Operational Restructure, Reorganization, Process, and Automation

In 2022, the executive leadership team at Bardavon moved an operational team to the Clinical Services team, as the team was highly clinical in their day-to-day work and needed more support. This team interacts with almost every service line in the organization, including client experience, provider experience, referrals, quality advisors, general counsel, and our consulting team. Over the previous 8 months, the team had three changes in leadership, and when the team was transitioned to Clinical Services, we only received 50% of the FTEs. I volunteered to develop process improvement and implement automation and technology improvements so we could maintain or improve the level of quality with half the team. After four weeks of taking over the team, the manager of this team was laid off, so I was then additionally responsible for the daily management and performance of the team.

• Developed a capacity model to ensure that the team is right-sized per case load; hired two additional team members as a result.
• Developed the team’s role and responsibilities; trained team; provided “open house” for organization to orient them to the team’s role.
• Assigned each team member to specific clients to build relationships, more fully understand and meet each client’s needs, and provide more accountability.
• Partnered each team member with associates from three different teams (each partner also assigned to the same clients), each providing a specific path of escalation and opportunities for collaboration and outreach, as needed.
• Created intranet pages, updated weekly, to provide insight into new process and technology improvements and to address all FAQs.
• Identified bottlenecks at each step in the five-step process where cross-functional analysis was needed and improvements could be made.
• Worked with Data & Analytics team to create a daily file that prioritizes each team member’s case load and with the Product team to consume the data and display the information in the system appropriately.
• Based on that daily file, we implemented weekly automation of communication to clients who had fallen behind in their documentation and submission of notes and claims.
• Documented all SOPs and published them on the intranet so that all teams across the organization could reference as needed.
Outcomes:
• Each team member used to have a minimum of 180 cases to work per day, with no prioritization, and a lot of time was spent looking into each case on the list to determine next steps.
o With the daily prioritization file and process and technology improvements we implemented, each team member has a maximum of 87 to work each day and the list is prioritized so they know what to work first.
o 48% improvement in identifying and prioritizing real work
• The maximum capacity of cases for any given team member to work was 57 cases per day.
o With the process and technology improvements we put in place, the minimum capacity of cases for any given team member to work is now 76.
o 33% increase in work capacity
• Before transitioning to Clinical Services, the average time required to get one reauthorization done was 7.3 days.
o Since all improvements have been made, work has been streamlined, and cross-functional partnerships created, it now takes 4.7 days.
o 36% decrease in turnaround time