THE 'EDGE REPORT BLOG

What Can Software Vendors Learn From Health Plans?

Having a wide range of experiences with both health plans and software vendors, it is intriguing to explore how each operates in tandem with the other, creating symbiont relationships that are crucial for one another's success. Reflecting on those common experiences many of us have, there are many things one could learn from another. 

One experience stood out to me recently while reflecting on my employment at my local health plan, first entering the healthcare payer space many years ago. I will never forget what my boss told me on my first day. He said, "We may not be the cheapest game in town, but nobody else is going to provide a better customer experience." 

As my journey through health plan operations continued, that commitment to customer service was always consistent. No matter the department, we went above and beyond for our customers; whatever they needed, we did our best to make it a reality. It was our commitment to our customers that drove our daily business decisions. Anyone who came from this health plan and, as I would discover later, many other health plans like it, will tell you their number one priority is, and always will be, the customer. It is simply engrained in the culture.  

Software companies certainly care about customer relationships. In fact, I have led optimization efforts to re-establish that rapport that is so critical for collective success. Where understanding the issues and being patient with our approach to the solution was required. Our Chief Revenue Officer Chris Conte wrote about patience and understanding our customers' challenges and how critical it is to remain sensitive to the issues facing health plans, providers, and members that are out of their control. 

While the level of commitment to customer satisfaction are likely equal between the two comparative entities, the biggest business problems encountered are navigating factors such as the strategy and logistics of servicing/delivering the many needs of a health plan with a streamlined, efficient process. Software organizations tend to matrix resources around the delivery of contracted products and services to best meet the quality and deadlines associated with the customer. As a byproduct, this means if someone at a software customer has an issue, they may need to go to a sales executive, account manager, program manager, project manager, project lead, product SME, or technical analyst, or business analyst, or application support ticketing process to get an answer or assistance. This means there are times a customer may experience delays or, worse, confusion about getting what they need. 

As a software vendor, I feel we can learn a lot about changing the relationship dynamics to increase rapport while providing a modern white-glove service. Healthcare is an emotional experience, and vendors who do business with health plans need to design their experience with that in mind. Creating a disruptive single contact-based model that breaks the existing state.

From a technology point of view, intelligent automation or hyper-automation should be playing a huge role in reshaping and redesigning the customer experience. 

As we look to the future as software vendors, we can evolve the model to reinvent the customer experience going forward using state of the art technology.

A modern digital one-stop-shop experience that goes above and beyond for anything our customers need is the customer service model of the next generation.

About the Author

Dustin Rojas

Dustin Rojas, Senior Director of Sales Engineering and Strategy, HealthEdge
LinkedIn
drojas@healthedge.com
Dustin Rojas is a senior healthcare technology professional with deep expertise and extensive experience in many aspects of Healthplan Operations, and the Payer Software industry.  Dustin primarily focuses on collaborating with the Sales team and the overall organization to lend his collective experience to the achieve the overall strategic goal of "Crossing the Chasm.”  As Senior Director of Sales Engineering and Strategy for HealthEdge, he regularly works with Prospects and Senior Leadership to assist in current sales pursuits, in addition to collaborating and consulting on emerging services opportunities.  Prior to joining HealthEdge in 2019, Dustin spent 22 years in a variety of roles in the healthcare payer space with organizations that include Great-West Healthcare (Cigna West), and Cognizant/TriZetto.

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