CVS Health currently has a manual process for enrolling clients and members in the Medicare Part D Program. The current enrollment process consists of multiple hand-offs, lack of integration between various backend legacy systems, and lack of a Centralized Enrollment Repository. These are primary contributors for many of the operational and architectural challenges, making the current process unsustainable to support projected member growth.
Client Success & Solution
The project aimed to deliver a centralized work flow, implement approval processes, provide audit and tracking capabilities, and integrate seamlessly with core legacy enrollment systems to handle membership volume growth. To accomplish its goals, CVS Health decided use Pega Rules Process Commander (PRPC) and tasked the experienced team at ArchiTECH Solutions to build and deliver a simplified, scalable, flexible, and state-of-the-art enrollment system of the future.
The end result included centralized work flow, newly designed approval processes, efficient and easy to use audit and tracking capabilities, and integration with the core legacy enrollment systems. Automated processes decreased time for new enrollments and changes to existing client accounts from two weeks to 24 hours.
Professional Services Provided
- Business Process Re-Engineering
- BPM Implementation – Pegasystems