Acting on Risk Appetite and Tolerances
Company Size
1,000+
Region
- America
Country
- United States
Product
- LogicManager
Tech Stack
- Enterprise Risk Management Software
Implementation Scale
- Enterprise-wide Deployment
Impact Metrics
- Cost Savings
- Customer Satisfaction
Technology Category
- Application Infrastructure & Middleware - Data Exchange & Integration
Applicable Industries
- Healthcare & Hospitals
Applicable Functions
- Business Operation
Services
- Data Science Services
- System Integration
About The Customer
The customer is a large health plan provider that provides coverage to more than half of its state's population. With a membership of over 500,000, the customer works alongside industry partners like the National Committee for Quality Assurance (NCQA) to continue providing affordable plans to its members. The customer extends its impact through an affiliated nonprofit foundation that supports social welfare and increased access to healthcare services. The company is a nonprofit organization with 1,000 - 5,000 employees and $2.9B in revenue. The company operates in the insurance industry.
The Challenge
The health insurance provider was facing major cash flow disruptions due to sudden losses of large accounts to competitors, especially during renewals. The company had multiple divisions and products, and used spreadsheets to report separate account revenue and cost data to the CFO. Connecting revenue to the direct costs, aggregating this information, and tracking data over time were error-prone and time-consuming processes. The cross-functional nature of product usage and double counting data made results difficult to interpret accurately.
The Solution
The customer used LogicManager to monitor revenue and direct costs from multiple systems, aggregating this information to track data over time. Visualizing these trends in charts provided a clearer picture over time. The customer discovered that a major cause of cash flow issues was the acquisition of existing members by competitors, especially during renewals of large accounts. In response to the new data collection methods, the customer was able to set risk tolerances on losses of key accounts, as well as their impact on cash flow. Formalized risk tolerances allowed the risk manager to build a business case for developing and deploying educational programs designed to decrease customer claims and prevent the increase of insurance premiums.
Operational Impact
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