The United Healthcare Corporation, headquartered in the United States of America, is an insurance firm whose industry focuses on helping individuals lead healthy lives through the offering of diverse health insurance coverage to its clients. The United Healthcare Group fulfills its mission across two domains, UnitedHealthcare and OPTUM. UnitedHealthcare is committed to delivering healthcare coverage and benefits programs while, on the other hand, it is committed to providing information and technologies to ensure that health services are enabled. A very important position is played in the accomplishment of the organization’s dynamic mission in its inclusive, customer support department. The customer service department serves as the major link between the customer and the organization or in other words customers are connected to the united healthcare group through the customer care department. It is therefore worth noting that for the company to make that sale it takes the effort of the customer care department and this signifies the great correlation between the company products and services, the company sales, the customers, customer care department and the organization in its entirety.
UnitedHealthcare segment of the united healthcare group provides a package of six insurance products or plans which comprise of coverage plans for individuals and families, insurance plans for employers, Medicare plans, plans for healthcare providers, insurance brokerage plans as well as brokerage plans all embedded on health. In all the respective products offered by the organization through the aforementioned business domain, the customer service department has a key role in effecting the products’ sales.
Plans for Individuals and families encompass the provision of health care covers, dental coverage, vision insurance among other insurance policies aimed at meeting the health needs of individuals and families (Unitedhealthgroup.com, 2017). Employer plans entail the provision of coverage options that fit companies of all sizes. Medicare coverage or rather what UnitedHealthcare calls Medicare Advantage plans entail Medicare supplement insurance coverage as well as prescription drug plans. The company as well provides physicians with online resources through its healthcare provider plans. Brokerage plans involve provision of tools and resources to enhance the service of insurance brokers to their customers and span the growth of their businesses, and the network plan assists individuals to access the right healthcare when in need of it which is achieved through an extensive provider network by united healthcare.
Optum is the second business domain of the united healthcare group, and as mention, earlier the business segment focuses on information and technology-enabled health services. The beneficiaries of the service and product portfolio of Optum are employers who through this service can be able to achieve most of their benefits offerings, manage finances of the health care and as well manage population health. Governments through federal agencies, Health and Human Services agencies, state agencies are provided with solutions that enable them to improve their performance while minimizing their costs. Health plans on the other hand benefit from Optum information and technology through membership growth, operational efficiency, risk management, improved clinical quality as well as improved consumer engagement. Through Optum Life, companies can enhance evidence in real-world for direct improvement of clinical care. About care providers, Optum enables clinics and businesses better achieve their performance as well as enabling them to control the transition to value-based care. Individuals and families, on the other hand, benefits from healthier living as result of pharmacy benefits, urgent care, primary care, and health care savings accounts.
The customer care department in the united healthcare group has a vital role in achieving sales for the wide service and product portfolio of the united healthcare group. Some of the department’s roles are:
Handling problems: The first stage in making a purchasing decision for consumers is conducting a research on the product to gain product information and probably use the information to compare benefits of the various substitutes in the market. Meanwhile, consumers will only tend to consider products whose information is readily available or availed in the market, and nonavailability of this information would mean disqualification of the product from the choice list of the consumer. What this means for the company is that it must provide easy and convenient access of its product information to the market if indeed it is interested in selling which then leads to the question of what best way to avail this information. In response to this, the united healthcare group has a customer service department whose major focus is to deal with inquiries and queries from its customers. Health information is sensitive and requires a clear way of dissemination to win the trust of the customers, and this is the only way sales can be made and improved. As such, the united healthcare group ensures that it has the right skills and competence in the customer care department to handle its customers’ problems, providing more information about their products to customers and to handle any rising issue from the customers. This role keeps their customers close, loyal and more willing to spend their money on the company’s products and services.
Sales: Moreover, the customer service department of united healthcare group is as well comprised of the sales agents whose mandate is to directly market the products and services of the company. Some of the team members in this department are full-time sales representatives whose daily business is to meet and engage with prospective customers to bring them on board to the company’s customer base. Sales representative, in this case, provide information about the company’s various health covers or plans and the information technology products and services provided through Optum.
Service delivery process flowchart
Places call with customer care/ contact centre
Contact centre-customer care
Enquires customer requests and provides feedback to the customer
Information and tech. department
Risk management department
Finance & accounting department
Billing and Approval billing and approval
Finance & accounting department
Subscription payment of service fee
Customer covered/subscribes to optum tech.
Flow Chart Diagram Defense
The customer care is the first contact with the customer to the company. The customer care provides the company or rather products and service information to the customer based on inquiries. From the information provided the client independently makes the purchase decision and authorizes a go-ahead.
The marketing departments for UnitedHealthcare and Optum are separate. The marketing officers from the respective domains take up the role of ensuring entry and registration of the customers’ relevant details in the domains database and forwards customers files to the risk management IT Advisory departments in the respective companies. Respective officers in these departments assess the risks involved in insurance for UnitedHealthcare and taking up the contract with optimum with consequent advisory provided to the customers. Personnel in these departments ensure minimum risk to the company while taking into consideration of the core objective of the company.
After risk approval and advisory, billing and all other financial transactions are completed by the finance and accounting department where the department heads of the two business domains finally approve customers’ subscription. The final role of reminding the customer of their periodic bills based on their product or service subscription rests on the customer care which ensures that all service charges are settled on the time and thus efficient cash flow management.
Contact point failures
Market communication gap
Customers have no direct contact with the marketing department which sounds ironically given the fact that the marketing department should have the closest contact with the customer. Instead, in most case, united healthcare group communicates with its customers through the customer care (Hoffman & Bateson, 2001). This signifies market communication gap as most of the clients today narrowly trusts and relies on the customer care’s information.
In my recommendation, united healthcare group should maximize its contact with the customers by linking customers directly to the marketing department or rather team for a comprehensive communication and what customers feel like credible information from a credible source. Customers feel more valued when they gave an interior access to the organization for information rather than being stopped at reception or customer care desk. This will as well increase their loyalty which ultimately translates to revenues.
Perceived service quality gap
The service delivery process for the company denies links between the customer and the finance and accounting department. Clients are very sensitive to financial information and therefore denying them direct access to finance either for purposes of advisory for specific purposes or any other purpose undermines the perceived quality of the brand in terms transparency in the minds of consumers (Lewis, 1995).
I would recommend United healthcare group to establish as a system that gives customers direct access to finance and accounting to boost its transparency and credibility which will largely contribute to the perception of quality in the customer’s minds. It will be hard for customers to default on a system they perceive credible and it will be easy for them to pay for the services rendered and thus reducing the risks of defaults to the company.
The service delivery process for the company limits the connection between the management and customers. The best management approach is not only the one that understands its employees but also one that understands its customers and therefore when the connection between the two critical sides of the business is limited there is a high likelihood of management failure and poor delivery of services (Kelley & Kelley, 2016). An organization is a system or somewhat interlinked subsystem where customers are a critical part of the system and thus requires more understanding by the management to avoid organizational failure. Linking customers to only the customer care is not enough. In my recommendation, therefore, management can only be effective and productive when it understands the people it serves and thus the great need for United Health Care Group to enable more connections between the customers and various departmental management.
Hoffman, K. D., & Bateson, J. E. (2001). Essentials of services marketing: Concepts, strategies and cases. South-Western Pub.
Hoffman, K. D., Kelley, S. W., & Rotalsky, H. M. (1995). Tracking service failures and employee recovery efforts. Journal of Services Marketing, 9(2), 49-61.
Hollins, B., & Shinkins, S. (2006). Managing service operations: Design and implementation. Sage.
Kelley, S. W., & Kelley, S. W. (2016). Retrospective: efficiency in service delivery: technological or humanistic approaches?. Journal of Services Marketing, 30(2), 133-135.
Lewis, B. R. (1995). 9 Customer care and service quality. Marketing Financial Services, 193.
Unitedhealthgroup.com. (2017). Optum Products & Services. Unitedhealthgroup.com. Retrieved 7 December 2017, from http://www.unitedhealthgroup.com/Businesses/Optum.aspx