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Case Study

How Humana Is Using Business Process Innovation to Deliver a Superb Customer Experience

Client

Humana Inc.

Humana Inc., headquartered in Louisville, Kentucky, is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company's strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people Humana serves across the United States.

Situation

Humana Team Needed to Master IBM Business Process Management Software Quickly to Enable a Simpler, Better Customer Experience

With the recent shift in the insurance landscape and healthcare laws, insurance carriers are looking for ways to simplify the consumer purchasing experience and to be more effective and efficient. Creating simplicity will allow for better service and lower administrative costs.

Humana is on a mission to design a new consumer experience across the Employer Group Segment. In collaboration with consumers, they seek to simplify, standardize and automate processes that will enable them to close the gap on health and wellness and drive efficiencies to manage costs. Through a new consumer experience driven by business process management (BPM) technology, they seek to remove complexity and differentiate their company in the industry.

As a step toward that goal, Humana needed a consistent, automated and paperless process to get customer needs into its core system. Such a process would enable them to bypass and eliminate many administrative tasks, creating a simpler and faster process and a richer customer experience.

This undertaking is expected to last four years and includes very specific financial goals and targets. Following project review with three vice presidents and the director of IT, Humana was ready to move forward with implementing their plan.

After reviewing various BPM systems, Humana chose an IBM BPM software suite that included IBM Business Process Manager Advanced V8.5 and Operational Decision Manager. They established a Process Innovation team - a hybrid group of individuals who demonstrated exemplary skills in creative thinking and programming from both business and IT perspectives. This would be the core team that would eventually master the new IBM tools that would enable them to effectively and efficiently create new processes.

Humana needed training expertise to accomplish their goals and maximize the value of their investment. They needed an agile training provider that could ensure a fast turnaround, provide guidance on curriculum structure and accommodate onsite and remote learners, including providing self-paced training for some foundational topics.

Solution

Tailored Training Solution that Included Foundational and Role-Specific Courses and Accommodated Learners Regardless of Location

Humana chose Global Knowledge because we understood what they needed, offered expert guidance on how to sequence the courses as they built upon each other, and had the agility to deliver it within their required timeframe of only four weeks. According to John Davenport, Director, Innovation & Integration at Humana, "Global Knowledge understood what we needed to accomplish. They weren't trying to give us a cookie-cutter approach. They didn't try to give me a solution that someone else had used and they thought would work for us. The Global Knowledge team was very responsive and flexible, and they took our requirements and came back with a workable solution."

The training solution was designed to take the Humana Process Innovation team through a series of courses that would enable all members to master process modeling and the playback development strategy and would build BPM role-specific skills as appropriate for each individual.

The initial course set the foundational knowledge for the entire group and focused on process modeling and the playback development strategy.

Because the Process Innovation group's launch coincided with the start of the BPM training program, the foundational course was tailored to include concepts on BPM as well as to provide insight into Humana's organizational paradigm shift to BPM. In fact, the first day of training included time with Humana program directors, who established the group's goals and leadership role in changing the culture within Humana.

After the foundational course, the team was split into groups for BPM role-specific training designed to enable skills in each area of expertise: business expert, analyst, application developer, integration developer, project manager and infrastructure expert.

Most of the training was delivered on-site at Humana headquarters, with some students in the classroom, while other off-site students logged in to attend the training virtually. Some foundational self-paced training was provided to enable students to understand BPM basics and to establish common terminology.

Instructors performed evaluations after each class to assess the class overall and to ensure all students were learning at the appropriate pace.

Results

Team Members Ready to Bring New Humana Customer Journey to Life

Through this tailored training approach, Humana reached their initial training goals of having all Project Innovation team members master process modeling and the playback development strategy and of having individuals on the team gain BPM skills specific to their role.

While the Process Innovation team was being trained, Humana performed an exhaustive consumer experience analysis to understand their customer's needs. With initial Process Innovation team training complete and training goals met, team members will now begin putting the training into practice to build and bring to life the improved journey for Humana customers.

In four to six months, Davenport will consider next steps for training as well as how to onboard new team members.

Using the BPM framework has enabled Humana to more flexibly craft processes and rules for more rapid deployment. Davenport explained, "It has also changed the way we look at a process. With BPM, the process now is becoming an asset of the company, and how well we design it will define how valuable those assets are." He added, "So, processes themselves move from a sheet of paper in a design document into an actual asset of the company that drives our work and manages our work for us."

From needs assessment to training delivery, Humana and Global Knowledge worked together to enable the new Process Innovation group to help change the culture within Humana. This is no small effort by the group or Humana as a whole. This effort is a huge undertaking that requires a deep level of commitment from Humana stakeholders and a keen understanding of the undertaking by Humana partners such as Global Knowledge.

To ensure solution success, Humana is adapting in a big way. Davenport explained, "We're very heavily oriented toward manual processes. As we move forward with this solution, our management team needs to move away from quality and production people to leaders managing and designing business processes that deliver the outcome that's expected and then monitoring that as it happens, and it's a different type of management mindset. I'm moving from watching the ones and twos to the tens of thousands of transactions and making decisions using analytics as we adjust business processes."

Though there is still a lack of understanding throughout the company about what BPM is and how to use it, Davenport explained that one of the goals of creating the small Process Innovation group was to help manage that. As the group's body of knowledge grows, they will spread it to management.

Davenport further explained, "We still have people that are concerned that technology will replace them, and to be perfectly frank, it will change what they do. What we're preparing them for is to rethink what their job is today and what the new jobs will be in the future. So that's the education part of this. It's not so much a 'figure out a way to cut a bunch of staff and move forward differently.' It's 'how do we bring the right people in to do the right work?' Hopefully, with that, we'll have very little impact on our employee base as a whole."

Humana's investment in new tools that will reshape their organization and in the training needed to maximize the use of those tools exemplifies how Humana has cultivated uniqueness by rethinking their processes to pioneer change within their organization so that its customers and organization may thrive together.

The experience outlined in this report applies only to the experience of Global Knowledge with respect to its contract for training services with Humana and does not guarantee the results of future experiences.