Client acts as an outsourcing partner to health plans, and other payors/clients to manage the Pre-Authorization process for high spend, high-risk clinical categories.
Inspirant has been engaged to assist Client in building a Claims Matching capability. This connects Client to claims before they are paid and allows Client to take direct control of matching prior authorizations to claim lines for payment. The value of the Claims Match solution is that it allows Claim to sell Pre-Authorization solutions to clients that have older, or less sophisticated, claims systems. The Claims Match solution takes the burden of matching the Pre-Auth off of the health plan claims team during an Claim implementation. The Claims Matcher solution was custom built using Java and Appian technologies.
Client is one of the largest customer-owned health insurers in the United States and fourth largest overall, operating multiple plans throughout the country. Client affiliates and subsidiaries offer group life, disability, and dental solutions, as well as a range of other individual solutions. The company serves more than 15 million members across five states and employs more than 20,000 people in over 60 local offices.
Inspirant Group has been engaged has been engaged to assist Client with several initiatives, including:
- Delivery and Technology support of system integrations for government programs
- Change Management and Implementation and of a new utilization management system
- Reporting and Data Analytics
Client is a division of a large power provider headquartered in the United States. Client operates the largest number of carbon-free nuclear plants in the United States. With 23 reactors at 14 sites in Illinois, Maryland, New Jersey, New York, and Pennsylvania, Client has the capacity to generate 20,300 megawatts of electricity.
Inspirant has been engaged to assist Client in their Digital Transformation. Many processes are currently done using paper which is not ideal in today's digital world. It makes responsibilities like reporting and quality control a challenge because all the data must be culled manually which takes time and is error-prone. Inspirant is helping implement Appian, a BPM platform, to facilitate the move to electronic data capture and reporting for their processes. In addition to this being a significant technical challenge, it also comes with the challenge of changing an ingrained culture that is hyper-focused on safety. Any changes to the way things are done must be approached carefully and thoughtfully.
For more than 100 years, Client has provided exceptional service to clients around the world in complex litigation, corporate and tax, intellectual property, restructuring, and counseling matters. The groundwork has been established for another century of superior legal work and client service.
Inspirant has been engaged to deliver ongoing Change Management and Talent Development work for Client’s over 2500 staff located across the globe. Current projects include standardizing firmwide core competencies, defining core values, educating staff on them through a series of interactive workshops, and partnering with firm executive staff on delivering leadership “fireside chats” for high potential firm leaders.