A leading healthcare payer in the U.S. dedicated to transforming community health by offering comprehensive managed healthcare services through government programs like Medicaid and Medicare, as well as commercial products.
The client needs to scale their staffing across the U.S., Philippines, and Guatemala to meet Annual Enrollment Period (AEP) demands without overspending or sacrificing service quality.
Historically, the client relied heavily on full-time hires to manage peak season volume. This approach limited agility, making it difficult to ramp quickly when forecasts shifted. During high-pressure weeks, performance consistency across multiple geographies also became a challenge.
With operations spread across multiple geographies, Everise built flexibility into the client’s core staffing plan, proposing a 60/40 workforce model that blended full-time agents and seasonal staff. This gave the client a scalable way of increasing headcount quickly while still maintaining control over cost and performance standards.
Implementation was phased over 6 months with staggered rollouts across three countries to reduce strain on any single region.
During the process, Everise implemented a four-prong operational framework to maintain performance.
Through a mix of full-time and seasonal employees, the client scaled fast, aligned with real-time demand, and reduced operational strain. Within six months, staffing grew 145% across 7 lines of business, peaking at 2,339 champions in December at the height of AEP. Operations ran seamlessly, with zero disruptions and a smooth ramp-down that avoided overextension.
| Total Headcount | |
|---|---|
| July | 954 |
| August | 919 |
| September | 976 |
| October | 1240 |
| November | 1703 |
| December | 2339 |
| January | 2248 |
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Throughout AEP, the client maintained over 95% schedule adherence, outperforming industry benchmarks (typically 88 to 90%) because of the four-pronged approach to workforce management.
Everise met 100% of SLA targets, achieving a 30-second average speed of answer (ASA) on 90% of calls, and was recognized as the client’s top-performing partner for General LOB support.