Upon review of the briefing document for DocSystems Billing, Inc., it is clear that problems exist within the organization, both at the surface along with potentially some underlying issues in the teams. In order to present a recommendation to the client, it will be important to identify the problems that exist within the organization, analyze how these problems differ within each area of the organization, and understand why the employees did not like a proposed process change to improve the situation. The recommendation will include a summary of observations, interpretations, and options for next steps. I will start with looking at the basic problems identified at the organization level as reported by Jim, the senior director in the organization. Jim is concerned about the overall processing times at the call center, including ensuring physicians get payments quickly and patient problems and appeals are services in a timely manner.
By asking more detailed questions, it seems the issue is not related to the Billing Specialist team (which was recently outsourced), but is more focused within the MIS (Medical Insurance Specialist) team, which is one of the teams that report thru a manager to Jim. Jim explained that the payment processing starts with the Billing Specialists, and gets escalated to the MIS team when problems arise with a payment. Jim explained that the delays in processing seem to be coming from this team due to heavy workload and juggling questions from the Billing Specialist team. He provided the example of the Platinum Tier physicians, who expected resolution in two to three hours, but are not getting issues resolved for fifteen hours. If the MIS team cannot resolve a payment issue, the payment can then get escalated to the SIC (Senior Insurance Consultants) team, who deal with the very complex payment processing, but this handoff does not seem to be happening on a regular basis. The SIC team also reports thru a manager up to Jim. Ultimately, Jim is looking for more collaboration on the teams to get the customer satisfaction increased.
After finishing my conversation with Jim, I asked to talk to some of the team members of the SIC team and the MIS team. I was surprised to hear a different perspective from these teams. I initially met with Rosie from the MIS team. I observed her work environment and asked questions about her role. She explained the various cases she was currently working on and explained that she was waiting to hear back from either physicians or patients on many of the cases. We discussed one case in particular that seemed very complex, and when I asked if she ever escalated these types of cases, she informed me that she liked working her own cases. Then an underlying issue was uncovered when she raised the concern that her job would be outsourced if she did not handle everything. When I asked her about the potential for the SIC team to share the workload, another underlying issue came to light with her response that big brother would be watching over her. Next, I met with Carlos, who is on the SIC team. He had been at the company for nineteen years and seemed very confident in his abilities.
I observed that his work load was significant less than Rosie and discovered that this was a fairly typical situation. During my conversation with Carlos, he pulled one of his team members, Michelle, into the discussion. As they talked more about their work load, an underlying issue surfaced when Michelle commented about the re-organization and the lack of interaction with their new manager. They also commented on the fact that they all received the same standard raise each year, no matter how much work was completed. I gleaned that they had no motivation to take on more work because they were not paid for their performance. The next day the team assembled for a design session to discuss a new process that Jim wanted the team to consider implementing. In addition to Jim, both Carlos and Rosie were in attendance, along with a manager from one of the call center groups. As the facilitator, I explained the approach that Jim suggested, which included more collaboration between the MIS team and the SIC team, that included the SIC team monitoring the cases and pulling them away from the MIS team.
Everyone seemed enthusiastic with the process change and did not raise any objections. After a break for lunch, Carlos started raising objections to the proposed solution. He felt this change would mean more work for the SIC team and felt the MIC team would pawn off tough cases. He saw the MIC team as lazy and not willing to voluntarily take on new cases. Once this objection surfaced, the agreement to the proposed process change could not be agreed upon, so the meeting adjured. Before I meet with Jim again, I wanted to re-analyze the data from all the groups to come up with a recommendation on how to proceed. First I looked at the data gathered from my interview and observations with Rosie. To summarize her concerns, she is very worried about her job being outsourced and she does not want her cases to be taken over by some else. In my opinion, these fears make her inefficient in getting the customer’s payment issues resolved because she will not allow anyone to help. I then looked at the data from meeting with Carlos and Michelle. They had completely different concerns that initially focused around the re-organization and the lack of interaction with their new manager and their standard pay raises, but then shifted to concerns about taking on additional work from the MIC team.
In my opinion, they were being pushed out of their comfort zone and were not interested in helping the organization improve. It seems there is no drive for them to take on additional responsibilities because they are not getting any incentives, either from their manager or from their compensation. Based on this data, I started formulating a recommendation for next steps that I plan to review with Jim at our next meeting. Based on the fact that the two teams have been in place for a while, I thought the Work Redesign intervention described by Hackman and Oldham (1980) would be a good approach since it focuses on structuring the work to be performed effectively while also being personally rewarding and satisfying for the employees. The first step in this intervention involves a Job Diagnostic Survey which was created by Hackman and Oldham (1980) to gather more detail about the tasks being done by a team.
This survey can be administered to both the MIS team and the SIC team to determine if the current tasks are well defined. I can work with Jim and the teams to look for ways to design the tasks more effectively by combining tasks, forming work units, establishing client relationships, vertically loading the job, and opening feedback channels. In order for this approach to be successful, it will be important to have incentives for the employees. Hackman and Oldham (1980) recommend that an appropriate compensation and reward system is established to ensure there is recognition for improved performance. I also determined that the Workout intervention, mentioned by Anderson (2012), would be a valuable exercise to help the team uncover ideas to remove inefficiencies from the process. The Workout session describes a five-step process (Ulrich et al., 2002). The first step is the introduction where participants learn about the goals, purpose, and structure of the meeting.
Next, the team brainstorms on ideas of what should be accomplished during the process, which leads to the third step to identify the top ten ideas. In the next phase, the teams look at action planning where they expand on the ideas and identify actions that can be taken to improve the situation. The final step is a town meeting where the participants present their ideas to senior management. After this session has completed, and the teams start implementing the actions, Jim will need to check on progress to ensure the team is staying on the right track. In conclusion, I feel by using both of these intervention processes, the teams are taking ownership in solving the problem for the organization, instead of being forced into a process they did not think would work. The first intervention should help resolve the organization issues with processing times and team collaboration by helping the team look at the big picture, then drilling down into the specific tasks that will improve these issues. It should also help the team feel more rewarded and more committed to improving the processing times for the organization.
I am hoping that the second intervention will help resolve the underlying issues within each individual team and cross-teams to improve inter-team working relationships and help the teams gain a sense of ownership among them and as an organization. When I look at the various intervention approaches from an individual and team perspective, I’ve been trying to determine how I can apply this to my team at work. As a manager, I am constantly applying the individual interventions such as coaching and mentoring. For example, one of my peers is new to management and is struggling to move from an individual contributor role to a manager role. I have offered to meet with him once a week to provide advice and direction when management situations arise within his team.
This has helped him become a better manager in a shorter period of time. I also provide coaching on a daily basis with my employees. I try to coach in real-time, so my team understands what they could potentially do differently in the future to achieve a better outcome. This helps improve their performance quickly, instead of waiting until a performance review to discuss issues. From a team perspective, I have noticed we have some issues between cross-functional teams which need to be addressed. I will need to work through the process of gathering more data and do diagnosis on the information before I can determine which team intervention would work for the groups.
Anderson, D. L. (2012). Organization development: The process of leading organizational change (2nd ed.). Thousand Oaks, CA: Sage Publications. Hackman, J.R., & Oldham, G.R. (1980). Work redesign. Reading, MA: Addison-Wesley. Ulrich, D., Kerr, S., & Ashkenas, R. (2002). The GE work-out. New York: McGraw-Hill.
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