Jennifer Richardson, Senior Vice President Operations Blue Cross & Blue Shield of Nebraska Agile Operations : Changing the way we lead…
Where we were… The health insurance industry…Whet we were… Agile IT Stable Operations Teams Enterprise Agile Command Governance Center The Affordable Prioritized CHI Care Act Central Backlog City Lean Keep Migration Introduced Your Plan Corelink Sustainability Agile Introduced Data Warehouse v.1 2009 2011 2013 2015 2010 2012 2016 2014
Where we were… Claim Operations… we were… Claims System migration: First groups migrated in 2009 : completely altered workflow • “Staffed up” Operations to ensure a seamless transition for our migrating members • By mid-2010, operations staff was at all-time high, we faced downsizing post-migration • Due to 2 month grace period, ½ our staff met productivity goals only every other month • Entitlement culture • ACA prompted continual changes • Archaic leadership practices • Productivity driven work • Letters to CEO from auditors: productivity goals “unfair”, we “owe” them a job until • retirement
The challenge… Leadership: Hired for subject matter expertise • Command and Control • Inconsistent Leadership • Highly empathetic/maternal • Created entitlement culture • Process controlled action • Work: • Significant waste in process • Bottlenecks • Slow delivery speed • Quality challenges/rework • Process heavy • Reliant on overtime
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Our solution… Introduce Lean Model… were… • Typical 4 week Lean Kaizen – First three weeks with co-leads – Last week with cross functional team of 5-7 • Each leader required to lead 2 per year • Implement by end of 4 th week • Team report out at end of week 4
Leadership Training • Servant Leadership – Factory model- we all contribute to the whole – Focus on providing support and leadership to front line employees • Facilitation – Learn to speak up – Drive healthy conflict • Shadow – Adopt - Modify
Lean Program Leadership Growth… focu cus on in t n tune une w with h que uestion o n old d continual co “l “layer below polici cies im improvement the surface ce” bet etter communica co catio man anag agers con onstan ant n owning the ow ev evaluation and reduce ced proce cess sharing of sh complace cency cy resource ces emp mpowered act ction
Lean Program Work Results… # of Employees Claims per Employee 500 3500 450 3000 400 2500 350 300 2000 250 1500 200 150 1000 100 500 50 0 0 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2010 2011 2012 2013 2014 2015 2016 2017 2018
Lean brought significant improvements, but there was still a challenging path ahead…
The next challenge… Work Challenges: • Large backlog of work • Constantly changing priorities Leadership Team Challenges: • Silos, handoffs, lack of collaboration Manager assigned work – • Quality and rework issues Pend and Wait – • Heavy process Productivity Focused – Time Spent: People Development work management and fire-fighting process improvement
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The Solution… • Workforce Team: • Evaluates all workloads and assigns work • Resolves impediments • Accountable to the team for results work management Completed in daily standups • Workforce Leaders: • Work management • Firefighting Fire-fighting • Resource Capacity Review Separate work to ensure Resource Managers: appropriate focus on priorities People Development • Process Improvement • people development process improvement
Leadership Triangle in Operations Workforce Management Team PRIORITIZE Workforce Manager STRATEGY EXECUTE Resource Managers Stand-Up Managers Team Leads SMEs from other areas Business Delivery Advisor Manager FUNCTIONAL LEAD FACILITATION
Responsibilities of the Work Force Team Improve turn-around time for our Customers • Prioritize backlogs & queues • Remove impediments from auditing teams • Increase exposure to other lines of business • Increased flexibility by resources • Strategize the technical and business changes • Improve communication across teams • Eliminate redundancy and duplicate work efforts • Create more visibility and transparency in order to be more • proactive than reactive
Responsibilities of the Staff Improve turn-around time for our Customers • Be accountable at daily stand ups for any aged claims • Come to the stand up and explain any claim over 30 days and what • impediments stand in the way of processing Bring any impediments to processing to daily stand up • NOTE: Not all staff attends stand ups. Leads represent the teams generally. Any auditors with claims over 30 days (or high dollars) come to the stand up.
Responsibilities of the Resource Managers Coaching and developing team members • Budgets • Employee Progression Program • Process Improvements • Hiring, reward programs and disciplinary actions •
The Agile Practices we use in Operations Servant Leadership Visual Radiators Stand-Ups Retrospectives Demos Collaboration Spaces Just Enough, Just in Time Define “Done” CLARITY * FOCUS * EXECUTION * CULTURAL TRANSFORMATION
Claims Workforce Management
Operations Stand up…
Leadership Team Tactical to Strategic Leadership: • Visionary • Big Picture/dot connector • Strategic planning • Value focus • Effective initiative owner • Continuous improvement • Effective facilitator • Influential change leader • Coach and mentor • Servant leadership
Agile Organizational Structure Before: VP Claims Director Claims Director Claims Director Claims Manager Manager Manager Manager Manager After:
How are we measuring success? Culture Collaboration + 42% ▲ Trust + 37% ▲ Respect + 27% ▲ Customer Focus + 27% ▲ Productivity Innovation + 25% ▲ Workable Claims/FTE + 20% ▲ Team Management + 23% ▲ Transactional Measures + 10% ▲ Optimism + 22% ▲ Aging Claims Reduced
COLLABORATION: We work as a Team to find the best solution. We speak up when we know something is wrong. Succeeding as a team is as important as succeeding individually. RESPECT: There is an atmosphere of mutual respect and genuine positive regard. Contempt and hostility are not tolerated. We empower other members of the Team to contribute. CUSTOMER FOCUS: As a Team, we put ourselves in our Customer’s shoes. We make sound decisions to meet their needs. We do not ignore problems outside our areas of responsibility. TEAM MANAGEMENT: Help Team Members grow and develop their career plan. Managers help improve the overall processes of the Team. INNOVATION: On this Team we speak up about our ideas and look for opportunities to perform our job better. We do not hold on to outdated, inefficient ways of doing things. OPTIMISM: The Team has an inspiring shared vision. They are enthusiastic, forward looking and appreciative of each other. There are low levels of cynicism, pessimism, helplessness, hopelessness or dwelling in the past.
Lessons Learned and Challenges • Very hard, but very rewarding. Adapt to the pace of change • Go together. We made these changes with our existing leadership team • Inspect and adapt • Always adhere to core principles • Empower the management team. Teach them to engage in strategic leadership
Upcoming challenges… • Great at execution – need to balance with successful achievement of meaningful results • Play to win
Qu Ques estio ions? Jennifer.Richardson@nebraskablue.com • https://youtu.be/nhe0KSGoUgc
Adaptability… Adaptability + Discontinue a meeting that no longer provides value. + Look at a process & suggest improvements. + Send a survey; use feedback to improve. + When you make a mistake, talk about it. + Adjust priorities. + Experiment. Try something new.
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