Client Successes

Workforce Optimization for a Medicare Administrative Carrier (MAC)

Mid-Western MAC

Challenge

A Medicare Administrative Carrier (MAC) located in the Great Plains has been working with Medicare for many years.  Due to changes in their contract with the Centers for Medicare and Medicaid Services (CMS), the volume of calls had dropped by 40%, leaving them with an excess number of staff.  While attrition kept them from having to reduce headcount, they had no clear approach to determine what was the optimum number of staff for their call centers.  Of equal concern, there was the real possibility of winning new business, requiring experienced staff that might otherwise be let go.

The call center leadership recognized that they were currently managing the schedules for their call center representatives (CSRs) in a highly static way.  This meant that, even though there was an understanding that certain days of the week had higher call volume, the level of staffing on the phones remained the same from day to day.   In addition, given the reduction of call volume, they also acknowledged that they were often over-staffed. 

CVP’s challenge was to develop an optimum workforce utilization model, a “best practices” model with policies and procedures, and an action plan that provided “value added” optimization across the call center organization. 

Approach and Results

Our first step, prior to even coming on-site, was to administer our call center diagnostic questionnaire.  This document allowed the client to describe their call center environment across staffing, financial and operational axes.  This data provided the CVP team with insight into how the operation runs and looked for possible challenges, such as over- or under-staffing and over- or under-utilization of the staff.

Once we were on-site, we executed our Workforce Optimization methodology: examining the existing organization structure, call routing and handling processes, quality monitoring processes, workforce management practices, management information reporting, performance measurements and monitoring tools, and call center technologies.

Utilizing proprietary workforce management tools, CVP developed staffing models against this MAC’s actual staffing, showing the gap between the staff that was currently working against the staff that was actually needed.  CVP then analyzed the processes associated with scheduling and staffing the call center, the organizational design, and the use of technology.  Risks and roadblocks to achieving the existing call center goals were documented.

Our next step with this client was to develop a roadmap that would overcome the identified disparity between world-class call center behavior and their current state.  This was done by determining the gaps across the five areas of workforce optimization: forecasting, service level objectives, scheduling, intraday management, and reporting.  The key initiatives for each of these five areas were determined and prioritized for execution, along with staffing needs, costs, and benefits.  Based on the resulting roadmap, CVP and the client were able to calculate expected return on investment (ROI) for both scenarios – current state versus a significant increase in business.   They found that within six months, implementation of this roadmap would lead to over seven times the return due to significant over-staffing at current state; even with a significant increase in business, the model would allow for an ROI three times their investment.