GEMS will be one of the first non private sector entities to truly focus on member-centricity.
As one of the most comprehensive projects undertaken by Consulta, which integrated various components of the company’s value proposition, it clearly revealed significant strategic value.
REAL TIME BUSINESS SUPPORT
Consulta’s hands-on project management successfully steered GEMS to this point in its transition.
BETTER RESULTS FOR BETTER CUSTOMER SATISFACTION
Implementation with undoubtedly result levels of service previously unexperienced in the sector.
GEMS is the second-largest medical scheme in the country with more than 1.78 million beneficiaries.
GEMS employs a diverse administration approach to service its members, which in itself introduces a number of complexities and challenges in so far as consistency in member service experiences is concerned.
With GEMS aspiring to be an affordable and member-centric scheme it is imperative to have an excellent member engagement model to support the scheme’s desired service and member-centric outcomes.
To further enhance the members’ experience GEMS identified the need to service them within their places of work. To this end, the Board of Trustees took a decision to establish a business unit of Client Liaison Officers (CLOs) to service members and potential members in their workplaces.
This further identified the need to evaluate of the existing CLO operating model and make recommendations that would create the framework for an appropriate delivery model aligned to industry standards and practices resulting in GEMS rendering the best possible services to its members.
To meet GEMS needs Consulta utilised TISSE. The International Standard for Service Excellence (TISSE2018) pulls together the main principles involved in improving/maintaining service delivery excellence, and provides a clear framework for step by step improvement by assisting in identifying the key criteria which need to be fulfilled for the organisation to achieve this goal.
The factors directly influencing the customer’s experience are the pillars of the 5Ps Service Quality Model that emphasises the importance of five key elements together with measurement of performance forming an essential analytical dimension.
How do the organisa¬tion’s objectives and strategies reflect the customer’s expectations?
Are the products/ services designed according to the needs and expectations of the customers?
Do the delivery channels facilitate delivery of customer service excellence?
How effective are the orgnisation’s processes in delivering the desired output to their customers?
Are the employee’s sufficiently skilled to enable satisfaction of customer needs?
GEMS was the first South African organisation that was evaluated against this international standard and several areas for development were high-lighted:
- Customer service delivery.
- Continuous improvement of policies.
- Customer related processes including the identification of competent process owners and process document control.
- Customer service training and proper employee knowledge assessment
- General performance measurement.
RETAINED PERFORMANCE THROUGH TRANSITION
The wok to date will enable GEMS to transition into a high-performance organisation.
TRUSTWORTHY ACTIONABLE INSIGHTS
The use of international best-practice “tools” like TISSE ensures trustworthy results.
FULL PROCESS PROJECT MANAGEMENT
The process using many elements of the Consulta value proposition was managed from end to end.
PRIORITISED IMMEDIATE RESPONSE
The deployment road map is ready for action.