UHC Provider Service Ops Global Operations - OGA

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 2024, PSO was the recipient of recognized with Gold and People's Choice Stevie Awards.

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

Optum Operations Philippines UHC Provider Service Operations (OGA) began in November 2012 as a pilot team of about 60 employees in Taguig City, Philippines, handling inbound calls for UnitedHealthcare commercial plans. From these modest beginnings, the department steadily grew, adding new lines of business and advanced capabilities. Today, it is a global team of 2,600 employees delivering voice, back-office, and chat services across multiple lines of business including Commercial, Medicare, Medicaid, USP, Surest, IFP and Portal Help Desk. With a presence in the Philippines, India, and Puerto Rico, Optum Operations Provider Service Operations remains committed to innovation and creating simpler, smarter experiences for UnitedHealthcare providers.

Since July 2023, OGA UHC Provider Service Operations has advanced its digital-first strategy through continuous expansion of chat capabilities, enabling faster and more efficient provider support. Despite post-pandemic challenges and return-to-office transitions, the team sustained a stable retention rate that continues to outperform prior years. During this period, OGA consistently achieved strong results in key metrics including Service Level, Net Promoter Score, First Call Resolution, Transfer Rate, and Quality. As a testament to trust and reliability, Optum Operations (and expanded into Philippines, India and Puerto Rico) UHC Provider Service Operations now manages the largest call and chat volumes across all partners, demonstrating scalability and an unwavering commitment to quality.

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

Over the past year, OGA delivered significant advancements in customer experience, digital enablement, operational excellence, and global workforce development-while sustaining best-in-class results across UHC's Provider Service Operations ecosystem.

• Digital & Automation Leadership:
• Supported UHC's rapid expansion of Provider Chat, delivering high-quality global chat operations with strong accuracy and handle time.
• Enabled major digital containment gains-from 9.4% to 20.2%-through AI-enhanced routing, virtual assistant expansion, and optimized IVR journeys.
• Launched KORA, an AI-powered virtual meeting facilitator that captures notes, assigns actions, and improves operational alignment across global teams.

Customer Experience Excellence:

• Sustained #1 UES and NPS rankings across nearly all Lines of Business from 2023-2025.

• Delivered elite KPIs:

  • Net Promoter Score (NPS): 86.83 (2023), 84.99 (2024), 86.52 (2025)
  • First Call Resolution: 96-98%
  • Transfer Rate: 9.7% 7.7% 6.6%
  • Quality: 97-98%

Employee Experience & Engagement:

• Maintained strong engagement and retention through recognition programs, learning academies, leadership roundtables, and cross-site collaboration events.
• Successfully upskilled thousands of advocates to support digital workflows-without expanding headcount or sacrificing service quality.

OGA's ability to deliver consistent excellence while scaling digital transformation makes it a standout global partner in customer service operations.

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):

OGA's achievements stand out because of their consistency, resilience, and impact across a highly complex global operation. While many organizations experience volatility across customer experience metrics, OGA has sustained top performance for three consecutive years-an uncommon level of stability in healthcare service delivery.

A Unique Global Engine:

OGA blends human expertise with advanced digital tools, supporting automation, AI-driven routing, intelligent chat, and workflow optimization. Their ability to integrate these capabilities while maintaining elite performance sets them apart from both internal and external competitors. Innovations like KORA demonstrate OGA's role in shaping operational efficiency across the enterprise.

A Culture That Enables Excellence:

OGA's workforce strength is a core differentiator. The team consistently maintains high engagement, strong retention, and rapid adaptability-demonstrated by their successful transition of thousands of advocates into digital and hybrid service roles without performance dips. This cultural stability is rare in global operations of similar scale.

A Benchmark for the PSO Ecosystem:

Across UHC's Provider Service Operations ecosystem, OGA consistently outperforms peer vendors-frequently ranking #1 across UES, NPS, quality, and service metrics. Their ability to lead the field year after year positions them as the benchmark for operational excellence.

OGA's sustained performance, digital partnership, and deep cultural alignment make it one of the strongest global customer service organizations in the industry.

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):

• OGA Performance Dashboard - OGA Performance
• OGA Contact Center Performance - hosted by AI Assistant KORA
• OGA Performance Executive Summary - hosted by AI Assistant KORA
• KORA AI Bot Introduction
• Customer Service Week Video - Showcased employee engagement
• United as One Video PSO Leader Site Visit - US leaders visit Philippines