Changing the way we lead Where we were The health insurance - - PowerPoint PPT Presentation

Changing the way we lead…

Agile Operations:

Jennifer Richardson, Senior Vice President Operations Blue Cross & Blue Shield of Nebraska

Where we were…

The health insurance industry…Whet we were…

Data Warehouse v.1 Corelink The Affordable Care Act Keep Your Plan CHI Sustainability 2009 2010 2011 2012 2013 2014 2015 2016

Agile Introduced Lean Introduced Central City Migration IT Stable Teams Agile Operations Enterprise Command Center Agile Governance Prioritized Backlog

Where we were…

Claim Operations…we were…

• Claims System migration: First groups migrated in 2009 : completely altered workflow
• “Staffed up” Operations to ensure a seamless transition for our migrating members
• By mid-2010, operations staff was at all-time high, we faced downsizing post-migration
• Due to 2 month grace period, ½ our staff met productivity goals only every other month
• Entitlement culture
• ACA prompted continual changes
• Archaic leadership practices
• Productivity driven work
• Letters to CEO from auditors: productivity goals “unfair”, we “owe” them a job until

retirement

Leadership:

• Hired for subject matter expertise
• Command and Control
• Inconsistent Leadership
• Highly empathetic/maternal
• Created entitlement culture
• Process controlled action

Work:

• Significant waste in process
• Bottlenecks
• Slow delivery speed
• Quality challenges/rework
• Process heavy
• Reliant on overtime

The challenge…

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acce cceptance ce of stat status quo react ctive capaci city pl planni nning ng

• Typical 4 week Lean Kaizen

– First three weeks with co-leads – Last week with cross functional team of 5-7

• Each leader required to lead 2 per year
• Implement by end of 4th week
• Team report out at end of week 4

Our solution…

Introduce Lean Model…were…

• Servant Leadership

– Factory model- we all contribute to the whole – Focus on providing support and leadership to front line employees

• Facilitation

– Learn to speak up – Drive healthy conflict

• Shadow – Adopt - Modify

Leadership Training

Lean Program Leadership Growth…

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proce cess emp mpowered act ction reduce ced complace cency cy in t n tune une w with h “l “layer below the surface ce” bet etter co communica catio n

Lean Program Work Results…

50 100 150 200 250 300 350 400 450 500 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

# of Employees

500 1000 1500 2000 2500 3000 3500 2010 2011 2012 2013 2014 2015 2016 2017 2018

Claims per Employee

Lean brought significant improvements, but there was still a challenging path ahead…

Leadership Team Challenges:

– Manager assigned work – Pend and Wait – Productivity Focused

Time Spent:

Work Challenges:

• Large backlog of work
• Constantly changing priorities
• Silos, handoffs, lack of collaboration
• Quality and rework issues
• Heavy process

The next challenge…

work management and fire-fighting process improvement

People Development

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• gress:

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ver- product ction, dupl duplicate w work rk be between a n areas unproduct ctive conflict ct pen end and wa wait pe peopl ple de developm pment no not pri priori ritized lack ck of re results the he gr grapevine lack ck of ability to re respond to ma market co conditions politics cs and turf wa wars

The Solution…

• Workforce Team:
• Evaluates all workloads and assigns work
• Resolves impediments
• Accountable to the team for results
• Workforce Leaders:
• Work management
• Firefighting
• Resource Capacity Review

Completed in daily standups

work management people development

Fire-fighting

process improvement

Resource Managers:

• People Development
• Process Improvement

Separate work to ensure appropriate focus on priorities

Delivery Manager

Business Advisor

Workforce Manager Resource Managers Stand-Up Managers Team Leads SMEs from other areas

Workforce Management Team

Leadership Triangle in Operations

FUNCTIONAL LEAD FACILITATION EXECUTE STRATEGY PRIORITIZE

• Improve turn-around time for our Customers
• Prioritize backlogs & queues
• Remove impediments from auditing teams
• Increase exposure to other lines of business
• Increased flexibility by resources
• Strategize the technical and business changes
• Improve communication across teams
• Eliminate redundancy and duplicate work efforts
• Create more visibility and transparency in order to be more

proactive than reactive

Responsibilities of the Work Force Team

• Improve turn-around time for our Customers
• Be accountable at daily stand ups for any aged claims
• Come to the stand up and explain any claim over 30 days and what

impediments stand in the way of processing

• Bring any impediments to processing to daily stand up

NOTE: Not all staff attends stand ups. Leads represent the teams

• generally. Any auditors with claims over 30 days (or high dollars) come to

the stand up.

Responsibilities of the Staff

• Coaching and developing team members
• Budgets
• Employee Progression Program
• Process Improvements
• Hiring, reward programs and disciplinary actions

Responsibilities of the Resource Managers

The Agile Practices we use in Operations

Servant Leadership Visual Radiators Stand-Ups Retrospectives Demos Collaboration Spaces Just Enough, Just in Time Define “Done”

CLARITY * FOCUS * EXECUTION * CULTURAL TRANSFORMATION

Claims Workforce Management

Operations Stand up…

Leadership Team Tactical to Strategic Leadership:

• Visionary
• Big Picture/dot connector
• Strategic planning
• Value focus
• Effective initiative owner
• Continuous improvement
• Effective facilitator
• Influential change leader
• Coach and mentor
• Servant leadership

Agile Organizational Structure

Before: After:

How are we measuring success?

Collaboration + 42% ▲ Trust + 37% ▲ Respect + 27% ▲ Customer Focus + 27% ▲ Innovation + 25% ▲ Team Management + 23% ▲ Optimism + 22% ▲

Culture

Workable Claims/FTE + 20% ▲ Transactional Measures + 10% ▲ Aging Claims Reduced

Productivity

COLLABORATION: We work as a Team to find the best solution. We speak up when we know something is wrong. Succeeding as a team is as important as succeeding individually. RESPECT: There is an atmosphere of mutual respect and genuine positive regard. Contempt and hostility are not tolerated. We empower other members of the Team to contribute. CUSTOMER FOCUS: As a Team, we put ourselves in our Customer’s shoes. We make sound decisions to meet their needs. We do not ignore problems outside our areas

• f responsibility.

TEAM MANAGEMENT: Help Team Members grow and develop their career plan. Managers help improve the overall processes of the Team. INNOVATION: On this Team we speak up about our ideas and look for opportunities to perform our job better. We do not hold on to outdated, inefficient ways of doing things. OPTIMISM: The Team has an inspiring shared vision. They are enthusiastic, forward looking and appreciative of each other. There are low levels of cynicism, pessimism, helplessness, hopelessness or dwelling in the past.

• Very hard, but very rewarding. Adapt to the

pace of change

• Go together. We made these changes with
• ur existing leadership team
• Inspect and adapt
• Always adhere to core principles
• Empower the management team. Teach them

to engage in strategic leadership

Lessons Learned and Challenges

• Great at execution – need to balance with

successful achievement of meaningful results

• Play to win

Upcoming challenges…

• https://youtu.be/nhe0KSGoUgc

Qu Ques estio ions?

Jennifer.Richardson@nebraskablue.com

+ Discontinue a meeting that no longer provides value. + Look at a process & suggest improvements. + Send a survey; use feedback to improve. + When you make a mistake, talk about it. + Adjust priorities. + Experiment. Try something new. Adaptability

Adaptability…

+ Suggest a solution instead of complaining. + Ask if you can take the lead on something. + Speak up when something doesn’t make sense. + People closest to the work make decisions. + Engage the team in a brainstorming session. + Ask: “What do you recommend?” + Tell someone what you want, not how to do it.

Empowerment…

+ Communicate the “why” behind a decision. + Q&A sessions with leadership. + Have meetings in open spaces. + Keep doors open. + Admit when you don’t have the answer. + Clarify your priorities. + Visualize things. + Celebrate when you reach a team milestone.

Transparency…

If you want to go quickly, go alone. If you want to go far, go go together.

African proverb

The flower that blooms in adversity is the rarest and most beautiful of all. -Walt Disney

Charles Darwin

“It is not the strongest of the species that survives, nor the most intelligent. It is the one that is most adaptable to change.” “It is not the strongest of the species that

survives, nor the most intelligent. It is the one that is most adaptable to change.”