In today’s evolving healthcare landscape, experience is no longer a differentiator; it’s an expectation. Payers face growing pressure to deliver seamless, personalized interactions not only for members but also for providers.
Our end-to-end intelligent Customer Experience Management (CXM) solutions simplify interactions and drive impactful outcomes—all while ensuring regulatory compliance. Our solutions help payers unlock:
- Lower operational costs powered by automated workflows, AI-guided interactions
- Higher member and provider satisfaction through frictionless omnichannel engagement
- Greater agility and efficiency
- Improved resolution rates with agent-assist technologies
10-20%
NPS increase
70%
Boost in agent productivity
5-15%
Improvement in FCR/resolution rate
20%
Contact deflection via self-service
30%+
Operational cost savings
Our Solutions
We bring 38+ years of healthcare expertise, 15+ cutting-edge digital CX solutions, and human-centered design to help healthcare payers radically improve how they serve members and providers. By combining design thinking, digital engineering, and AI embedded into live interactions, we enable continuous improvement in experience, resolution, and operational efficiency.
Customer Lifecycle Management
Personalize member journeys using AI and data insights to improve engagement across the lifecycle.
Member Engagement Services
Deliver omnichannel engagement with AI that personalizes interactions based on real member behavior.
Contact Center Operations
Enable proactive engagement with AI that improves resolution and reduces friction across interactions.
Appeals & Grievances (A&G) and Provider Disputes
Accelerate resolutions with workflow automation and case tracking tailored for regulatory compliance.
Channel & Self-Service Optimization
Optimize self-service channels with AI to improve containment, adoption, and overall service quality.
Provider Engagement Services
Simplify provider interactions with AI-enabled workflows to improve efficiency and service quality.
Personalize member journeys using AI and data insights to improve engagement across the lifecycle.
Deliver omnichannel engagement with AI that personalizes interactions based on real member behavior.
Enable proactive engagement with AI that improves resolution and reduces friction across interactions.
Accelerate resolutions with workflow automation and case tracking tailored for regulatory compliance.
Optimize self-service channels with AI to improve containment, adoption, and overall service quality.
Simplify provider interactions with AI-enabled workflows to improve efficiency and service quality.
Platforms
Why Sutherland
Deep Domain Expertise
With 30+ years of experience and 4000+ payer domain operation experts, we are uniquely positioned to deliver measurable outcomes through our advanced healthcare payer solutions and healthcare payer services.
Cost Savings
Harnessing 15+ payer digital platforms, we can help healthcare payers streamline operations and reduce administrative overhead to reduce costs to enable competitive pricing and optimize resource allocation.
End-to-End Transformation Partner
A carefully selected set of enterprise and point solution partners across the payer value stream help deliver exceptionally engineered experiences.
Outcome-Based Engagement Model
More than 70% of our client engagements use outcome-based/TCO models, meaning we take full ownership across the entire lifecycle to deliver outcomes aligned to specific business goals.