Streamlining the HMO membership enrollment process of a client manufacturing company

• Main Author: Samarita, Julius Christian D.
• Format: text
• Language: English
• Published: Animo Repository 2020
• Subjects: Reengineering (Management); Health maintenance organizations; Business Administration, Management, and Operations
• Online Access: https://animorepository.dlsu.edu.ph/etd_masteral/6169; https://animorepository.dlsu.edu.ph/context/etd_masteral/article/13234/viewcontent/Samarita__Julius_Christian__11595663__Streamlining_the_HMO_Membership_Enrollment_Process_of_a_Client_Manufacturing_Company_Redacted.pdf
• Institution: De La Salle University

This action research paper focused on streamlining the HMO (Health Maintenance Organization) membership endorsement process of one particular client company, a manufacturing firm. As an Account Executive in the Health Solutions - Global Team in our company, I work with a team in providing consulting services and recommendations on healthcare plans for our client companies. The problem concerns the delay and inaccuracy in the HMO membership enrollment process of that particular client company. Addressing this problem is important since the activation of the HMO membership is critical to the timely delivery of health services to employees of that client company. In cycle 1, our team provided an HR online enrollment platform to effectively manage the accuracy in putting in the membership information and prevent delay in submitting the membership enrollment to the HMO provider. However, after we have created the online HR platform, our team also found another bottleneck in the unclear assignment of tasks involving my company’s staff (Account Broker) and our client’s staff (HR Associate), such that this issue was addressed in cycle 2. Overall, our team was guided by Lewin’s Change Model and Vakola’s Business Process Reengineering Framework for the interventions made during this action research.