Engage for Health Plans

Purpose-built relationship management for health plans

Product Overview

Hitachi Solutions Engage for Health Plans offers providers a practical solution to effectively manage and foster profitable relationships across agencies, customers, brokers, and other partners. Our solution enables you to focus on all aspects of your business and the customer lifecycle, from relationship and engagement management to business development.

Business outcomes

  • Streamline the onboarding process from end to end, giving everyone visibility into execution and data at every stage so they can work together efficiently
  • View current and historical plan information, agency performance metrics, and upcoming activities customized to each user’s role
  • Find people with unmet insurance needs with rich analysis and segmentation tools that help identify the best prospects
  • Convert leads to policy with structured processes for following up on leads, advancing opportunities in the pipeline, and bringing new plans on board quickly

With Dynamics 365, we can build a single view into the heartbeat of every member, while we deliver more interoperability to providers, partners, members, and employees.

Michael Della Villa, Chief Information Officer, MVP Health Care

Read the customer story
Provider Services Dashboard Screenshot

Quote to card

Execute better across the entire quote-to-card lifecycle

Allows you to provide superior transactions and engagements, every time. The solution gives you a holistic view of all data from one system consolidates the entire process into a single and automated workflow, personalizes and speeds interactions, and integrates across all channels.  It also provides dashboards, performance management, and automated tasks to help you execute better across the entire quote-to-card lifecycle.

  • Opportunity management: Identify and execute on sales opportunities with better collaboration, tracking, and process management
  • Group and individual segmentation: Grow premium by zeroing in on good leads, including group opportunities in your area or individuals who have recently moved from a group
  • Lead management: Streamline and automate lead management and ensure consistent follow-up on leads generated from the exchange
Provider Services Dashboard Screenshot

Group plan administration module

Engage everyone in the process

Process plan onboarding and renewals quickly and efficiently, giving everyone full visibility into the process and clear next actions to drive completion. The Group Plan Administration module gives health plan administrators a comprehensive end-to-end platform for managing onboarding and renewals that engages everyone in the process.

  • Group segmentation: Better understand your customers and use data points such as company, organization, division, and plan details to effectively group and segment them
  • Onboarding and renewal management: Automatically create, assign, and track all tasks and information associated with plan onboarding, so your teams can process new health insurance payers quickly and efficiently
  • Implementation management: Automate the implementation process to increase efficiency and capture changes with ease
  • Report automation and summary of benefits: Automatically create scheduled reports and summary of benefits documentation to save time and ensure the highest degree of accuracy

Member integration toolbox

Put data to work

Establish a true, 360-degree view of each member by rapidly integrating disparate systems in accordance with industry best practices. The Member Integration toolbox helps you aggregate member and plan data from policy administration, claims, billing, imaging, document management, and other systems so you can put that data to use.

Provider Services Dashboard Screenshot

Distributor relationship management module

Promote greater ease of doing business

Make it easier for your distributors to work with you and turn the strength of your distributor relationships into a powerful competitive differentiator. The Distributor Relationship Management module provides performance management and superior visibility into your distributor network, along with tools that promote greater ease of doing business.

  • Agent and broker performance management: Improve visibility into distributor performance, such as premium goals and submissions, so you can understand the value of your relationships and find opportunities to better work together
  • Agent and broker sales plans and call reports: Make sure you’re well prepared for each interaction or agency visit with a complete understanding of performance metrics, interaction history, and recommended actions
  • Agent/broker portal: Make it easier to find and share information, stay connected, and work together to achieve desired outcomes by interacting with distributors via web portal
  • Interaction journal: Track interactions with distributors to better to gain insight into your relationship history and monitor how your relationships have changed over time
Provider Services Dashboard Screenshot

Member care module

Provide better service

Truly focus on providing superior member services by giving everyone a complete view of member information along with intuitive service tools. The member care module helps you provide better service in the call center and manage interactions across service, marketing, billing, and all other touchpoints.

  • Member 360: Get a complete view of member data—no matter where it’s stored—so you can communicate the right message at the right time and resolve service requests quickly and accurately
  • Telephony integration and call center console: Give call center agents a consolidated desktop that exposes health insurance payer information, service apps, and guidance in the context of every service call
  • Case management: Improve resolution by capturing customer information and efficiently managing cases from end to end
Provider Services Dashboard Screenshot

Provider services module

Get visibility into provider organizations

Engage for Health Plans helps store, represent, and manage all the complexities in provider information and relationships. The Provider Services module gives you visibility into provider organizations, including basic organization details, activities, and grievance management.

  • Provider 360: Improve member and provider satisfaction with access to better information to support greater alignment between members and providers
  • Provider Calls and Visits: Foster consistent, productive provider engagement with intuitive planning, best practices, and reporting tools
  • Grievance Management: Give providers reliable information about member grievances and improves response time for providers and members

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