Healthcare PBM Contact Center Service Level Recovery Project

Client Overview

A mid-sized healthcare company in the Pharmacy Benefit Management (PBM) market, processing daily mail orders for patients with chronic, complex, and routine medication needs. With a 100+ agent contact center, the client faced the challenge of delivering exceptional service across multiple client teams and service levels while navigating seasonal fluctuations in call volume.

The Challenge

The client’s contact center experienced a significant spike in call volume, with an increase of 50% over forecasted levels during peak season (Q4 to Q1). This surge led to longer wait times, escalated Customer Service Representative (CSR) overtime, a higher frequency of repeat calls, increased costs, and rising agent attrition.

As a result, patient satisfaction was at risk, and the client faced operational instability. With limited time and no immediate ability to hire additional CSRs, the challenge was clear: achieve service level recovery under significant pressure, without increasing staffing.

The Solution

TSarro & Associates executed a rapid and comprehensive assessment of the contact center's current state, identifying critical pain points across people, processes, technology, and organizational design. Within days, we developed and implemented a tailored recovery plan focused on tactical and strategic actions, including:

• Reviewed workforce management teams' modeling to better handle the surge in call volumes.
• Enhanced call routing strategies to reduce bottlenecks and minimize caller wait times.
• Introduced short-term process improvements to manage agent productivity without increasing burnout.
• Established a clear framework for accountability and operational consistency.
• Leveraged off-phone resources for call handling functions and identified the source of off-phone work.

Our team worked closely with the client's leadership to deliver immediate action and results while also planning for long-term operational improvements.

The Results

Through focused interventions and rapid execution, we achieved:

• 70% improvement in service levels within weeks.
• A significant reduction in escalations and overall call center disruptions.
• A return to normalized operations, stabilizing both agent performance and patient satisfaction.

Additionally, we provided the client with a strategic roadmap for sustained improvement, focusing on enhancing the customer experience, improving operational efficiency, and reducing costs. The plan also included built-in contingencies for managing future seasonal spikes, ensuring the client could navigate these challenges more effectively in the future.

How to Cut Costs and Boost CX Effortlessly

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