Call Contact Center Center FCR FCR Best Best Practice Award Winner

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1 Call Contact Center Center FCR FCR Best Best Practice Award Winner Award for Career Development Program: UPMC Health Plan published

2 Career Development Program Best Practice Success Story Company Description UPMC Health Plan, the second-largest health insurer in western Pennsylvania, is owned by UPMC, an integrated global health enterprise. The integrated partner companies of the UPMC Insurance Services Division which includes UPMC Health Plan, UPMC Work Partners, LifeSolutions (EAP), UPMC for You (Medical Assistance), and Community Care Behavioral Health offer a full range of group health insurance, Medicare, Special Needs, CHIP, Medical Assistance, behavioral health, employee assistance, and workers' compensation products and services to nearly 2.3 million members. Their local provider network includes UPMC as well as community providers, totaling more than 125 hospitals and more than 11,500 physicians throughout Pennsylvania and parts of Ohio, West Virginia, and Maryland. They seek to offer the highest quality and value to their members and their community. As part of the UPMC family, they work closely with the world-class hospitals, physicians, and researchers at UPMC, and with community provider partners across their service area, to deliver awardwinning health care products, programs, and services. They seek to do all this with a personal touch, helping members and their families enjoy the best possible health and quality of life. UPMC Contact Center Description Location Pittsburgh, Pennsylvania, USA Contact Types General inquiries, benefit, and eligibility coverage from Members and Providers CSR Headcount 300 Contact Channels Phone, , website, chat, and mail Contact Volume 3 million+ contacts per year

3 Background Service Excellence is dependent upon the quality of those team members who have direct contact with our membership on a daily basis. Hiring team members who truly embrace the spirit of Service, who are kind and caring, and who have the ability to learn complex products and systems ultimately leads to our success. Our Member Services team is the voice of UPMC Health Plan. They represent the company in its entirety given that they are the first point of contact when a member reaches out to resolve an issue or to ask a question. Therefore, recruitment takes a high priority, and we carefully select our new team members. Opportunity Statement The recruitment of high-quality frontline team members is essential to maintain an optimum level of member satisfaction. At UPMC Health Plan, we are dedicated to staffing our Call Center with representatives who will adopt our mission and integrate our values into their everyday interactions with both external and internal customers. Best Practices Used To identify these most successful candidates, we worked with Select International to create a robust recruitment program. The program was based on the attributes of the most successful CSR s, leadership feedback, and the UPMC Values. The process is outlined below: Application/Values Assessment: Determines educational & experience, ability to embrace and display our UPMC values Application/Resume/Values Assessment Review: Onboarding team review Phone Interview: Assesses phone skills as well as motivational fit; e.g., background fit, customer service skills, etc. SACS On Line Skills Assessment: Two hour timed online testing for customer service, empathy, desire to help others, and multitasking Behavioral Based Hiring Manager Interview: Ensures candidate has cultural fit and spirit of service in their heart Offer: Call from HR & welcome letter, welcome call from Manager, welcome & call from onboarding team Background Check/Physical & Drug Screen The recruitment process not only identifies the most successful candidates, it also begins the process of embracing them into our culture as a career, not as a job. On the first day of

4 employment, our CSR s are immersed into the career advancement at our organization as a whole. At New Beginnings (UPMC s new hire orientation), team members learn about many of the careers at UPMC and how team members can apply and move up in the organization. On day two, all CSR s have a Senior Leadership Meet and Greet, including the Associate VP of Customer Engagement, Director of Member Services, Director of Medicare Enrollment & COB, and Director of Commercial Enrollment. This meeting not only connects the new hires with our senior leaders, but the intention is to create excitement around the career path journey that they will have available to them by joining our team. A booklet is shared with the new CSR s that includes our full career path and the requirements to reach the next level of Senior CSR. The Director of Commercial Enrollment shares her story of how she began her career as a CSR and what she did to make it all the way to director. We discuss all of the levels a team member can achieve in our Call Center. Beyond this, we share information on careers outside of the call center and stories of CSR s who made that journey. We share how the most successful careers outside the call center, the CSR had worked all the way through our career path prior to making that move to another department.

5 Below is the Career Path that his shared with the team: While our Career Path has evolved over time, with additional positions and levels added, we got a wakeup call in 2014 in reference to our Promotion/Career Advancement Program with our SQM Survey. Team members shared that this was a top priority to fix. In working through the detailed comments, team members shared that they did note have an understanding of the requirements and that leadership was just promoting who they liked. This concern drove immediate action on our part. We worked to develop specific criteria on how a team member can grow from one level to the next. These requirements were shared with all of the team members at team meetings. We created a checklist that is shared with the team members in the meet and greet meeting. This document is also covered in one on ones with supervisors and managers. Career Advancement is a key conversation in these meetings. One of the key areas on the requirements is the VOC. Team members have to achieve specific scores on our After Call Survey that is offered to every member who calls. An automated announcement is played prior to connecting with the CSR asking that they stay on the line, and an automatic transfer to the service takes place at the end of every call.

6 Please see the sample requirements to move from CSR to Sr. CSR with key VOC areas highlighted: The coaching that team members receive weekly from their team leads focus on all of the required elements, with the exception of attendance. Coaching includes all of the VOC data from the survey, as well as a review of positive and constructive comments that members have left for the CSR. A recorded call is reviewed and member experience and FCR is the focus of the call review. This coaching focus is not only to ensure team members own and embrace the process for creating outstanding member experiences.

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8 FCR/Csat Outcome With this great focus on member experience, we are realizing outstanding results. On our most recent SQM Benchmark Survey, our FCR score soared by six percentage points. Not only did we see that the members were receiving an outstanding experience, CSR s expressed a higher level of ability and ownership related to FCR, ultimately driving the Career Advancement. At the six-month point in the CSR s career, they have a meeting with senior leadership again. At the beginning of the meeting, the team members are congratulated on making it through the first six months, which we know is the biggest accomplishment based on the rigorous training program and complexity of our business. Everyone shares what they feel their biggest accomplishment was and are recognized and thanked for the great effort they made towards this. Another review of the career path and promotion requirements are reviewed. Since it is the one year mark where team members are eligible for a promotion, we share with them that they are entering the six month period that will determine their promotion eligibility. They are reminded of the most important thing to achieve the promotion is to create an outstanding experience for our members. We encourage them to make sure they consistently review the promotion checklist at each one on one they have with their leadership and in every coaching session. Beyond having team members promote through the career path, a great focus is promoting to all leadership levels from within. Through career path meetings with team members and monitoring of the performance, key leaders are identified. All team members once they achieve the third level have key additional responsibilities that leverage their individual talent. With all of this we continue to grow and develop the leadership the team member possesses. When positions are available that they are qualified for, we encourage them to apply and champion them through the process. The examples given below share the journey that some of our key leaders have taken and how they achieved their career success. Employee Feedback Maureen Beermann; Coordinator, Evolent Member Services Being a customer service representative is the best way to develop a firm understanding of UPMC Health Plan. It is essential to learn each product, how to explain each benefit, and most importantly, how to speak with the members and providers in a professional and compassionate manner. I started my career with UPMC Health Plan as a customer service representative after some previous call center experience. Due to having two small children, I was offered a part-time

9 position that fit into my life perfectly. Working three days a week, I knew that I needed to quickly comprehend the products. My efforts did not go un-noticed and I received a Super Star award. Soon I was promoted to Senior Representative, then to Health Care Concierge and into a fulltime position. I now have been working as the Assistant Manager of one of our new retail locations after gaining my Resident Producer s License for Life and Fixed Annuities, Health and Disability. Having been a customer service representative was a great advantage in this position. I was able to bring to the position a wealth of knowledge about each product that I would be selling. I was also able to share this knowledge with my coworkers. The customer service skills that I had developed while working at the call center easily transitioned into face-to-face interactions. However, my passion was working in the call center, so when a Supervisor position over at Evolent was posted, I applied and was awarded the position. Most recently I have been promoted to Coordinator of the Evolent member service team. I look forward to bringing my many years of customer service experience to this position. I would like to be an example that being a representative is a perfect place to start. We are the face of the company and although it is a very difficult job at times, growth is unlimited after mastering this position. Loretta Cunningham; Director, Commercial, Marketplace & CHIP Enrollment I began my career at UPMC Health Plan on July 14, I was happy at my previous job; however, I desired to make a change to a larger company. I decided to attend a job fair to recruit member services representatives. The job fair was open to walk-ins. There were a large number of individuals applying for the position. I interviewed with Anne Palmerine who was a Manager at that time. I was excited when they called me and offered me the position. I decided to make the lateral move to gain medical benefits for my family. I had a Bachelor s degree, experience in customer service, business, and leadership. I did not have insurance knowledge or background. With the help of some great trainers I learned how to service benefit questions as a Customer Service Representative. On 7/25/2004, I was promoted to a Customer Service Generalist. The position is similar to a Sr. Customer Service Representative today. I had a desire to continue to grow and develop. I was promoted to a Team Leader on 4/3/2005. The Team Lead position was invaluable to me. I worked closely with Pat Rodgers and she spent time mentoring and developing me. She also assisted me by working with the training department to develop Team Lead training. The Team Lead training gave me tools to step out of the role of a peer to a leader. On 7/23/2006, I was promoted to Supervisor in Member Services. The position gave me a new perspective on leadership. I attended Management with Impact, Targeted Selection, and Manageability, along with other management classes. On 9/27/2009, I was promoted to Coordinator and had dotted

10 line to Anne Palmerine who is now a director. I participated in the Genesys implementation project and learned how to work on a project team. While I was a Coordinator I was selected for the mentoring for Growth program in Operations. I was thrilled with the opportunity to have a mentor for my career development. On 8/29/2010, I was promoted to Manager of Commercial and UPMC for Kids Enrollment Services, then to Sr. Manager in 2012, and most recently in 2016 to Director. I am happy I took the first step and applied at UPMC Health Plan during the job fair. I am thankful every day for my job with a great company. I am also thankful for the wonderful and talented individuals who give of themselves for my development, training, and mentoring. Monique Bradley; Manager, Commercial, & CHIP Enrollment I began my career with UPMC Health Plan on June 25, I was working as a loan officer and wanted to move to a larger, more reputable company. I had exposure with UPMC because earlier in my life I worked as a Phlebotomist at two UPMC facilities. I knew that UPMC was the strong company I wanted to be a part of. I came in as a Customer Service Representative and from there I m happy to say that my career path moved very quickly. My key responsibility on the Commercial team was to assist our members with any questions or concerns while striving for one call resolution and 100% member satisfaction. In November 2008 I was promoted to Sr. Customer Service Representative. My added duties in that position allowed me to partner with various departments such as Compliance and Account Management which I greatly enjoyed. That experience led to my promotion to Customer Service Concierge in February Working for this company and especially under my then Director now VP Anne Palmerine, showed me that diversity, dignity, and respect are truly valued and promoted here. That was a breath of fresh air to me and I knew that I truly wanted to make my life career here and desired to possibly continue into leadership because I had such positive role models in the department. That opportunity came November 21, 2010 when I was promoted to Team Lead of the Commercial and CHIP Enrollment Department under my Sr. Manager, Loretta Cunningham. From there I was promoted to Supervisor, October 7, 2012 and I am happy to say I was recently promoted to Manager. Working in this department is truly a blessing and I am challenged each and every day which I thrive on. In addition to that, I directly report to a Director who truly cares and drives our PRIIDES values while promoting a positive, healthy work environment. I am truly thankful for my job with this great company that has allowed me to work and mentor with such great leaders.

11 Brittany Fisher; Coaching & Engagement Lead, Medicaid Member Services I began my career at UPMC Health Plan in Medicaid Member Services in November 2010 as a Customer Service Representative. I have a passion for helping people, so I absolutely loved coming in to work every day! I was very determined to grow in my role, so I did whatever I could to succeed. Going above and beyond on every call for every member was extremely imperative to me. Before I began my training, I was assigned to a special project to assist members schedule their mammograms for an event at Magee Women s Hospital. I scheduled over 80 appointments my first month here! I was recognized for the job well done in our monthly meeting. That meant everything to me! It was then when I realized this is where I want to be. When my yearly review came up, I was promoted to a Senior Customer Service Representative. I was assigned certain special projects to complete, such as the Not My Patient project. I worked very diligently with this project, as well as servicing our members on inbound and outbound calls. I was consistently winning incentives for always being the one with the most appointments made for our members every month! Another year passed and I received my next promotion, a Health Care Concierge. With this promotion, I was given additional responsibilities such as mentoring our newly hired staff, servicing our Medicare and SNP members, assisting my peers on the Resource Unit line, and also updating eligibility in our pharmacy system for Express Scripts. My manager and supervisor recognized my abilities and job well done by nominating me for the ACES and Superstar Awards. I won both! After being in this role for another year, I decided to continue my career in another department within Member Services called Member Satisfaction. During my year in Member Satisfaction, I monitored the After Call Survey and our First Call Recovery s, coached struggling representatives to success, tracked trends, and trained team members on Customer Service and the First Call Recovery process. After being in this role for a year, I decided to take a chance on a new position called a Coaching & Engagement Lead. This position was where I started, Medicaid Member Services. I was offered the position and thankfully accepted it! In this role, I have many responsibilities. Primarily, I lead a team of direct reports. I handle their payroll, coaching, reviews, and time off requests. I also assist the team on the Resource Unit and with any escalated issues. This fall will be my 6th Anniversary at UPMC Health Plan. I am so grateful for the opportunities I have been given these past 6 years and I couldn t imagine being anywhere else!

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