5 great answers built on Pega for your Healthcare provider management problems

The least prioritized (and invested) IT system, in a Payer organization, is that of Network Management. This is, however, expected to change in the future, since Payer organizations have started realizing that both Provider and member service ratings, as well as Medicare payer rating could be badly impacted by not providing the right provider data 

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Envisioning /Implementing PLM using Pega BPM and Pega Robotics Process Automation (RPA)

Health insurance companies face a huge challenge for maintaining their Provider network. The provider database of any health insurer is error prone. The direct impact of the having erroneous data impacts the business in many dimensions like inaccurate provider directory, incorrect claim payments sent to providers due to wrong address. With the Increased scrutiny from 

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Smart Automation for Banking & Financial Services Customer Due Diligence and KYC

The enormity of the effort and spend for compliance is best illustrated by Jamie Dimon’s speech to shareholders last year – JPMC spent over $1.6bn on their Compliance Department, employing 13,000 people to ensure they address regulatory issues and compliance. This after they paid more than $16bn in legal penalties in 2015! Compliance is an 

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Pega and RPA: Top 5 quick ROI opportunities in healthcare automation

Pega’s acquisition of OpenSpan has triggered a lot of excitement among customers, competition and service providers. The acquisition has opened up a whole lot of avenues for overcoming the business challenges healthcare payers are facing today on account of mundane manual tasks and also due to use of multiple silo systems. These organizations, in their quest 

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Road to a mature business-driven BPM COE

As more and more organizations travel the BPM road, the journey leads to questions about achieving a greater rate of success leveraging BPM in business transformations.  BPM is no longer a workflow automation approach but a strategic discipline that is both powerful and transformative.  In that light, organizations are seeking ways to drive faster up 

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Reimagining quality of BPM implementations for a great customer experience

Recently, I had the pleasure of hosting a webinar with Forrester analyst, Clay Richardson, and Venkata Ramana Lanka (LRV), Senior Director and Solutions Leader within the Independent Software Quality practice at Virtusa. The webinar with the topic “Embrace change, ADOPT for success” we discussed on the need to reimagine the process of quality assurance and 

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Pega 7 upgrade: A journey worth taking

A leading financial information services provider was running Pega 6.2 for one of its biggest and most complex business functions. However, the application performance had degraded over time and the user interface code was also getting progressively obsolete, requiring significant changes to support a new browser version. Above all, the obsolete Pega version and the 

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Promising event, PegaWORLD 2015 is expected to reveal the way ahead in shaping Digital Enterprises

Establishing customer centric processes is a key business driver for organizations today. Business and IT leaders are increasingly focused on enabling their enterprises to engage their customers – creating avenues for next best interactions, transforming the way in which they engage customers while staying competitive & keeping costs down. Constantly changing customer landscapes, ever changing 

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Moving from custom development to BPM platform

When an organization begins developing a custom application, they have multiple factors to consider such as the latest technology platform, methodology to be used, agility to make the enhancements, ability of business users to conceptualize and recommend, flexibility to change or enhance the application and to support the nexus of forces (social, mobility, analytics and 

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3 ways credit card providers can use BPM to enrich their service offerings and achieve business transformation

Business process management (BPM) in credit card services has covered credit card issuance, card servicing and bills management, but in 2014-2015 the focus is going to be more on better customer service, best in class case management systems and dispute management. With increasing security breaches and data thefts taking place in 2013, there are three 

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Regulatory compliance and risk management – Role of BPM in driving efficiencies and flexibility for financial services firms

I’m excited about participating as a panelist at the FSOkx BPM Innovation Forum on September 17th.There is so much change currently happening in the financial services industry and BPM is perfect to help meet the tremendous challenges ahead. In my 20+ years in the financial services industry, I have not seen so much change and 

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