BACKGROUND

HealthRules Payor is HealthEdge's mainstay product. It is a next generation core administration system that provides transformational capabilities to health plans of all types and sizes. This product has hundreds of features that cater to Health Plan's IT. Overall it caters to over 800 users and over 20 customers some of who are the big names in the insurance landscape.

BUSINESS PROBLEM

Every feature done in Payor is extremely complicated. Before I joined HealthEdge, the product managers rarely reviewed the intended solution, design approach and screens with customers and end users. This resulted in multiple Sales Force tickets for missed or misunderstood functionality, usability and user flow.

MY ROLE

After doing extensive Payor research, I shared the Payor persons with the entire company. Those personas started being used during stories writing and gooming. Every complicated feature now goes through UX exercise as shown below. The proposed solutions and alternates in the same are reviewed with customers ahead of time to make sure we are hitting the mark and small changes can be catered to early. Focus is very strong on prototyping. My team also conducted surveys for smaller features. At the other end of it, continuous Usability Testing is done to ensure the new features are not pain points. I provided close supervision, cross functional team support, framework and direction to the team that did most of the work. I guided the team to solve Information Architecture problem first. I pitched in with ideas.

DOMAINS

Health care IT, Health care Insurance, Claims Adjudication

UX

User Research, Interaction Diagramming, User Flows, Prototyping, Design Reviews, Usability Testing, Surveys

TOOLS

Invision, Sketch

The following are some of highlighted projects which were received very well. I mostly

Net Adjustments View

Here the claims adjustor needs to be able to see a summary view of all adjustments rather then spending times in individual claim lines and doing the math.

This was a part of team's research

End Result

USER METRICS

Customer Service Reps, Claims adjusters and their supervisors can see their work metrics. (Team effort)

CLAIMS SUMMARY

Claims adjusters can see all the main pieces of the claims summary in one place. (Team Effort)

CUSTOMIZABLE TABS

When we want to provide multiple sub views via tabs, we had to research and find the right pattern. This was done via surveys. (Junior UX Designer's effort)