Rx Connect Pro

Rx Connect Pro is an internal Humana website designed to help our call centers better serve our Prescription Drug Plan (PDP) members. The site pulls in relevant information needed to answer the top PDP calls all in one place, in a way that is easy to relay that information back to our members and better answer their questions.

Rxconnect dashboard and stage tracker gif

Dashboard view of Rx Connect Pro, with a look into claims data and the Stage Tracker feature.

The Problem

Prescription Drug Plans make up over half of Humana’s Medicare business, and was identified as one of our most under-served membership populations. Historically, Humana’s websites, tools and member materials have been designed to focus on plans that include medical insurance, which doesn't apply to this user base and therefore creates an experience for PDP members that is lacking.

One of the ways in which Humana is improving this experience is through our call centers. In addition to tools & materials not entirely focused on the PDP membership, the PDP product itself is extremely complicated, difficult to understand, and equally as difficult to explain. A need to better serve our call center associates, in order to better serve our PDP members, was clear.

The User Value

Rx Connect Pro was developed in partnership with over thirty Customer Care Specialists (CCS) from Humana’s call centers. Iterative designs along with working software were presented to them throughout the engagement.

Feedback from the start and throughout the engagement remained extremely positive, confirming week after week that we were on the right track. We learned quickly through both on-site call shadowing and user testing that the CCS’s needed their existing tools to be consolidated, in a way that is quick to access, straightforward, and more importantly, easy to convey this complicated information back to our members. For example, we noticed that the number of applications and systems that were used for each call were extremely time consuming. Through this learning, we were able to consolidate the number of access points needed to obtain the most valuable member information, and present just that on the Rx Connect Pro dashboard.

One of the more complicated features of Rx Connect Pro is the Stage Tracker. We heard repeated frustrations from the call centers around the ability to explain how a member got from one stage of coverage to the next. The Stage Tracker utilizes a unique algorithm that interactively pulls claims and spend data together, in a format much like one would expect to see from their banking website. This makes the feature relatable & familiar to the user, which in turn, helps to better communicate with the member.

“I feel like I’m not thinking when I use this, and that’s great. I can put members at ease. I can answer questions easier, and it helps me help them understand things better.”
Humana Customer Care Specialist

What We Built

The team initially developed a prototype to simply test and learn if a tool such as Rx Connect Pro would prove to be valuable. It was learned very early on through user shadowing, interviews and testing that Rx Connect Pro was something that the call centers very much wanted and needed.

The team came up with a simple, at-a-glance dashboard that provides access to data from multiple systems all in one place. The application solves for the top call types for both Humana Pharmacy associates as well as associates that speak specifically to plan benefits. By bringing all of this information into one place, we were able to reduce inter-departmental call transfers with our pilot user group by 64%.

Information on the dashboard is organized in a way that the CCS can quickly scan to get an overall picture of where the member is currently within their plan, as well as details around Humana Pharmacy orders and a drug pricing module. Each module on the dashboard expands to provide additional information, however only as it’s needed.

Rx connect CSR image

On-site shadowing session with one of Humana's Customer Care Specialists.