Member experience platform serving 22M lives.
The payer's digital estate had grown through product launches, acquisitions, and vendor changes. We consolidated member access, care navigation, and plan servicing into a single front door that still respected market, employer, and regulatory differences behind the scenes.
The situation we walked into.
Members were logging into different portals for claims, benefits, pharmacy, care navigation, and provider messaging. Call-centre agents had become the human glue between systems that should already have been connected.
The payer wanted a unified experience without forcing a massive backend rewrite upfront. That meant front-end coherence, API mediation, and a carefully sequenced retirement plan for legacy surfaces.
A simplified view of the delivery shape, the control points that mattered, and the signals the client team used to keep the program on track.
The changes that made the outcome possible.
Experience blueprint
We mapped high-friction journeys across commercial, Medicare, and employer-sponsored plans to define one front-door pattern.
Identity and access
A new identity layer gave members, providers, and caregivers context-aware access without duplicate credentials.
Journey orchestration
Claims, benefits, pharmacy, and care programs were stitched together behind APIs and notification services.
Service deflection
Agent tools and member self-service were designed together so contact-centre scripts matched digital flows.
How the delivery moved from pilot to scaled operation.
Journey prioritisation
We targeted the member tasks generating the highest avoidable call volume and the most fragmented entry points.
Platform foundation
Identity, navigation, and content services shipped first so old and new journeys could coexist safely.
Journey migration
Benefits, claims status, pharmacy, and care messaging moved into the new front door in waves.
Legacy retirement
Portals and support scripts were decommissioned in lockstep with adoption metrics and agent feedback.
What changed after the transformation settled into the run.
Members found answers faster
High-volume service requests became trackable self-service flows with fewer dead ends and clearer next steps.
Agents got a single context view
Call-centre teams could see what the member had already tried, which shortened calls and improved first-contact resolution.
Digital experience became measurable
Product teams now improve journeys using task completion, abandon points, and deflection data instead of anecdotes.
The biggest win was not the app score. It was hearing our service teams say the digital journey finally matched the conversation they wanted to have with members.Chief Experience Officer - National healthcare payer