“What Digineer delivered was an absolute clutch (call it “game winning”) home run for Government Programs. They helped raise the trust levels and IT brand up several notches.”
– Senior Director, Medicaid
CLIENT & SITUATION
Every year on January 1, modifications to government-sponsored benefit plans take effect. This impacts the client’s ability to properly determine member eligibility, adjudicate claims, and accurately process over $1B prescriptions a year. It’s critical that all independent projects required to meet the 1/1 deadline work in unison and against a robust standard project methodology in order to meet the “can’t fail” implementations on time and on budget.
Throughout the year, Federal and State governments issue new mandates or update regulations that require system changes to remain compliant. Many of these project-initiated changes are implemented on a rolling basis, while others occur with the software code going live on 1/1 – the first time a new member plan or government regulation takes effect.
Because of the sheer number of changes, their interrelated nature, and the number / scale of systems that need to be changed, highly effective program management is essential across resources, scope and time management.
The client engaged Digineer to conduct an exhaustive risk assessment of its project portfolio and practices to mitigate any issues with the potential to impact its ability to properly process claims (i.e., prescriptions) at the annual 1/1 “go-live” point. The work included:
- A detailed review of 200+ projects across 27 assessment categories to recognize and objectively rank known and unknown issues in order to draw focus to areas of higher project risk.
- Establishing the framework, practices and staffing for an Operations Center to work collaboratively with the larger enterprise Production Support Organization to quickly detect, prioritize, and resolve any issues.
- Implementing an IT Trouble Ticket Tracking system to assist with shift transitions, issue resolution, and the reporting of metrics.
- Supporting supplementary system regression testing of new systems features and changes.
The Digineer-led Readiness effort delivered outstanding results that:
- Shortened the “time to resolve” of many 1/1 issues by over 40% through the creation of project reference guides and playbooks.
- Served as an important bridge between the business and IT components of the organization while simultaneously improving awareness about cross-platform issues and risks.
- Identified and recommended a series of best practice opportunities to advance ongoing readiness through continuous improvement and documentation of lessons learned for future use.