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Leading Health Plan Provider

Reimagining the Patient Experience with a Leading Health Plan Provider

Background

The Health Plan Provider, the largest insurance company in the Pacific Northwest, serves over 2 million members across Washington and Alaska. Driven by a mission to enhance member satisfaction and operational efficiency, their team sought to reimagine the member portal experience. Their vision: a seamless, empowering digital journey that could match the innovation seen in other industries.

Despite a wealth of internal research and customer feedback, the Health Plan Provider’s CX and Innovation teams faced challenges transforming insights into a compelling product strategy. That’s where UpTop stepped in.

Challenges

Like many healthcare organizations, the client was constrained by legacy systems and third-party tools that limited their ability to create cohesive, personalized digital experiences. Their existing member portal was fragmented, making it difficult for members to find care, manage prescriptions, view claims, or enroll in plans. Support call volume remained high due to the lack of self-service options.

Internally, stakeholders were eager for change but needed alignment, direction, and a clear path forward.

Project Info

client
Leading Health Plan Provider
Industry
Healthcare / Insurance / Member Services
type
Web Portal
services
Ideation/Envisioning, Prototyping, Journey Mapping, Digital Strategy, Visual Design, UX Design

Project Info

client
Leading Health Plan Provider
Industry
Healthcare / Insurance / Member Services
type
Web Portal
services
Ideation/Envisioning, Prototyping, Journey Mapping, Digital Strategy, Visual Design, UX Design

Background

The Health Plan Provider, the largest insurance company in the Pacific Northwest, serves over 2 million members across Washington and Alaska. Driven by a mission to enhance member satisfaction and operational efficiency, their team sought to reimagine the member portal experience. Their vision: a seamless, empowering digital journey that could match the innovation seen in other industries.

Despite a wealth of internal research and customer feedback, the Health Plan Provider’s CX and Innovation teams faced challenges transforming insights into a compelling product strategy. That’s where UpTop stepped in.

Challenges

Like many healthcare organizations, the client was constrained by legacy systems and third-party tools that limited their ability to create cohesive, personalized digital experiences. Their existing member portal was fragmented, making it difficult for members to find care, manage prescriptions, view claims, or enroll in plans. Support call volume remained high due to the lack of self-service options.

Internally, stakeholders were eager for change but needed alignment, direction, and a clear path forward.
“Going through it all, they really challenged us to think differently about things and challenged us to ask - Are we going down a path of focusing on the customer and making sure we are getting the right outcomes out of this? I'm very pleased with the outcome and I'm looking forward to sharing this work internally with our business partners.”
– Director of Product Management & CX

Approach

UpTop began by consuming the Health Plan Provider’s research, analytics, and customer insights. Armed with this foundation, we conducted stakeholder interviews and mapped existing customer journeys. We then hosted a series of multi-day envisioning workshops that brought together CX leaders, product managers, designers, developers, and decision-makers.

These sessions were grounded in design thinking and journey mapping, enabling cross-functional teams to empathize with member pain points and co-create innovative solutions. The workshops covered key areas including Shop & Enroll, Find Care, Benefits, Pharmacy, and Claims.

Throughout the process, UpTop created a collaborative space where bold ideas could flourish—free from internal constraints or fears of legacy system limitations.

Solution

We created a prototyped user journey centered around a fictional persona, “Mary,” to showcase how a redesigned portal could transform her experience across the healthcare lifecycle. This prototype:
  • Unified the member experience under a common story framework
  • Illustrated seamless digital interactions across all service areas
  • Visualized how third-party tools could be replaced with native, intuitive designs
  • Highlighted ways to empower members with self-service tools and clear information
The workshops and resulting designs gave internal stakeholders clarity and excitement around a shared vision—moving from research to action.

Results

The Health Plan Provider left the engagement with a validated prototype and a compelling narrative for internal buy-in. Key results included:
  • A cohesive customer journey framework across critical service areas
  • Streamlined digital experiences aimed at reducing support call volume
  • Empowered internal teams to break free from legacy constraints
  • A technology roadmap and strategy for execution 

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