MaxorPlus operates in a complex, highly regulated industry, administering prescription drug benefits for over 300 employers nationwide. As a pharmacy benefit manager, it manages prescription distribution and formulary creation for healthcare plans. To ensure cost-effective access to medications, MaxorPlus navigates intricate networks of pharmacies, drug manufacturers, and healthcare providers.
“We have to provide an extended level of service because we’re dealing with members’ medications—and there aren’t many things more important than that,” says Mitch Mann, Vice President for Member Services at MaxorPlus.
This makes customer service a pivotal part of MaxorPlus’s operations, with Mann in charge of ensuring that every interaction meets high standards of quality and efficiency. His teams of agents—called “member advocates”—handle about 40,000 calls a month, mostly from members inquiring about their mail-order prescriptions or plan benefits, from coverage and deductibles to out-of-pocket payments.
Balancing Efficiency and Customer Experience
However, building a team of dedicated and well-qualified member advocates is not without challenges. Training also poses a significant challenge to MaxorPlus. The company’s training program is virtual and lasts six weeks, which is not always easy to manage effectively.
“Remote work adds challenges in connecting and engaging with people, so we emphasize culture, recognition, reward, and growth opportunities,” says Mann.
Spread across 15 states, his teams of member advocates work fully remotely, requiring ongoing adaptation in training methods to ensure effective skills development. Their supervisors also have limited understanding of the day-to-day challenges member advocates face when accessing necessary resources, and they lack opportunities for over-the-shoulder shadowing and coaching.
Overall, MaxorPlus aims to maintain strong customer service without sacrificing efficiency, and vice versa. So while average handling time (AHT) significantly influences staffing decisions, the company doesn’t want to compromise the quality of customer service just to shorten call times. This is why it also considers other important metrics such as first call resolution and customer satisfaction.
As Mann stresses, “Efficiency is crucial, but so is customer experience.”
Empowering Supervisors with Full Insights
To help address these needs and complexities, MaxorPlus adopted Observe.AI. In particular, it utilized Screen Recording and Agent Performance and Coaching capabilities to improve member advocate performance monitoring and coaching.
Previously, MaxorPlus supervisors struggled with limited insight into escalated conversations. There was no visibility into whether member advocates were adhering to processes and using tools and resources correctly, making it difficult and time-consuming to investigate areas of confusion.
With Observe.AI Screen Recording, supervisors have gained a 360° view of conversations, including audio, screen activity, transcripts, and metadata on a single pane of glass. This comprehensive view enables them to evaluate and coach member advocates effectively. They can efficiently uncover the root causes behind AHT and call escalations by watching member advocates’ screen recordings, helping validate performance issues and provide 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. We also don’t need to pull someone into a breakout room to listen to a call.”
To ensure compliance when accessing sensitive data such as protected health information, supervisors use Observe.AI features like selective redaction and authentication verification. Screen Recording also enables them to review interactions without compromising patient privacy.
“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,” explains Mann.
Enhanced Skills and Career Development
The ability to monitor performance more effectively using Screen Recording and to provide proactive coaching has led to better career development opportunities at MaxorPlus, with more than 100 member advocates recently earning promotions. Supervisors have increased their coaching sessions after implementing a new program that includes weekly call monitoring.
“Observe.AI empowers us to do coaching more efficiently and effectively, saving our leadership time and enhancing performance,” shares Mann.
As a result, his teams achieved a 7% improvement in AHT and a 2% increase in customer satisfaction between January and April 2024. Quality assurance (QA) scores also rose by 2% during this period.
“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.”
Better Client Support Through Timely Data Delivery
Observe.AI’s Screen Recording functionality has proven instrumental in enabling MaxorPlus to address critical issues for its clients. For example, MaxorPlus utilized Observe.AI to help a client quickly identify relevant calls, using keyword searches to extract inquiries, evaluate interactions, and promptly gather data.
“This ability to deliver key data in a timely and effective manner helped us demonstrate excellent support for our client during a difficult time,” says Mann. “It further strengthened our relationship and enhanced our ability to manage our business more effectively.”
Positioning for Success
As MaxorPlus expands its operations, the company anticipates significant growth and new opportunities. “We expect to get into Medicaid and Medicare in 2026, which will only increase the demand for highly skilled member advocates,” says Mann.
To support this growth, MaxorPlus will continue adopting advanced solutions like Observe.AI to enhance 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,” adds Mann.
Book a demo today or explore the new features of Observe.AI to enhance your operations.
.png)
.png)
.png)
.png)
.png)
.png)
.png)
