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CVS - BIDS & ORDERING PROCESSING MANAGEMENT
CVS Health currently used a manual process for enrolling clients and members in the Medicare Part D Program. The enrollment process consisted of multiple hand-offs, lack of integration between various backend legacy systems, and lack of a Centralized Enrollment Repository. These were primary contributors for many of the operational and architectural challenges, making the existing process unsustainable to support projected member growth.
The project aimed to deliver a centralized work flow, implement approval processes, provide audit and tracking capabilities, and integrate seamlessly with core legacy enrollment systems to handle membership volume growth. To accomplish its goals, CVS Health chose Pega Rules Process Commander (PRPC) and tasked the experienced team at TechCORE MSS formerly known as ArchiTECH Solutions to build and deliver a simplified, scalable, flexible, and state-of-the-art enrollment system of the future.
The end result included centralized workflow, newly designed approval processes, efficient and easy to use audit and tracking capabilities, and integration with the core legacy enrollment systems. Automated processes decreased time for new enrollments and changes to existing client accounts from two weeks to 24 hours.