Case Study: Experience Modernization

Elevating Member Experience at a National Health Plan

Modernized member experience across web and mobile—meeting members where they are to bring the most convenient, intuitive, and meaningful healthcare experience everywhere, every time.

THE CHALLENGE

Deliver the Easiest Healthcare Experience—Everywhere, Every time

A national health plan with 5 million+ members set a North Star to deliver the easiest healthcare experience—everywhere, every time, yet fragmented touch points, lack of human-centered design approaches, and slow release cycles held it back.

Engagement Objective

Facilitates the health plan's digital experience innovation, design and product management for their member experiences

Business Impact

Maintain strong market share by achieving high member engagement and satisfaction, ensure loyalty, and build trust

User Value

Remove friction and uncertainty, so members feel equipped to successfully manage their healthcare and insurance needs

how i led

Role, Team, & Constraints

We stood up a centralized Digital Experience (DX) Design Center to drive innovation, design, and product management with a Build–Measure–Learn cadence and SAFe-aligned portfolio governance. Taking a journey-led approach, we leveraged data to anticipate member needs, simplify high-value tasks across channels, and empower better health though cost transparency and a frictionless member experience.

1

Design Center Lead

Analyzed, explored, and developed user experience strategies. Supported product roadmap planning, and led design ops from feature exploration to prototyping, user testing, and hand-off.

2

Team Composition

Led a product team of 1 senior product manager, 1 BA, 1 content strategist, and 3-4 designers. Collaborated closely with client, business owners, product owners, engineering teams, and various solution vendors.

3

Key Constraints

HIPAA/PHI and web accessibility compliance, complex program requirements, legacy integrations, multi-vendor coordination, balancing experience innovation with addressing technical debt.

WHAT WE DID

Key Initiatives & Accomplishments

The DX Design Center functions as the internal Solution Exploration work stream of the larger DX Program, working closely in a staggered cadence with the Solution Delivery & Deployment work stream in regular program increment releases. This ensures the program is continuously innovating and enhancing member experience.

Below are notable achievements and major initiatives I have led and executed:

Healthcare Cost Advisor

Moving from Anxiety to Assurance in Members’ Healthcare Planning

The health plan embarked on a mission to help members plan for their future based on their healthcare needs and financial goals using personalized data and accurate simulation tools.

Design Sprint

2-day workshop with local plan representatives to align on strategic goals, empathize with member needs, co-designed potential solutions, and prioritized ideas for further exploration.

Prototype & Test

Prototyped and tested key concepts with members

Quantitative member surveys collective measurable data to gauge interested and assess potential features

Learn & Iterate

Designed landing page to educate an increase engagement with an MVP 3rd party vendor solution

Established flexible foundation for multi-phased roadmap


Member Mobile App

A Lean Start-up Approach to Deliver Mobile Experience Early and Often

After launching an MVP app with limited core features in 4 months, the program developed a comprehensive strategy and roadmap for the mobile app, through its Mobile App Product Strategy Initiative:

  • Facilitated workshops aligned business and member goals
  • Roadmap with prioritized features provide actionable plan based on value vs. effort.
  • Built alignment on vision and product goals, then In-app experience survey helps to boost positive ratings and collect feedback on opportunities for improvement
  • Ongoing iterations to continuously enhance with new features and improved experience

Over time, the quality of the app improved with feature enhancements and improved experience, boasting a 4.5 star rating on the iOS app store with over 19K rating.

Key features include member ID card, View Claims, 24/7 Nurse Line, Virtual Doctor, Financial Overview, Incentive Programs, EoB, Provider Finder, Secure Messaging, Interactive Benefits Tool, Enrollment Information, etc.


Prescription Drug Cost Tool

Check drug costs, plan coverage, and compare costs across benefit plans

63% of plan members considers the Drug Cost Tool most important to have from their health insurance plan. Following the initial launch of the drug cost tool on the public website, our team designed an authenticated version for plan members with personalization such as plan specific pricing, coverage summary, and the ability to save their preferred pharmacy.


Unified Design System & Accessibility Update

A standard set of reusable components to ensure consistency and compliance

There was an urgent need to upgrade the member web portal to be web accessible and WCAG 2.1 AA compliant. Our team took the opportunity to define a standardized design system that will not only meet web accessibility standards, but also create a consistent user experience across platform, accelerate design and development, and minimize inconsistencies and design debt over time by having a shared set of principles and guidelines.

We adopted Atomic Design as the primary methdology, and take a 4-phased approach:

1

Inventory & Audit

Took inventory of 100+ pages across the portal, and performed a detailed visual audit to assess patterns and inconsistencies

2

Accessibility Guidelines

Researched and collated a set of common component guidelines and best practices

3

Unified Design System

Designed and define the design system atoms, molecules, organisms, templates, and pages

4

Design System Artifacts

Created a centralized design system artifacts and prototyped key pages for guidance and reference


Operationalizing the Member Journey

Holistic View of the Member Experience with All Available Product and Tools

By visualizing the vast array of 100+ products and services along the enterprise member journey, then layering the consumer segments with available performance/utilization, stakeholders now have a big picture view of the member experience ecosystem to identify gaps or redundancies, and how it impacts the overall member experience.

Persona profiles are built upon detailed consumer segmentation summaries on technology behavior, health, financial and insurance attitudes, an incentives interest

Each tool are mapped to journey phases and target points. Based on persona profiles, member journey "stories" illustrate common scenarios and experiences.

The Member Journey Map was leveraged for ideation workshops to explore opportunities based on experience index report, improve awareness and engagement with new tools, and increase compliance with HEDIS measures.

An evaluation framework was developed to help stakeholders uncover unmet needs, make informed decisions on product vision and roadmap, and priortize their investments in new tools and target points.

Success

Outcomes & Impact

01

Engagement Lift at Scale

Drove +25% user satisfaction, +50% mobile use in six months, and +37% completion of annual health assessments.

02

Transparency & Trust

Price transparency tools with authenticated, personalized experience boosted member satisfaction and trust with their plan provider.

03

Journey-led Portfolio Alignment

Operationalization of the member journey map enabled better decision making on priorities that align with their digital strategy

04

Human-centered Innovation

From MVP to roadmap-driven iteration, workshops aligned business goals with member needs to elevate the user experience and empower better health.

Key Takeaways

A centralized, design-led operating model—anchored by journey mapping, agile test-and-learn, and targeted personalization—translated directly into measurable wins: higher satisfaction and engagement, trusted cost transparency (81% satisfaction), and a 4.5★ mobile experience. These outcomes show how disciplined product practices convert strategy into member value at scale.

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Doris Mao Lin | Los Angeles, CA | 310-497-2949 | dorismaolin@icloud.com | linkedin.com/in/dorisl/ | dorismaolin.me