:
Data Pipeline & Visual Analytics | WhereScape, Snowflake, & Tableau
Client's Unique Data Challenge

This Healthcare Payor Client had a "data silos" issue that was impacting their ability to access and accurately see their data, causing data trust issues across different departments and the organization as a whole.  They had important data residing in multiple systems and didn't have a good way to create a single source of the truth.  In addition, they had several manual processes that were both inefficient as well as adding to their data quality issues.

They had  three (3) primary areas where they wanted to focus their efforts to build trust in their data within their organization:

Claims Data Analysis:

With claims data in multiple internal systems, coupled with 3rd Party Processor data, the Client didn't have a single source of truth to perform claims analysis.

Policy Lifecycle Analysis:

The Client wanted to better understand the data around their policy lifecycles.  Without an end to end view of the policy (sales to claim payout) they were not able to fully score the value of each policy.

Agent Hierarchy & Commission Payment:

Without a single source of truth around agent hierarchy and sales teams and accounting using different data sources, leading to internal departmental conflict and a lack of trust in the commissions data across the organization.


 

 

Teknion's Approach

Teknion began by understanding the Client's current data landscape and sources of information as well as interviewing different departments within the organization to better understand the type of analysis they were doing with the data.

Teknion then made a recommendation which included modifying data structures, moving data to the cloud for improved access across the organization and a set of automation tools that would replace manual process, improve efficiency and increase data quality.

Lastly, Teknion laid out a roadmap for a multi-phase approach to the project with detailed timelines and budgetary guidelines for each phase.

Delivered Solution

Teknion knew they need to assist the Client to get their data right before we could help them to start to rebuild trust in the data.  We accomplished this in several ways:

Leveraging Snowflake as a Cloud Data Warehouse:

By leveraging Snowflake we were able to create a new modern data warehouse that offered a modern approach to data architecture and the ability to provide access to data to more people across the organization.

New Data Architecture:

By restructuring the data as it flowed into Snowflake, we were able to provide consistency across disparate data sources, new meta data elements and a mechanism to monitor and improve data quality.

Data Automation Tools:

By leveraging modern technology platforms like WhereScape coupled with Snowflake, the Client is able to dramatically eliminate time consuming manual processes and improve the quality of the data.

Self-Service Visual Analytics Tools:

Through a side by side analysis of Power BI and Tableau, we were able to demonstrate to the Client how Tableau provides a better solution for putting insights into the hands of more employees and delivering on their vision of self-service analytics.

Client's Wow Outcome

This engagement was able to generate several significant positive outcomes for the Client.

Claims Data Analysis:

  • A single source of truth for analyzing claims
  • Eliminated 520+ hours/year of manual processes
  • New Insight into claims processing backlog
  • Significant trust in data improvement

Policy Lifecycle Analysis:

  • End to End visibility of policy
  • Elimination double/triple counting of policy revenue through better forecasting insight
  • Significant improvement in policy Risk Assessment
  • Significant trust in data improvement

Agent Hierarchy/Commission Payment:

  • Real time changes reflected in agent hierarchy
  • Increased visibility in productivity of agents, regions, divisions for better forecasting
  • Increased accuracy of commission payouts
  • Increased trust in data across sales, sales management, operations and accounting.

 

 I would like to learn how Teknion can help me solve my organization's unique data challenge.