Help Introduction and conclusion?

Introduction?

Development of Policies, Procedures, and Standard

UnitedHealthcare and Optum Inc. (Optum) do not outsource their IT department or IT projects, all IT aspects of IT are handled internally. Optum's help desk and IT department are made up of Optum employees. SubroPoint is a cloud-based application, however, UnitedHealthcare owns, operates, and manages the cloud internally.

As of 2019 the business managers were instructed to give the problem statement to the IT department, who is required to make the necessary fixes and changes. The IT department is expected to use their specific process or methodology. Unfortunately, only the IT department is privy their processes. This information was requested from the IT department, who responded that the information was not shareable.

The business managers identify an issue and generate a problem statement. This problem statement will identify the issue at hand and the goal statement, which explains the expected end result of the project. Once the problem statement is completed, the business manager then creates a project business benefit, which identifies the savings to the company as well as other benefits associated with the project, for example reduced provider abrasion. The project business benefit will also contain a blue-chip alignment, which calls out what business objective the project is tied to, for example revenue growth.

The business managers are also responsible for maintaining the project status and reporting the project milestones as they are completed. Optum typically measures project milestones by phases. The business manager will define the phase the project is in along with its status, this includes reporting when the phase is ready for completion and sign off. The business manager will also identify any phase deliverables that are outstanding with projections for completion.

Finally, the business managers are responsible for identifying project risks and issues. This would identify any foreseen issues, for instance; time zone differences, process questions, additional system enhancements required, along with their expected costs. The project issues step would also contain information pertaining to the next steps of the project.

Once the problem statement is completed and signed off, the business manager will gather the information and project charter. The project charter will contain a project title, project id, project champion, project black belt, problem statement, goal statement, critical quality, objectives and measures, business case and financial impact, scope, and schedule estimates and initiative resources (who is handling what aspects of the project and their estimated completion dates). The schedule estimates and initiatives will consist of several phases; define, measure, analyze, improve, and control and will identify when each phase was completed, and contain the important notes from that phase.

Though SubroPoint was purchased and customized, the process would best fit the RUP method. The RUP method which is "owned by IBM, provides a framework for breaking down the development of software into four gates" (Blatzan, 2020)

The customization of SubroPoint most closely followed the methodologies of RUP because of the four steps. The first step Optum took when starting the customization was to identify who the stakeholders were and to give them access to the test site so they would understand how SubroPoint currently operated. The second step was to identify what customizations were needed and to design the fixes and implement them. The final step of RUP identifies the training of the users.

The main purpose of the RUP methodology is to "avoid reinventing the wheel and focuses on rapidly adding or removing reusable chunks of process and addressing common problems" (Blatzan, 2020) It is clear from the study of the purchase, customization, and implementation of SubroPoint that Optum was focused on obtaining a system that could be rolled out quickly to avoid any negative affects on the business.

Add the textbook to the bibliography, references or works cited page.

Yes, Optum follows UnitedHealth Group's Information Security Policies and Standards. These policies provide "the foundation for assuring the availability, integrity, and confidentiality of all UnitedHealth Group Information Assets, whether verbal, written, printed or electronic, that are processed or stored on information technology systems, transmitted over networks, or maintained in any form" (UnitedHealth Group, 2020)

Additionally, the Enterprise Information Security Organization sets the Information Security Policies and Standards across UnitedHealth Group. It is important to note that Optum is part of UnitedHealth Group.

At UnitedHealth Group, the resource administrators are responsible for protecting the IT systems they have been assigned. Their duties are "establishing, monitoring, and operating them consistent with all applicable policies and control standards as documented in the UnitedHealth Group's Information Security Policies, related baselines, security standards, and security procedures" (UnitedHealth Group, 2020)

UnitedHealth Group also has established an Information Risk Services office, this office is part of the "Enterprise Information Security (EIS) Organization and is designed to promote compliance with the Company's mission and various federal, state, and local security and privacy regulations" (UnitedHealth Group, 2020).

The enterprise information security organization has designated a Business Information Security Officer to each business organization, who is responsible for overseeing the information risk program within that business organization.

UnitedHealth Group's "Chief Compliance Officer is responsible for overseeing UnitedHealth Group's compliance with all applicable laws and regulations as well as coordinating compliance programs between regions and Business Organizations. The Chief Compliance Officer reports on the effectiveness of UnitedHealth Group's compliance programs to the Audit Committee for the Board of Directors" (UnitedHealth Group, 2020)

This information was gathered from Optum's hub, which is an internally website that only employees can access however it needs to be cited.

Cite: www.hub.uhg.com

Establishing the Need and Gathering Requirement

As Optum's subrogation business continued to grow it became apparent that its current system SubroTrack would need to be replaced as it did not have the functionality or the ability to be customized to grow with Optum. SubroPoint was selected because of the functionality that currently existed within the application as well as the relative ease in making enhancements and changes. Optum's current platform, SubroTrack, had enough functionality to efficiently handle the department's work, however, the software had numerous drawbacks.

The biggest drawback Optum found in staying with SubroTrack was the limited resources available for system enhancements. Currently, Optum's management maintains a list of recommendations for system changes related to improving functionality, efficiencies, and processes. The IT support staff that is responsible for making the requested changes is shared across multiple departments within Optum. This only allowed mangers to provide quarterly requests that consisted of priority enhancements which were then prioritized based on funding and development and time requirements. The managers would then work with the IT support staff to promote their initiatives, provide financial savings forecasts along with their evidence of importance. The IT staff would then notify the managers of what items would fall within their time allotments. Contrarily, SubroPoint has a dedicated IT support staff solely for the subrogation application, which allows Optum's explicit needs to be a priority.

Yes. This meeting was considered a general brainstorming, where the impacted staff, business managers, team leads, and regional directors gathered to determine what was needed and what it would take to make it happen. Optum uses brainstorming as way to gather multiple opinions and ideas to be considered before moving forward with a project.

The initial request for a new application came from the business managers. As the business managers were receiving complaints from the SubroTrack users for much needed upgrades, such as correspondence, it became clear SubroTrack enhancements and upgrades were not a priority of the IT department. Optum's IT department did not consist of any staff dedicated to SubroTrack, therefore, any changes were met with exceedingly, long time delays, if they were determined to be important enough to be implemented. Importance was determined by how many staff members were affected by the issue. Because the subrogation department is divided into business groups, via clients, issues were specific to these small groups, which made it impossible for the business managers to get upgrades and enhancements approved as they were seen as only having a small impact on the overall business.

Optum already possessed a subrogation system, SubroTrack. This system was developed by Optum in-house and forced to attention the issues that needed to be addressed in a new system. Because Optum knew what the drawbacks were for SubroTrack they knew what they wanted in their next system.

The process of finding the next subrogation system was handled by Optum's business managers, regional directors, and SubroTrack's business manager. Once it was determined what type of system was required this information was given to the vice president, president, and chief executive officer. Where the decision was made that Optum would purchase a system that was ready to go and would not develop another subrogation system in-house.

After the decision to purchase a system was made, the business managers and regional directors started identifying subrogation systems they believed would fit Optum's needs. It was quickly identified that Legacy Equian's SubroPoint system would be the best fit because of the functionality that currently existed within the application as well as the ease in making enhancements and changes. Optum believed this system could easily be tailored to their needs now and in the future as the subrogation business grew.

The details surrounding he purchase of Legacy Equian have not been made available to the public.

Yes, it included SubroTrack's product managers, Optum business managers, and regional directors. The frontline users were not involved beyond the requests previously made to their business managers and team leads regarding enhancements and changes Optum's current system required.

The parties that contributed to gathering the requirements for the application were the business managers, SubroTrack product manager and the regional directors. The business managers provided the input they had previously received from the front-line users regarding what was needed from a new system to the regional directors and the SubroTrack product manager.

A Power Point workflow document was created. The workflow document contained the entire project, including the issue scope and projected outcome. Additionally, a fishbone graph was completed during the brainstorming phase.

The executive sponsors were Loreen Arms and Dave Sheppard, who are both executive directors. At Optum executive sponsors are known as project champions. Heather Henderson reviewed the requirements as the subject matter expert and worked with the project champions to sign off on the requirements.

Optum's business managers championed the project. Their motivation came from having a system that would be tailored to their needs and would allow future customizations and fixes as needed. As managements expected recovery amounts increased from year to year, the business managers believed they would need a system that would assist the frontline users in obtaining the expected recovery goals. This system needed streamline the daily tasks of the frontline workers and provide improved efficiency to assist in obtaining their goals.

The project managers were responsible for communicating updates to the business managers, and the business managers would keep their teams up to date as to what phase the project was in, what items they were working on, and when the rollout would begin. The project managers and the business managers participated in meetings three to four times a week, to discuss the project's status and issues.

The project leaders were responsible for updating other business owners, who were expected to trickle down the information related to the project to their direct reports. Other forms of communication used by the team were formal email communications and focus groups with applicable stakeholders. The product managers and business managers also sponsored office hours where anyone could join and talk about SubroPoint. This was used to obtain general feedback from the frontline workers and identify what their expectations of the end product were.

No, there were not disagreements. The staff involved was eager to customize SubroPoint and get it implemented. The customization of SubroPoint was exciting for the project team, because Optum's current system SubroTrack was very limited on changes and was not sufficiently meeting the needs of the frontline users. SubroPoint would allow most of the requested changes to be made and implemented, which reduced the rise of conflict because business managers would no longer be required to show their requests were more important than another business manager's request was.

Before SubroPoint went live, a test site was created. The test site had various clients moved to it (those clients remained in SubroTrack and were only used in the test site for testing purposes, the data was not live). A team was selected to work the files in SubroPoint in the test site, while this was taking place issues were identified as well as correspondence that SubroPoint was lacking. For instance, SubroPoint's letter generating tool contained substantially fewer correspondence choices than SubroTrack contained.

As the users in the test site identified issues and changes that needed to be made, these requests were given to their business managers. The business managers were responsible to draft the requested changes, identifying the change needed and why it was needed. The business manager would give this request to their regional director for approval. Once a regional director signed off on a request it was given to SubroPoint's product manager. The product manager would work with the IT department to determine the cost of the change and the time it would take for the fix to be created and implemented.

Once the impact and cost of the change was determined, the request would be presented to the executive directors, who would review the change request and either sign off or deny the request.

Systems development / Implementation options and decisions

Yes, Optum has an IT staff dedicated to application development, however, the services they provide are geared towards Optum's customers. This service is used to "seamlessly implement and optimize enterprise applications" for Optum's customers (Optum, 2021).

A bibliography, references or Works Cited page will need to be created.

Cite: https://www.optum.com/business/solutions/health-plans/technology-operations/it-consulting-system-integration.html

Optum already possessed their own system, SubroTrack, which was developed in-house. Optum knew at the beginning of the process they wanted to purchase a system that was developed and ready to go live. They believed that a system that already contained its own IT staff and was ready to go would be the easiest route and disrupt business the least. It was crucial for Optum to find a system that could easily be rolled out and cause the least amount of provider abrasion possible.

The decision to purchase a system was made, Optum did not intend to develop an application in-house or to outsource the development of one.

Yes, Optum decided to purchase an already existing system.

The option to develop a new system in-house was not considered. Optum already possessed a subrogation system, SubroTrack that could have been further developed, however, time restraints and functionality capabilities lead Optum leadership to decide to purchase an already existing system.

The decision to purchase a system ready to go live was essentially made by Optum's CEO. Optum already had its own system, SubroTrack, which was developed in-house, therefore, they understood the undertaking of developing a new system from scratch. Optum's goal was to purchase a system they believed was ready to go live which could implement relatively quickly so the impact on their client base was limited. The decision to purchase a ready-made system was instant, there was no desire to develop a new system in-house.

No, the decision was made because of the belief it would be the easiest and fastest way to improve the subrogation system at Optum with the least amount of provider abrasion. When Optum choose SubroPoint they believed the transition to from SubroTrack would be seamless.

There was not a formal request for proposal. Any formal request for proposal at Optum would be considered external and only used if Otpum was developing something for a customer. Internally, the project leader drafted a summary and synopsis to be used for the proposal request.

There were not any external vendors involved in the purchase or implementation of SubroPoint. To protect the sensitive data contained in the systems, UnitedHealth Group and Optum do not outsource.

SubroPoint required many customizations to fit Optum's needs. The customizing was completed by Optum's IT department dedicated to SubroPoint. Though the actual customizing was completed by the IT department, the business managers, project managers and regional directors were responsible for identifying the need and the process it followed until it was handed off to the IT department.

The application was customized to meet Optum's needs, Optum did not make any changes to accommodate SubroPoint. SubroPoint was a subrogation software, therefore, it was structured around the subrogation business.

4. Application implementation

The work of the development or acquisition team does not end with the delivery of a completed application. There is a lot left to do. Implementing the information system is a complex process that includes testing, training, documentation, acceptance, integration with existing systems, and cutover to production.

SubroPoint was not developed it was purchased by Optum, however, there were many customizations required to tailor it to Optum's specific needs. Shortly after the purchase of Legacy Equian it was discovered that SubroPoint lacked information and correspondence that Optum required. To remedy this issue the teams started working together to determine what SubroPoint was lacking before Optum could take it live. This process was determined by the teams working to customize the system. Once each item identified had been completed and signed off, the teams would move forward onto the next phase of the project. After the phases were completed and signed off, the team knew it was time to move forward and take SubroPoint live. After the first launch of SubroPoint, many misses were identified, and it was determined there more customizations were required before the next client would be taken live.

The implementation of SubroPoint was handled by the IT staff designated to SubroPoint support, the business managers, SubroPoint's product manager, regional directs and executive directors. The implementation was handled internally by Optum employees. Though, the project had a project champion, once it was time to implement the software, this project was handed off to the IT department.

This process was all handled internally by Optum employees as well.

• Executive directors
• Regional directors
• Optum business managers
• Equian business managers
• Subrogation analysts (frontline users)
• SubroPoint product manager
• Equian employees (used to train Optum employees in using SubroPoint)
• Optum's SubroPoint IT staff.

Additional testing was performed using real-case scenarios which identified issues with the medical claims data load, as well as errors with membership. Though there was not the creation of test strips, once the data was taken live in SubroPoint it was easily identified by the frontline users and business managers there were errors with how the claims data loaded into SubroPoint. Additionally, it was found that membership was not transferring from the claims systems into SubroPoint correctly. The IT staff was responsible for creating the fix and implementing it to resolve these issues. How these two issues were fixed was handled by the IT department and other departments are not privy to that information.

After the Optum IT staff completed the restructure of the coding system and the issues with the medical claims data load and membership were corrected, Heather Henderson collaborated with the Optum IT staff to categorize what changes were most important and needed now verses the changes that could be rolled out in a later release. Once the changes that were needed now were completed and the test cite appeared to be functional, Heather decided it was time to go live with SubroPoint. Heather gathered the final sign offs and requested the move of Optum's clients in phase one to be moved over to SubroPoint, phase one was now live.

Due to the large volume of work Optum was dealing with, they decided to move each line of business from SubroTrack to SubroPoint in six separate waves. This would ensure a thorough and work-based migration starting with Optum's smallest clients to reduce any potential impact to workflow, Optum identified these waves as phases. Optum started with the smallest client groups and will move towards the largest. To date, Optum has completed phase one and is in the process of completing phase two.

SubroPoint was selected as the system Optum wanted which led to Optum's purchase of Legacy Equian. The system was specifically chosen because of its ability to be customized and assist Optum in gaining additional ground in the subrogation industry. SubroPoint was chosen because of its functionality and ease of customizations, and the ability to grow with Optum's subrogation business.

SubroPoint had its own IT staff, who were hired by Optum after the purchase of Legacy Equian. Because they developed SubroPoint for Legacy Equian, they contained all the knowledge to install, implement and customize the application.

To prepare for the "go live" date Optum's impacted staff attended system training sessions and provided feedback to their business managers, who forwarded that information to Heather Henderson. The information was turned into internal documentation, which was used to customize SubroPoint more towards Optum's needs.

Additional training occurs for the frontline users as their clients are brought live into SubroPoint. The business managers and team leads were trained initially, by Equian staff, and now assist in training the frontline users. Once a user becomes familiar with SubroPoint they are also considered a reference point for new frontline users in training.

Conclusion?