UHC Provider Service Operations: One Journey, Every Channel - Turning Omnichannel into Measurable Results

Unitedhealthcare Provider Service Operations (UHC PSO) is business area within Unitedhealthcare. With over 5,800 global employees, we provide best in class multi- channel service to our nation's healthcare providers. This includes answering questions, resolving issues, and processing medical claim settlements. In 2025, PSO was the recipient of recognized with Gold and People's Choice Stevie Awards.

Briefly describe the nominated organization: history and past performance (up to 1,250 characters):

UnitedHealthcare Provider Service Operations (PSO) supports more than two million healthcare providers through a complex, high-volume service environment spanning eligibility, benefits, claims, authorizations, credentialing, contracting, and demographics. With a workforce of over 5,800 employees and global partners, PSO has historically operated within a fragmented, call-heavy service model common across the healthcare industry-one that often resulted in long resolution times, repeated contacts, and inconsistent provider experiences.

Recognizing the need for transformation, PSO embarked on a multi-year journey to modernize provider engagement. Rather than optimizing individual channels in isolation, PSO focused on building an integrated, omnichannel ecosystem that allows providers to move seamlessly across voice, chat, digital self-service, and proactive resolution paths-without losing context or continuity.

This evolution laid the foundation for PSO's shift from reactive issue handling to proactive problem prevention. By combining advanced analytics, digital channels, and specialized resolution teams, PSO redefined how providers interact with UnitedHealthcare-creating faster, more consistent, and more satisfying experiences while reducing operational friction and cost-to-serve.

Outline the organization's achievements since July 1, 2023 that you wish to bring to the judges' attention (up to 1,500 characters):

Since July 2023, PSO has executed a comprehensive omnichannel strategy designed to meet providers where they are-digitally, efficiently, and consistently across every touchpoint.

At the center of this strategy is a digital-first, chat-enabled service model. Provider chat adoption increased from 3.2% in 2023 to approximately 24% in 2025, supported by AI-powered bots that handle common inquiries such as claims status, eligibility, authorizations, and plan details. Digital containment more than doubled year over year, reaching over 20%, representing millions of automated interactions resolved without advocate involvement.

PSO integrated voice, chat, portal, bots, APIs, and back-office workflows through a one-stop desktop, ensuring advocates retain full context regardless of channel. The Multi-Skilled Advocate Model further strengthened omnichannel continuity by enabling advocates to support both call and chat interactions, reducing transfers and improving first-contact resolution.

AI-driven tools (bots): - Expanded bots to include Claim Status & Reconsideration, Plan Details with Member Relationship Indicator, Coverage & Accumulations (Copay/Coinsurance), PCP Referral History and COB Enhancements. Bots now log interactions and generate reference numbers for robust reporting.

Beyond reactive channels, PSO expanded the Provider Resolution Center (PRC)-a proactive analytics-driven function that identifies and resolves systemic issues before providers need to call or chat. From 2024-2025, PRC prevented over 10 million potential provider abrasion moments, significantly reducing avoidable contacts.

Together, these initiatives created a cohesive, scalable omnichannel ecosystem that balances automation with human expertise-improving provider access while preserving service quality.

Explain why the achievements you have highlighted are unique or significant. If possible compare the achievements to the performance of other players in your industry and/or to the organization's past performance (up to 1,500 characters):

PSO's omnichannel strategy stands out because it delivers measurable customer satisfaction gains while reducing complexity, contact volume, and cost-a balance few healthcare organizations achieve at scale.

While many organizations struggle to integrate channels, PSO designed its ecosystem to function as a single, connected journey. Providers can begin in self-service, transition to chat or voice when needed, and benefit from proactive issue prevention-without repeating information or encountering disjointed handoffs. This cohesion directly translated into performance outcomes: call contact rates declined by more than 20%, transfer rates reached historic lows, and overall contact demand fell year over year.

Contact Rate and Service Performance: Exceeded the 2025 YTD MBO target with an overall contact rate of 64.59, down 11.4% year-over-year and call contact rate down 20.5%. This improvement is driven by a steady shift in provider preference toward digital tools, with October's channel mix holding at 23.7% chat and 76.3% calls.

Customer experience results underscore the success of this approach. Call NPS remained strong at 84+, while Chat NPS improved by approximately six points year over year, reflecting growing provider confidence in digital channels. User Experience Scores (UES) consistently exceeded 90% for both call and chat, outperforming healthcare industry benchmarks and validating omnichannel effectiveness across preferences.

Equally important, PSO's strategy is sustainable. By preventing issues through PRC analytics, enabling multi-skilled advocates, and expanding automation responsibly, PSO avoided workforce reductions while improving productivity. Teams delivered $65 million in operational savings ($12 million above plan) while maintaining industry-leading satisfaction.

In an industry often defined by fragmented experiences, PSO demonstrates how an integrated omnichannel strategy can simultaneously improve satisfaction, efficiency, and trust-setting a new standard for provider service excellence.

Reference any attachments of supporting materials throughout this nomination and how they provide evidence of the claims you have made in this nomination (up to 1,500 characters):

• Who We Are Presentation - Details of initiatives and key performance metrics dashboards, and provider feedback
• AI Strategy Video - Highlights PSO Digital Strategy
• Advocate Assist AI Bot Video - Brief Demo of bot that assists call advocates
• Virtual Assistance Prior Authorization AI Chat - Brief demo of chatbot for providers
• Chat Bot Demos
• A Day in the Life of a Contact Center Advocate Video
• Service Model Transformation Video