Case Study

Expedited global delivery location shift due to state regulations.

A regional health plan serving Medicare, Medicaid, and commercial members in New York.


Case Study - Large NY Health Plan
Business Process Transformation
Digital Transformation

The Problem

Since 2014, Sutherland and the client have had a strong partnership. Employees in the US, India, and Philippines provide a wide- range of services to the client including claims administration, customer engagement, and provider data management. In 2016, regulators caught our client by surprise with a new requirement for a quick and sudden shift of their existing non-US claims operations to a US-based location. Our client knew this quick transition had to happen without any impact to their large claims volumes and already high quality scores. To make this happen, our client needed a partner with a wide set of global sites to choose from and the expertise to quickly and efficiently transition existing operations, without any impact to their members or providers.

The Sutherland Transformation

Our client trusted Sutherland to handle this operational transformation. To begin, Sutherland consulted the client on their various geographical options, leading to the client choosing Sutherland’s Houston, Texas site as their location for claims administration services. We then created a transition plan that was to be implemented in four waves over a handful of months. The transition began by working with managers and subject matter experts (SMEs) from the existing site to create a mentoring and training program for new Houston employees as services began to transition to them. Real-time feedback was provided to the Houston employees to give them real hands-on experience. Our client was able to focus on their core operations while Sutherland managed the transitions on their behalf.

Sutherland has the experience and expertise to quickly transition new and existing operations to our wide set of global delivery sites and into the cloud.

The Results

Sutherland fully transitioned claims operations to the new site and did it on schedule. The claims production never dipped, staying at or above their pre-Houston levels. Given the current economic, political, and regulatory environment in healthcare, we continue to consult with the client’s leadership team about their global operations strategy so they can stay one step ahead of the competition and ever-changing regulations.

Today, Sutherland and the client have:

employees providing high quality services
global delivery sites

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