iems

Insurance Enterprise Management System

Summary

The market leader for dental insurance in Hawaii launched a multi-year initiative to replace a legacy Enterprise Management System based on Sybase PowerBuilder with a more modern system based on Oracle and .Net. Having originally built a solution more than twenty years earlier, the goals for the project were to build a more flexible, performant, scalable solution for the future. The system has 20 modules, such as Billing, Claims, Customer Support, Mailroom, Products, COBRA and Medicare, which together handle all in-house information management operations, including customer and provider services.

Role

Initially our role focused on identifying challenges in the existing team's definition, design, development and delivery processes. User requirements were not well understood, and the team had not adopted a structure for organizing work. We trained the teams on Agile, and we started three new modules with the improved process. This was a five year project with modules/features rolling out after phased acceptance testing.

Outcomes and Innovations

  • Created and reviewed user stories for 12 modules
  • Led teams to create user stories, UI designs, test cases, and maintained product backlog
  • Oversaw defect tracking and tracked KPIs to monitor processes
  • Served as Scrum Master as needed to teach healthy practices
  • Served as Product Owner to build and manage backlog and deliver high-quality modules

Example Artifacts

Processes

While we advocated for a high-degree of adherence to Agile principles and Scrum and Kanban techniques, the organization settled on a hybrid approach. The compromises that were made resulted in loss of efficiency and duplication of efforts, and did not incorporate strong quality improvement practices. We delivered “on time” and met user expectations, but the process was costly and wasteful. MataiNet estimates the program costs for the organization were at least 50% higher than needed, and maintenance and defect issues will continue to be issues.

Platform/Tools

  • Jira, Confluence, Figma, bitbucket, Jenkins
  • MS Office suite
  • .Net, c#, Kendo UI
  • Oracle
  • HIPAA compliant