UPMC Health Plan Contact Center of the Year (Over 100 Seats) - Other Service Industries

UPMC Health Plan, headquartered in Pittsburgh, Pennsylvania, is owned by the University of Pittsburgh Medical Center (UPMC), a world-renowned health care provider. An integrated health care delivery system, we are committed to providing our members better health, more financial security, and peace of mind. Our provider network includes 140 hospitals and 29,000+ physicians, serving 4M Members.

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

Where others measure calls, we measure care-delivering a world-class experience that puts members at the center of every decision. As part of UPMC Health Plan, backed by the world-renowned University of Pittsburgh Medical Center, we leverage our integrated delivery and financing system (IDFS) to create seamless, coordinated care. Our contact center thrives because of our people: 369 dedicated concierges who share a mission-improving lives through every interaction-and are empowered by a culture of empathy, coaching, and recognition. Their commitment powers service at scale: 4M+ members supported through 2.4M inbound calls, 46K chats, 20K web messages, and 540K outreach calls annually. With our concierge philosophy, First Call Resolution and service recovery ensure issues are resolved quickly and compassionately.

Guided by real-time feedback and advanced analytics, we refine workflows to remove friction and deepen trust-turning moments of need into moments of confidence across every channel. Often called the "heart of the organization," our work extends beyond the contact center-driving enterprise-wide enhancements that align processes, technology, and culture to sustain world-class experience goals.

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

We didn't just raise the bar-we became the bar for member experience excellence in our industry by delivering results that redefine world-class service. Our passion is fueled by what matters most-the voices of our members. Their feedback tells the story: 4.8/5 satisfaction, 96% first-call resolution, and 98.2% concierge helpfulness, because every interaction deserves excellence. These achievements reflect more than metrics - they reflect a team's passion for excellence. As consumer expectations evolve, we stay ahead by leveraging Speech Analytics to continuously refine the five pillars of our World Class Score: Ownership, Empathy, Advocacy, Digital Tools Education, and Closing. Together, they create a performance framework that ensures every interaction reflects our world-class promise. We expanded our World Class Score beyond voice to include chat, ensuring our omni-channel approach to excellence delivers consistency and quality across all member touchpoints. Our relentless focus on care and resolution drove a 41% reduction in member complaints, reaching the lowest grievance rate per 1,000 members since 2019 and proving that world-class isn't a goal - it's our reality. Our people are our greatest asset. We make engagement a priority by creating a culture of growth, recognition, and purpose that empowers our concierges to deliver excellence. With 97% participation and 77% engagement, we outperformed the company average, setting the standard for success. Our commitment to excellence earned perfect CAHPS scores across all member experience measures and culminated in our 11th J.D. Power Certification-#1 in member satisfaction for Commercial plans two years running and Medicare plans three years running. These accolades go beyond recognition - they establish us as the gold standard for member experience excellence.

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):

In a world where efficiency often sacrifices experience, we broke the mold - proving both can thrive together. We achieved a 38.95% reduction in call volume by thoughtfully addressing pain points, including a 21% drop in transportation-related complaints. Even as we advance digital self-service and automation, we prioritize empowerment over replacing the human connection. Our First Call Resolution remains exceptional at 96%, far above the industry norms. We don't settle for mediocre; zeroing in on the 4% of interactions that matter the most through our service recovery process - turning challenges into trust-building moments. Our JD Power results confirm why our achievements our unique. We didn't just lead in member satisfaction - we ranked #1 across all eight JD power measures, outperforming competitors in every critical dimension of member experience. Paired with top-tier Net Promoter Scores, these metrics confirm that our strategy drives both loyalty and advocacy. Advocacy is where loyalty becomes measurable - and we delivered utilizing our innovative speech analytics measurement, achieving a 10.31-point increase. This result is a direct outcome of our strategic focus on service recovery, digital innovation, and frictionless experiences. Behind the metrics are our people - and we've made them our priority. In a known for high turnover, we reduce attrition to just 14.45%, well below the norm, supported by 56K training hours, 15,000 coaching sessions. We've innovated training through our 360 Learning Platform to deliver engaging, accessible training. For example, we transformed our mandatory annual Medicare compliance training into an interactive experience using gamification, which yielded a 94% pass rate. These results aren't just improvements - they're industry defining. By combining operational efficiency with exceptional member experience - built on trust, empowerment, and innovation - we've set a new benchmark that competitors strive to reach. Our approach proves that innovation and care aren't opposites - they're the formula for leadership. This is how we continue to lead the future of member services.

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):

Slides 3-7 provide an overview of UPMC Health Plan, Member Services, and our Mission & Vision. Slides 9-14 outline key performance highlights, including our J.D. Power Certification.

Slides 16-19 highlight the dedication of our Health Care Concierge Program, including executive testimonial to support our mention of being the "Heart of the Organization". Slides 20-23 emphasize our commitment to delivering world-class service in every interaction. Slides 24, 25 discuss our service recovery and the priority we place on the 4% unresolved interactions. Slide 26 outlines our proactive outreach initiatives that reinforce our mission of world-class service.

Slides 27-35 detail our People & Culture, showcasing our focus on employee engagement through career development, recognition, and special programs, supported by employee testimonials on slide 30. Slides 37, 38 highlight career development opportunities, including a testimonial supporting growth from Health Care Concierge to leadership.

Slide 40, 41 recognizes our Award-Winning Coaching Team and comprehensive training program that supports our mission of world-class service. Slides 42-43 highlight our dedicated training for leadership, supported by feedback on the impact it has on employee growth.

Slides 44 detail our Speech Analytics platform and how we integrate it into our operations to enhance service delivery. This is followed by the innovative digital tools and technological enhancements aimed at improving the member experience in slides 45-46, including the focus we put into transforming frontline feedback into excellence. Slide 47-48 outlines community-based engagement through our tech guide program and Bilingual support.

Finally, slides 50-53 celebrate the achievements, awards, and accomplishments of our remarkable Member Services Team. Together, this presentation demonstrates UPMC Health Plan's unwavering commitment to delivering service excellence by creating moments of trust, transforming challenges into confidence, and setting the benchmark for the industry.