Creating Connections: Changing the Profile of BPO Professionals in Health Care

Healthcare organizations have traditionally outsourced transaction processing – running insurance plan enrollments, processing claims and bills, making calls to review utilization requests and follow up on care plans, etc. However, as healthcare providers, payers, pharmaceutical companies, medical device companies, etc. increase their focus on how to better serve their constituents, they need to provide more personalized services and create more connections with consumers.

This focus on the healthcare consumer experience provides an opportunity for BPO employees to make a change – to use their own interest and ability to find better ways to serve individuals in healthcare. It is, after all, often the reason they get into the industry in the first place – to provide health care services to people. This kind of shift in focus and ability needs nurturing, however, and service providers are in a state of transition as they – and their employees – navigate the change. We are seeing some movement in this direction among service providers.

As an example, EXL is creating opportunities for its clinical staff to be a part of the change in BPO, and in the healthcare industry. This includes:

• Communications: EXL is training its clinical staff in engaging communications skills and motivational interviewing techniques. The intent is to enable nurses to be more proactive in conversations with patients on their health and care, to address a broader range of questions to navigate through and across, for example, care plans and insurance, and help drive better use of healthcare for better medical outcomes and reduced administrative cost. 
• Context: The EXL Healthcare Academy also provides cultural context on not just the U.S. healthcare principles and regulation, the details and interface with workers comp and disability, but why it is important and of value to consumers, health care providers and insurers.  To maintain clinical skill sets through practical experience, nurses can spend time in clinics and local hospitals with counterparts to see patients and the latest developments “on the floor.” The reason for all this contextual training is to enable empathy – to connect with patients and members with an understanding for “their world,” and to be able to appreciate the impact of their work.
• Career: Employees develop multi-year career roadmaps that include considerations for opportunities within EXL and in the industry more broadly, with clinical and management options.  The roadmaps allow associates to lay out the skills and abilities – clinical and non-clinical – they need to develop to move along the path, and map in the training and experience to get there.

EXL’s program is one example of how service providers are looking at what matters to the employee base they know they need to retain, and the critical capabilities they need those employees to have to deliver results in an increasingly complex industry. Taking those insights to heart as we develop the Healthcare Payer Operations Blueprint, we will be looking for how service providers are creating programs designed to generate energy, engagement, and results for the long term.  This is the start of a rethink for the role of the BPO employee, the BPO experience for a consumer, and the ultimate value that outsourcing service providers need to drive in the future.

With the combination of communications, contextual, analytical, and technology training, service providers can help to change the profile of the healthcare BPO professional. The EXL example puts nurses on a career path with options both internal and external to its own business. This recognizes its workforce not just as BPO employees, but as professionals in their own field with valuable domain expertise that they can be empowered to share with consumers. Such an approach will help drive value for healthcare clients by creating more meaningful, informed and humanist interactions and engagement in health care.