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Case Studies

Transforming Compliance into a Strategic Advantage for a Fortune 500 Healthcare Organization

Highlights

  • Enhanced Compliance Monitoring: Inovaare’s solutions enabled real-time compliance monitoring, reducing audit preparation time by 60%.
  • Automated Risk Management: Implementation of AI-powered tools like Usher reduced manual workload, leading to a 50% efficiency boost in risk management processes.
  • Improved Operational Efficiency: Centralized data management and automated workflows decreased the compliance response time by 40%.

Quantifiable Results

60%

Reduction in audit preparation time, allowing for faster compliance reporting and action.

50%

Improvement in risk management efficiency, resulting in a $100,000 annual cost saving.

40%

Decrease in compliance response time, improving overall operational performance.

The Customer

A Fortune 500 managed care company headquartered in Long Beach, California, United States. The company provides health insurance to individuals through government programs such as Medicaid and Medicare. It is focused exclusively on government-sponsored healthcare programs for families and individuals.

Challenges

Before partnering with Inovaare, the health plan faced several challenges:

  • Reliance on manual processes led to inefficiencies and increased risk of errors during compliance audits.
  • Disjointed systems hindered a unified view of compliance and risk data, complicating reporting and oversight.
  • Manual workload and fragmented systems resulted in elevated compliance management costs and delayed responses.

Goals

To overcome these challenges, the health plan aimed to create a unified, efficient, and cost-effective compliance management framework by:

  • Automating compliance monitoring and reducing the manual workload associated with audits.
  • Centralizing data management for a comprehensive and real-time view of compliance activities.
  • Reducing operational costs while improving the accuracy and speed of compliance responses.

Solution

After evaluating several technology solutions, the health plan selected Inovaare’s solutions due to its robust automation capabilities, low-code development features, and comprehensive data management. The key aspects of the solution deployment include:

  • Usher AI: Automating compliance tasks through real-time data analysis and reporting, streamlining compliance activities and reducing manual intervention.
  • GRC Modules: Incorporating Inovaare’s Governance, Risk, and Compliance (GRC) modules for comprehensive risk and compliance management, with features like audit tracking, issue management, and automated corrective actions.
  • Data Scrubber: Implemented data scrubbing tools to ensure data integrity across compliance reports and reduce preparation time.

Benefits

The implementation of Inovaare’s solutions provided the health plan with:

  • Increased Efficiency: Automated compliance monitoring reduced audit preparation time by 60%, enabling quicker regulatory responses.
  • Centralized Data Management: The platform’s centralized approach provided a unified view of compliance data, enhancing decision-making and oversight.
  • Cost Savings: Automation led to a 50% improvement in risk management efficiency, resulting in significant cost reductions in compliance operations.

Outcomes

  • Inovaare delivered holistic business value by turning compliance operations into a key enabler of strategic growth.
  • The automation of compliance monitoring and risk management enhanced regulatory readiness and strengthened stakeholder trust.
  • By improving efficiency in risk management, the solution minimized operational risks and reduced regulatory exposure, safeguarding the organization’s financial health.
  • Faster compliance response times increased agility, allowing for quicker decision-making and proactive management of compliance activities.
  • These enhancements freed up resources for Molina to focus on expanding member services and other strategic priorities, positioning the organization for long-term growth and operational excellence.

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