Insurance Claims Data Warehouse and KPI Dashboard for a Major Health Care Insurer

The Client

A major health care insurer

The client and its affiliates provide health benefit services to more than 3.2 million members across the mid-Atlantic region.

The Challenge

The company utilizes multiple applications to track and administer health insurance claims. Executives from the claims department wished to have a high level understanding of how their employees were performing in handling the claims. They also wanted to high level information about the health care providers with whom they deal, such as which providers are submitting the most claims. Because of the multiple applications used by the company, consolidating this data into one location would be a major undertaking.

Another challenge would be to provide this data to the business executives in a dashboard format. One of the requirements of the system was to provide not only high-level KPIs for the claims department, but also to provide the ability to drill down into the data to do further analysis. The data needed to be formatted in such a manner as to allow for simple dimensional drilling, and needed to be presented in a manner that was easy to use for the business users.

The Solution

Altek Solutions worked with the client's Application Development Team and with key members of their business units to analyze their Business Intelligence needs and determine the best possible solution to getting the business the data they required in a timely fashion.

Our consultants took a three step approach:

• Evaluate the current technological environment in order to determine the best technical solution for the client.
• Design & Implement a new data warehouse that would allow for more efficient data analysis and trend forecasting by the claims department users.
• Train client's developers and administrators on how best to maintain the system that was developed.

The Benefits

Altek Solutions' project team was able to successfully design, develop and implement a data warehouse that combined data from three separate sources. By utilizing Business Objects' Data Integrator, they were able to move data from the source into the data warehouse efficiently and consistently. The project team also developed an executive information system utilizing Business Objects' Application Foundation.

Tools & Technologies

• Business Objects & WebIntelligence
• Business Objects Application Foundation
• Business Objects Data Integrator
• ERWin Data Modeler
• Oracle 9i
• Dimensional Data Mart Modeling
• Project Management