WK4 SUMMATIVE ASSESSMENT GEMBA WALK AND OPPORTUNITIES FOR IMPROVEMENT

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Feb 20, 2024

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Summative Assessment: Gemba Walk and Opportunity for Improvement Renetta Roland University of Phoenix MHA/505 Doria Chege 04/02/2023

United Health Care Group/Optum360 United Health Group/Optum360 is a large organization that has smaller organizations under one umbrella. The organization that I worked with is Optum and the position I currently held is entry-level claims billing. Gemba Walk will help me with my future goals with the company and while doing a SWOT analysis, it will show how the company can cover the gaps and provide improvements throughout the organization floor. Our product and services with Optum360 are lab testing with Quest Diagnostics. We do patient and client billing. The labs get the requisition from the doctor, and they draw blood; file the insurance and get test results. The billing department makes sure that it is billed correctly to the insurance and the patient. The overall mission is to help people live healthier lives and help make the health system work better for everyone. Mission & Values - UnitedHealth Group (2023). Some of the values that the company have are building a trusting relationship with the patient and staff. Having compassion for the people we work with whether it is internal or external, being innovative with updated equipment, and performing our best. But, with any company, there are challenges, especially with change and growth. The step-by-step Gemba Walk will show where gaps are and what options we should review to close them and show improvement overall. Observation/Call Center Working in a call center, a health care call center can be very stressful because regulations and health care guidelines apply to us as well. The only that is different we must take account of AHT, Hold Time, and intake call productions, all while staying in compliance with HIPAA. Since call centers are numbers-driven, sometimes we can lose sight of the employee’s health and well-being. Doing the SWOT analysis, showed where we fall short with communication and updated technology. Lacking communication can lead to confusion and a

high turnover rate. When technology is outdated, it allows frustration among patients and employees. The patients are trying to review bills on the patient portal and the system crashes, they call claims billing, and we provide information that the patient can’t see and making the call volume rise because customer services are trying to de-escalate the call and then the patient threats to go to our competitor LabCorp because there’s systems are more updated, and the wait time is not long. Now the company is using the information from surveys to better serve the patients and now the company proving the staff with more updated equipment and our IT team is more available to deal with technical issues that will arise during a call. Our workforce management team is forecasting the call volume to schedule the staff better to take calls more efficiently. Gemba Walk If I was in management, I would utilize Gemba Walk to have a successful call center. The first thing I would do is create a team and this team will be a person from each level of management, this way it will show different points of view. The focal point of the team is to watch for KPIs and how to make it manageable for the floor to reach and the patients that are calling in are taken care of in a timely manner. Once a team is created, communicate this information to the floor so that everyone is aware that someone will come around and ask questions, so that they do not feel intimidated and be able to build up enough trust so that they can be honest on what will make the process easier to work. Also, communicate that different people will come by during a certain time. Once the team gathers all the information from the employees that provided feedback on what will make the process more effective, they will create a SWOT analysis and come up with options on how to close the gap. After careful review, have a team huddle explaining the Gemba

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