The Challenge

The client offers an over-the-counter benefits program and serves more than 15 million Medicare Advantage members, routinely deploying targeted programs to make healthy products accessible and affordable. At the start of each Medicare plan year, member inquiries about supplemental benefits and rewards pour into the contact center, forcing the client to onboard over 800 agents within three months and ready them for peak season. That demanded a careful balance: equipping agents with constantly updated benefit information and stronger skills while holding the line on empathy, accuracy, and compliance, meeting AHT targets without eroding call quality, closing knowledge-base gaps that dragged on CSAT, and standing up outbound scripting that could pivot quickly.

The Solution

ResultsCX deployed Rubraik Assist to strengthen every step of member engagement. Its proprietary, in-flow agent intelligence surfaced the right knowledge inside the workflow, helping agents retrieve information and resolve member queries promptly – improving accuracy, helping agents avoid penalties for inaccuracies, and driving AHT down – while rapid integration of knowledge updates kept agents current as benefits changed through the plan year. Rubraik Analyze identified the two most common inbound call drivers and scripted outbound campaigns against them, turning frontline patterns into proactive engagement. Alongside the technology, ResultsCX experts sustained a culture of empathy and proficiency through team communication, incentives, and training, so agents did not just resolve issues but connected with members on the benefits that support their health.

The Customer

The client is a health and wellness benefit provider serving over 15 million Medicare Advantage members, operating where CMS is pushing to increase the utilization and appropriateness of supplemental benefits, and where member understanding directly determines whether those benefits get used. Facing a compressed onboarding window and an annual inquiry surge, the provider needed agent enablement that scaled fast without compromising compliance or care. Rubraik Assist and Rubraik Analyze gave the client the in-flow intelligence and call-driver insight to engage millions of members with accuracy and empathy, sustaining CSAT above 94%.