MHA 505 week 4 (2.5 pages)

Introduction

A Gemba walk is a process a company would take to try to show were a company goes wrong and sees what kind of improvements can be made.

When using Gemba Walk in a company one needs to keep in mind the mission statement. With my place of employment the mission statement is “To ensure all Californians have access to high-quality health care at an affordable price” ("Blue Shield Mission Statement", 2016).

A Gemba walk is a process designed for continued improvement of enhancing a process and to reduce waste. I have decided to walk and observe the department of customer service department with the main supervisor.

The reason I have chosen customer service is because this area gets a lot of feedback of how customer service representatives do not help resolve members or provider issues the first time they call in to report it. Some of these representatives have been accused of being rude and not at all thoughtful to the individuals calling.

In my observation I have observed the customer service reps had several callers on hold for long periods of time and in the end not being able to help them and their issues get transferred elsewhere like in the claims area or just gets routed to a different are entirely.

A good opportunity of waste would be able to be decreased the numbers of time the member calls in and get some representatives trained in claims so they can easily help get the issues resolved, the claim paid, therefore deleted the number of times they need to call. This would be considered a long term goal for the department. For the short term if training is not an option, is to have customer service reps sit with different claim employees and get some pointers on the main issues of certain calls.

Another great way to help reduce waste would be to add a phone line to certain claim employees that way the customer service reps can call these individuals with any issues and the claim rep could pull up the claim, work the claim and get it paid while the member is still on the line.

Conclusion

With these changes in place I do believe customer service could be a number one department within Blue Shield and could be able to handle these calls on first time basis and get the inventory and the number of calls reduced.

References

Blue Shield Mission Statement(2016). Retrieved from http://www.blueshieldca.com/about/corporate-info/mission-values

What is a Gemba walk and why is it so important(2019). Retrieved from https://www.sixsigmadaily.com/what-is-a-gemba-walk/