How a Regional Health Insurer Achieved a 15% YoY Growth Plan for Medicare Sales Through Call Center Optimization
Health Insurance · Regional U.S. Provider · 4M+ Members · Medicare Sales Call Center · Growth Strategy
The Challenge
A regional U.S. health insurance provider with over 4 million members was entering a critical growth phase for its Medicare business. Leadership had set ambitious enrollment targets for the coming year and needed to understand what it would take to deliver significantly higher sales performance through its call center — without proportionally increasing costs.
The challenge was multifaceted. Medicare sales operate within a highly regulated environment with strict compliance requirements, specialized customer experience standards, and complex enrollment processes. Simply adding headcount wouldn't be enough — the organization needed to ensure that every aspect of the call center operation, from staffing models to call handling strategies, was optimized to convert more leads while maintaining the quality and compliance standards that Medicare demands.
The leadership team needed a clear, actionable roadmap that connected staffing levels, training investments, operational tactics, and financial projections into a unified growth plan — complete with an ROI model that would give executives confidence to approve the required investments.
Our Approach
Blue Orbit Consulting partnered with the insurer's leadership team to build a comprehensive sales call center growth strategy grounded in Medicare-specific best practices. Our engagement spanned four key workstreams:
Contact center discipline review against Medicare sales best practices — Given the unique complexities of health insurance and Medicare compliance, we reviewed each contact center discipline — including sales processes, quality standards, call handling procedures, and regulatory adherence — against industry best practices specific to Medicare enrollment and retention.
Strategic roadmap development with stakeholder alignment — Collaborated with key stakeholders across sales, operations, and leadership to co-create a strategic roadmap of prioritized tactics designed to drive improved conversion rates, enrollment volumes, and overall sales performance.
Staffing model and capacity sizing — Sized the staffing levels required to achieve the organization's financial objectives and service level targets, determining the exact number of agents, team leads, and support roles needed to handle projected inbound and outbound Medicare sales volumes.
ROI model construction for investment approval — Built a detailed return-on-investment model connecting the proposed staffing increases, training programs, and operational improvements to projected revenue gains — giving leadership a clear financial case to support the growth investment.
The Results
Growth plan targeting 15% year-over-year enrollment increase delivered — The organization received a comprehensive, actionable growth plan designed to drive incremental 15% growth in Medicare enrollment year-over-year through a combination of resourcing, training, call handling, and contact strategy improvements.
Staffing model aligned to financial and service level targets — A detailed capacity plan connected headcount requirements directly to enrollment projections and service level commitments, eliminating guesswork from the hiring and budgeting process.
ROI model secured executive buy-in — The financial model provided leadership with a clear view of investment requirements versus projected revenue returns, enabling confident decision-making and budget approval for the growth initiative.
Medicare-specific operational improvements identified — The best-practice review surfaced concrete opportunities to improve conversion rates, call handling efficiency, and compliance adherence — tailored specifically to the regulatory and experiential demands of Medicare sales.
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