Overview
A healthcare technology company won a state contract to run call center support for its Medicaid dental program, which covers dental care for low-income families and individuals. That meant answering calls from members with questions about their benefits and from dental offices checking coverage and claims. When the company’s staffing partner couldn’t hire enough people, callers ended up on hold for hours. Qualfon scaled the team from 54 to 195 associates in four months and cleared the backlog by mid-August. Within weeks, the state wrote to congratulate Qualfon’s client on the turnaround.
The Challenge
Our analysis revealed several issues:
- Hundreds of callers waiting for hours. The program’s original staffing partner fell well short of the headcount the contract required, leaving Medicaid members and dental providers stuck in queue.
- A hiring market Qualfon had never recruited in. Every associate had to live in the state the program served, and Qualfon had no existing presence or reputation there.
- No bandwidth for vendor training. The client’s team was stretched too thin to train an incoming partner, and its standard new hire curriculum ran six weeks.
- No room to overpromise. The client built its recovery plan around Qualfon’s hiring projections, so every headcount number Qualfon shared had to show up on the phones.
Our Solution
Qualfon started with the people it already had. Qualfon had supported this same program under its previous administrator, so 54 associates who already knew the work moved over and took live calls after five days of training.
Our Talent Acquisition team launched in-state recruiting at the same time and filled three training waves between June and August. Our training team learned the client’s materials on their own, then brought several top performers from the earlier program back as trainers. New hires learned from people who had done the job well, and the client didn’t have to pull any of its own staff to train them.
Qualfon also brought its full operations leadership structure to the program, including operations managers, team leads, quality assurance, and workforce management, and that team worked alongside the client from the first week to spot process gaps and build workflows the program didn’t have yet. Our reporting team later built a direct upload of associate payroll hours into the client’s timekeeping and invoicing systems, which removed invoice discrepancies and now serves as the standard the client expects from every other vendor.
The Results
Queues dropped as soon as the second training wave reached the phones. Within three months of signing:
- The program cleared its call backlog by mid-August 2024, and the state congratulated Qualfon’s client the first week of September.
- Qualfon scaled the team from 54 to 195 associates in four months.
- 91% of new hires graduated to nesting and 83% advanced to production across three training waves, all recruited in a market Qualfon had never hired in before.
Performance held over the following year:
- Customer sentiment reached 99.1%, staying above the 90% goal for 12 consecutive months, including through the ramp period.
- First contact resolution reached 98.1% against a 90% goal.
- Average speed of answer on the member queue stayed between 33 and 49 seconds, well inside the 60-second goal, with abandon rates under 2%.
"They came to us needing staffing, but what made the difference was every department pulling together. Training, workforce management, quality, recruiting, and our operations team all showed up for this client, and we were careful to only promise what we knew we could deliver."
-Janette Tulimaiau, Regional Operations Director, Qualfon
The client now considers Qualfon a preferred vendor. It added a care coordination team in August 2024, handed Qualfon full ownership of its member phone queue and provider chat, and has since brought Qualfon onto programs in two additional states.
How Qualfon Can Help Your Business
When a regulated healthcare program falls behind on staffing, members and providers feel it first. Qualfon brings recruiting, training, workforce management, quality, and operations leadership together from day one, so new programs reach proficiency fast and stay there.
You set the performance standards and compliance requirements, and we build and lead the team that meets them.
About Qualfon
Qualfon is a global BPO provider of omnichannel customer experience and business support solutions with locations on several continents. We are an agile partner specializing in call center support, revenue growth, and marketing services committed to serving our clients and their customers throughout the customer journey.
Learn more about Qualfon’s CX Innovation and Back Office Support Services.
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