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Digital case study

Service Excellence transforms the customer experience


How a global managed health care company is reinventing its customer service operation—and delighting its members


Client: Global managed health care company
Our Role: PwC helped the client to design a new process and, through an agile development process, built a system that became the primary interface for customer support agents.
Industry: Health Services
Services: Salesforce Services, Service Excellence



Improving customer satisfaction by making support more efficient

The managed health care and medical insurance industry has long been plagued by generally poor customer satisfaction levels, a problem that has largely worsened over time. While consumers worldwide have come to expect rapid, personalized answers to the questions they pose to businesses, our client—one of the largest international operators in this industry—found itself instead beholden to outdated and archaic systems that were blocking call center workers from responding to customer requests efficiently. When faced with a customer inquiry, agents would have to access up to six different systems to search for an answer, resulting in backlogged call queues, frazzled agents and an increasingly upset membership of more than 100 million individuals.

For our client, this didn’t just mean angry customers, it amounted to a serious business problem. Those harried call center agents were stuck in limbo as they searched disparate system after system for each answer, wasting time and often ending up with the wrong response. Service metrics were plummeting and, due to low efficiency, the cost of support was climbing. Furthermore, because of the complexity of the many systems that agents had to master, training costs were through the roof. A new employee hired to work in the call center would require a minimum of six months of training before being ready to engage with customers.

Our Service Excellence team was brought in to attack the problem by revamping the way the client’s customer service reps interacted with these systems. We leveraged next-generation AI and machine learning technology to ensure that support staff could find the best answer to a question more quickly. By setting up a more intuitive and intelligent desktop solution, we aimed to make agents more efficient and accurate when responding to customer calls.


Using Salesforce Service Cloud to gain new customer understanding

We attacked the problem at its most critical bottleneck: The disparate systems that support agents were forced to use whenever a call came in. We collaborated with the client to design a new process and, through an agile development process, built a system that became the primary interface for customer support agents. Built using the Salesforce Service Cloud, the system was designed to incorporate new and previously inaccessible insights drawn from email, chat and social media comments—while integrating seamlessly with the client’s existing back-end systems. The result was an intuitive system that agents would find easy to learn and quick to master—one that would provide more efficient access to the right answers every time a customer call came in.

Our Service Excellence solution was built to handle complex service requests

All told, the new solution included more than 100 points of integration with the client’s back end and was designed to handle more than 60 different types of customer service calls at launch. These calls were consolidated, and their workflow was streamlined to make it easier for customer support agents to process inquiries. Ultimately, by reinventing the experience for service agents, our Service Excellence solution allowed the client to transform the customer experience as well, leveraging the solution’s deep library of digital tools, industry-specific customizations and enhanced technologies such as AI and advanced analytics to create a best-of-breed technology tool.

“We worked closely with the client to determine what exactly wasn’t working in its support centers, and how we could reinvent those processes. This wasn’t just a technology solution, it was a business transformation that had dramatic results for both the client’s employees and its customers.”

Anil Swami, PwC Partner

25% reduction in time spent per support request, plus improved agent uptime and faster onboarding

The resulting application—designed in less than two months and implemented over the course of a year—has decidedly lived up to its high expectations.

For starters, agents are far more productive than ever. Some key results include:

  • Agents spend 25% less time handling each customer request, making them considerably more efficient

  • The agent occupancy rate—the amount of time they spend handling calls vs. idling—has climbed from 75% to 78%, mitigating agent downtime

  • Critically, the amount of time it takes to train a new agent on how to use the system has decreased from a jaw-dropping year to roughly eight to twelve weeks

The new system is also designed to adapt with the business. When the client wants to add a feature to the system, it no longer means giving agents yet another app they must check during each support call. The Salesforce Service Cloud system includes the flexibility needed to easily expand the solution as needed.

As expected, customers have also been thrilled by the upgrade. Customer inquiries are being handled faster and more accurately, with less time wasted on each call. The client’s Net Promoter scores are up, as is employee satisfaction. All that feeds into a virtuous circle that is making everyone in the equation happier and boosting profitability in the process.


Anil Swami

Partner, PwC US

Noaman Khan

Noaman Khan

Partner, PwC US

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Neil Dhar

Neil Dhar

Vice Chair - Chief Clients Officer, PwC US