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Payor and PBM
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With consumers taking charge of their healthcare decisions, payors and pharmacy benefit managers (PBMs) must work to better understand them and consider their needs throughout their lifecycle. At Convergys, we understand the healthcare customer. They desire knowledgeable employees who can address their needs on first contact, access information quickly, and treat them as valued customers.

Benefits

From acquisition to retention, we help clients leverage member viewpoints to develop a memorable and cost-effective customer experience.

  • Acquisition: Maximize telesales while making a good first impression through proper staffing, knowledgeable and effective agents, and appropriate use of technology.
  • Member and Provider Service: Delight customers−who have increasingly high expectations−yet still control, or reduce, costs.
  • Retention and Loyalty: Understand the causes of member defection and take steps to reduce it.

Our portfolio of solutions includes:

Thought Leadership Series Thought Leadership Series

Issue #1: Targeting and Securing Your Customers
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Our Portfolio of Solutions Includes

Quality Agent-Assisted, Sales/Enrollment

Growing membership means shifting from a reactive to a proactive sales culture - and Convergys can help. Whether it’s providing cost-effective, flexible capacity during open enrollment, or ongoing support through our high performance sales and retention programs, Convergys drives acquisition success.

  • Effective licensed agents trained in consultative selling
  • Specific expertise in Medicare enrollment and senior service
  • Dedicated save desk capabilities to improve retention

Measurable Results: For a leading PBM, we enrolled over 440,000 members in one season with conversion rates reaching nearly 40 percent.

Acquisition Services - Build Membership

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Meets Medicare Growth Goals with Quality

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Quality Agent-Assisted, Member and Provider Service

Looking to capture quick savings by targeting specific call types and programs for outsourcing? Convergys can help. With 15 years of healthcare experience we bring unmatched expertise to reduce costs while driving improvements in customer satisfaction.

  • Agent hiring, training, motivation and supervision driven by customer satisfaction
  • U.S. and near-shore, as well as bilingual and home agent programs, for flexible capacity
  • Back Office solutions that combine integrated document management, data entry and transaction processing with workflow management

Measurable Results: For a leading health insurer, we reduced training time by 33 percent saving them nearly $10.5 million.

Member and Provider Service - Reduce the Cost of Superior Customer Service

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Provides Seamless Service with Home Agent Solution

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Relationship Management Technologies

Need to contain costs without decreasing customer satisfaction? Our self-service automation and assisted service optimization technologies are available licensed or on-demand to meet your needs.

  • Self-Service to Live Agent - Suite of intelligent products – self-service, notification and call routing – that enables multichannel member interaction
  • Convergys Dynamic Decisioning Solution - Real-time enterprise policy management solution with upsell/cross-sell, retention and cost-containment capabilities across channels
  • Intervoice Voice Portal - Power of speech and web-based standards provides a personalized experience for end-users

Measurable Results: For a healthcare client, we reduced agent-handled prescription status calls more than 15 percent with automated messaging – saving $4.5 million.

Using Multichannel Automation to enhance member and provider relationships

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Triples containment rate in automated self-service IVR while improving customer experience

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Customer Analytics and Consulting

How do you build loyalty in an industry where more than two-thirds of consumers consider all the players “the same”? By differentiating yourself through outstanding customer service – and Convergys can help.

  • Customer experience mapping to ensure consistently positive service regardless of contact channel
  • Analytical tools to uncover ways to gain efficiency, reduce costs, and deflect or prevent calls
  • Formal satisfaction measurement and benchmark to guide and evaluate service and cost reduction initiatives

Measurable Results: For a nation-wide payor, we estimated $1.4 million savings annually by preventing callbacks with data uncovered in Point-of-Service Evaluations (POSE).

Designing a Member Experience Strategy to Bridge the Customer/Company Divide

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Retention Services - Take Steps to Reduce Member Defection

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Convergys Customer Satisfaction and Loyalty Services

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