Health

Application Systems Theory

Blue Cross Blue Shield of Illinois: Service Management Staff Challenges. Blue Cross Blue Shield of Illinois: Service Management Staff Challenges.
1.0 Introduction
The Blue Cross Blue Shield of Illinois traces its beginnings back to the Great Depression in the 1930’s by Health Care Service Corporation. It was started to provide an avenue where residents of Chicago would have access to affordable healthcare. The Blue Cross Symbol was adopted in 1939 and the Blue shield symbol was adopted in 1947 (hcsc.com, 2014). The organization’s mission is to promote the health and wellness of her members and communities through accessible, cost effective, quality health care (BCBSCIL, 2009). The customer service staffs have a low morale due to lack of career growth opportunities. This is due to the low staff turnover at the department.
2.0 System theory Description of the BCBSCIL Customer Service Department
2.1 Inputs
The customer service department is renewed by the inflow of energy and information from her immediate external environment. The department coordinates with the external environment enabling it to import adequate energy from it for sustainability. The department is the direct link between the clients and the organization. Through these constant interactions, they are able to notify the management on service areas where improvement is necessary and where it is up-to date (Amagoh, 2008).
2.2 Throughput
This involves the reorganization of the system inputs thereby transforming the energies inside the customer service department’s system (Meyer et al, 2010). The maximization of value of health insurance services is dependent on how the customer queries are relayed to the management and how the management responds to them (Amagoh, 2008). The level of communication, competence of staff and the management of this department have been consistently called to question. There is a need for retraining of customer service staff on product knowledge as well as claims processes and procedures. The middle management is congested which delays timely response to client queries, as information must go through numerous channels.
2.3 Output
The transformation of the internal systems allows for adequate service delivery. This creates confidence and assurance on the client as regards the quality and reliability of the services of BCBSIL (Sundarasaradula &amp. Hasan, 2004). Due to inadequate communication, incompetent staff and management issues, the customer queries are not properly handled leaving clients complaining of poor services.
2.4 Systems as Cycles of Events
The interaction between the systems input-transformation-output processes must establish BCBIL as a consistent organization in attaining its key mission (Meyer, 2010). When the customer queries are received, they are escalated to the management for action and this is followed by prompt and accurate response to the clients. This creates a sense of reliability on the organizations part and makes their services dependable.
2.5 Negative Feedback
The department has systems that have been instituted to restore order whenever there is a hitch. For instance, workers here work in morning and afternoon shifts, leave days are pre-planned and organized to ensure a constant delivery of services (Marquis et al, 2012). We
3.0 Description of the Problem
The problem in this department is caused by a low morale on the part of the customer service staff. This is caused by the lack of career growth prospects because the organization has a low turnover of employees. This is also compounded by the fact that the middle level management is congested which reduces the chances of career development among the lower cadre of staff at the department.
3.1 How to Address the Problem
The systemic deficiencies can be addressed in the following ways.
3.1 Desired Outcome
To improve the staffs efficiency and contribution to the organization’s vision of providing quality and efficient service (Mc Cormack et al, 2008).
3.2 Goals and Objectives
The goal of the corrective measures is to motivate them so that the organization can benefit from their optimum production. In addition, their level of product knowledge and claims processes is vast which makes them ideal candidates for promotion not just in the department but other departments of their choice.
3.3 Policy and Procedures
Promotions will be interdepartmental and priorities will be given to staff that have demonstrated knowledge and interest in growth in other areas of the organization.
All staff on a rotational basis to increase to improve their product knowledge and interpersonal skills should serve the customer service department in.
The management levels at the department will be reduced to increase the ease of communication and action.
3.5 How the Resolution upholds the Organizations mission and vision
The resolution injects a sustained wave of vibrancy department. This will ensure that the department becomes a source of in-house training on the organization’s products and processes.
Works Cited
Sundarasaradula, D., &amp. Hasan, H. (2004). A unified open systems model for explaining organizational change. In S. Gregor &amp. D.Hart (Eds, Information Systems Foundations: Constructing and Criticizing (pp. 125-142). Canberra, ACT, Australia: Australian National University Press.
McCormack, B., Manley, K., &amp. Walsh, K. (2008). Person-Centred Systems and Processes. In K. Manley, B., McCormack, &amp. V. Wilson (Eds.), International practice development in nursing and healthcare (pp. 25-29). Oxford, England: Blackwell.
Meyer, R. M., &amp. OBrien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828-2838.
Marquis, B. L., &amp. Huston, C. J. (2012). Leadership roles and management functions in nursing: Theory and application (Laureate Education, Inc., custom ed.). Philadelphia, PA: Lippincott, Williams &amp. Wilkins.

Back To Top