Case Study: UnitedHealthcare achieves nine-fold faster physician contracting and enterprise-wide workflow standardization with Pegasystems

United Healthcare - Customer Case Study

UnitedHealthGroup (UHG), a large healthcare and benefits organization, faced fragmented systems, limited end-to-end visibility, and a lack of reusable components that made processes unintuitive and inefficient. The company’s goal was to simplify and standardize operations to lower administrative costs, improve customer service, and create a center of excellence for faster, more accurate responses across call centers and operations.

Partnering with Pega, UHG consolidated tools into a unified workflow and case-management platform, automated claims, referrals and prior-authorizations, modernized enrollment, and created a physician contracting workflow and provider self-service journey. The transformation delivered a nine-fold improvement in physician contracting cycle time, established a BPM enterprise standard and CoE, expanded the Pega user base to 200,000, delivered 39+ programs with strong ROI, trained 700+ employees, and strengthened relationships with members and providers.

UnitedHealthcare

Laura Ciavola

Senior Vice-President, Medicare and Retirement