Training Top 125 Best Practice: Aetna Inc.’s Service Without Borders Initiative

The initiative required not only training to learn new workflows, but also a culture shift for employees to trust their own decisions by doing what is right for the member.

Aetna Inc.’s Service Without Borders initiative training began in April 2017 and continues today with ongoing training. It consists of all of Service Operations, including but not limited to the following departments: Calls, Claims, Complaints and Appeals, Clinical, Provider, Business Transactions, Workforce Management, Quality, and Training.

Service Operations is helping achieve Aetna’s corporate strategic goal of improving consumer health and engagement by living the health insurance company’s common purpose and advocating for its members’ best health through this initiative. The Service Without Borders initiative puts the member first in every decision while building a culture of individual accountability, trust, ownership, and empowerment. The initiative required not only training to learn new workflows, but also a culture shift for employees to trust their own decisions by doing what is right for the member.

Program Details

The Service Without Borders pilot curriculum consisted of nine hours of classroom-based instructor-led training (ILT) for 24 customer service representatives (CSRs). An onsite ILT delivery method was not efficient for full deployment of Service Without Borders to 3,000 members of Calls and Claims staff, so Aetna implemented a blended learning strategy. It created seven self-paced e-learning technology-based trainings (TBTs) for CSRs and claim processors, plus three ILTs providing practical application for CSRs and an ILT for supervisors after they complete the prerequisite CSR TBTs. 

Each week, managers hold discovery sessions during their team meetings. Discovery sessions allow CSRs and claim processors time to discuss the issues and successes they are encountering with the program. This also allows the managers to gather feedback and ideas that come from their teams.

Aetna also developed a weekly video series called The Customer Journey.With the help of call analytics, the company trends calls for issues. For reinforcement trainings, Aetna shows the CSRs what the member had to go through from their first call until resolution was met. Then they see the right way of how the call should have been handled the first time. 

A bi-weekly newsletter is released to all of Service Operations highlighting success stories and kudos to those CSRs, nurses, claim processors, and appeal analysts who are living Aetna’s common purpose and applying Service Without Borders.

The Service Without Borders initiative has many levels of support. The senior vice president of Service Operations was involved from the beginning of the pilot phase and continues to be invested in the ongoing program and training. During the development stages of training, the team had daily calls to review all developed curriculum, marketing materials, and communications in which he would voice his concerns, opinions, and approvals. The weekly calls continue with the implementation team, the SVP, and all his direct reports to update on results, trends, successes, and lessons learned. 

During the launch of the program, the SVP and his direct reports traveled to Aetna’s offices around the United States, Costa Rica, and Columbia to hold an official kick-off of the program. The members of senior leadership then assisted the trainer in facilitation by opening each supervisor training.

Results

The blended learning approach reduced CSR training time by 37.4 percent. Aetna reduced the 9-hour pilot training time to 5.6 hours of ILT and learning delivery combined content, reducing call staff time off production by approximately 19,400 hours.

Since the birth of Service Without Borders, the net promoter score (what members think of the service received) rose from 69.4 percent in 2017 to 72.2 percent in 2018. First call resolution score (calls handled without a callback) rose from 94.9 percent in 2017 to 95 percent in 2018.

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