As a leading pharmacy benefit manager, MaxorPlus administers prescription drug benefits for the employees of more than 300 organizations across the United States. Its mission is to ensure members have seamless access to their medications by navigating networks of pharmacies, drug manufacturers, and healthcare providers. To achieve this, the company has embraced cutting-edge solutions such as Observe.AI.
Balancing Efficiency and Quality
MaxorPlus’s agents—called “member advocates”—handle about 40,000 calls a month, and address everything from mail-order prescriptions to healthcare plan benefits. Training these member advocates has been difficult because they work fully remotely, spread across 15 states. Supervisors also had limited understanding of the challenges member advocates face when accessing necessary resources. These challenges included a lack of visibility on how to adhere to work processes, and properly use tools and systems.
To uphold high standards of customer service without compromising efficiency, MaxorPlus turned to Observe.AI. It implemented Screen Recording as well as Agent Performance and Coaching capabilities to improve performance monitoring and training.
Full Insights into Interactions
By deploying Observe.AI Screen Recording, supervisors gained a comprehensive view of member advocates’ conversations, including audio, screen activity, transcripts, and metadata. This 360-degree view enables effective advocate evaluation and coaching. Supervisors can uncover the underlying causes of high average handle times and call escalations by reviewing screen recordings, validating performance issues, and providing targeted training opportunities.
“Before, we could just hear the call,” says Mann. “But with Screen Recording, we can see the call and what the member advocates are doing. So, we can be more effective in our skills development and understand what’s going on.”
Observe.AI also ensures compliance with sensitive data through features like selective redaction and authentication verification, promoting adherence to regulations.
According to Mann, “We have to work with partners that are also compliant and support our regulatory requirements because the consequences of non-compliance are quite significant in our industry.”
Driving Performance Excellence
Enhanced performance monitoring and proactive coaching have resulted in better career development opportunities, with more than 100 member advocates earning promotions. Weekly call monitoring has also increased coaching sessions.
As Mann highlights, “Observe.AI empowers us to do coaching more efficiently and effectively, saving our leadership time and enhancing performance.”
This led to a 7% improvement in average handle time and a 2% increase in customer satisfaction between January and April 2024. Quality assurance scores also rose by 2%.
“We typically run very high customer satisfaction scores, so seeing a 2% increase is significant,” notes Mann. “And for the QA scores, we increased our results while transitioning to a radically different scorecard.”
Timely Data Delivery
Likewise, Screen Recording has helped MaxorPlus efficiently address critical issues for clients. The ability to quickly identify relevant calls using keyword searches has proven instrumental in delivering data promptly, strengthening client service and business relationships.
“This ability to deliver key data in a timely and effective manner helped us demonstrate excellent support,” shares Mann.
Setting the Stage for Greater Success
As MaxorPlus anticipates significant growth and new opportunities, including entry into Medicaid and Medicare in 2026, it expects demand for highly skilled member advocates to increase. To support this growth, the company plans to continue leveraging advanced solutions like Observe.AI for better performance monitoring, coaching, and customer experience.
“Our partnership with Observe.AI strengthens our ability to operate efficiently and positions us for success in navigating the complexities of the healthcare industry,” says Mann.
Discover how MaxorPlus elevated the patient experience with Observe.AI. Read the full customer success story and request a demo!
