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A provider-sponsored health insurance company serving over 1.8 million members and 40,000 providers in New York faced growing pressure after the COVID-19 outbreak. Medicaid, the government-funded health insurance program for people with limited income and resources, had paused changes to enrollment during the pandemic. As that process resumed, states began reassessing members who still qualified for coverage through Medicaid redetermination, putting millions at risk of losing care. At the same time, demand for faster, more connected services was growing. The insurer transformed its operations to meet this challenge while prioritizing its members. To bring this vision to life, the company partnered with Virtusa to drive large-scale Agile transformation. The collaboration reduced external expenses by over 40% and enabled the insurer to respond faster, more efficiently, and with care at the core.
As post-COVID Medicaid redetermination resumed, millions of vulnerable Americans faced the risk of losing health coverage. For the insurer, serving over 1.8 million New Yorkers, the urgency was clear: ensure no member was left behind.
But internally, the organization was fighting a different crisis. Its delivery ecosystem had become too fragmented to function under pressure. The organization had issued 12 proposals involving different buyers, service contracts, and delivery models, which added complexity and reduced coordination.
Testing environments operated in silos, with no unified view, coordination was slow, and governance was fragmented across layers of external support. High attrition in key roles added volatility to already unstable workflows, resulting in employee burnout.
Duplication of effort, inconsistent quality, and delayed decision-making made it hard to scale the response the insurer urgently needed to cater to its customers’ needs. The organization recognized that it couldn’t guarantee timely, consistent care for the people without simplifying and unifying its service delivery system
The insurer decided to eliminate the complexities of its systems with a single, responsive Agile model that could prioritize care for its members. It partnered with Virtusa to lead a full-scale transformation beyond operational consolidation, building a delivery engine fit for the scale and urgency of modern healthcare.
Virtusa proposed a tower-by-tower strategy using its Flying-Formation framework, which is grounded in stakeholder feedback, business value mapping, and risk alignment. As part of this approach, Virtusa brought together cross-functional teams from solutions, offerings, service lines, application development, and client services to architect a unified, end-to-end delivery model.
The strategy included gathering deep business intelligence, analyzing competitive strengths and weaknesses, and listening closely to stakeholder feedback through surveys. Virtusa designed customized commercial and delivery solutions while carefully mapping value and risk to build trust.
Through the partnership, the insurer focused on empowering the people delivering care every day by combining innovation, automation, and talent in a single, integrated model. Over 160 roles were transitioned across five business towers. More than 50 Agile squads were activated. As part of this integrated service and transformation deal, delivery teams across India, the United States, Canada, and Mexico were rapidly mobilized to support development and quality engineering.
Virtusa deployed a layered talent strategy combining multi-region sourcing, AI-led screening, accelerated onboarding, and supply chain optimization. Post-offer engagement and tightly coordinated recruiting cycles ensured a consistent pipeline of qualified talent across locations. In less than 90 days, 80% of roles were staffed with vetted, cross-geo talent. Automation was introduced to reduce manual efforts, and real-time collaboration was made possible across its global operations.
Hiring scaled through 5,000+ sourced profiles, 3,000+ interviews, and more than 300 vendor partnerships. Daily staffing health checks, SLA-led oversight, and deep executive alignment sustained the Agile transformation.
Virtusa stood out for its technical capability and how it listened. Instead of proposing a one-size-fits-all solution, Virtusa engaged tower by tower, aligning every aspect of the delivery model to the insurer’s member-first priorities. The organization needed a partner who could act fast, think strategically, and stay grounded in the mission of care. Virtusa's willingness to co-design—from recruitment to automation to governance—helped build trust in the process, with its employees and its customers.
With the integrated service transformation in place, the insurer gained end-to-end Agile coverage across mission-critical functions. Delivery became more consistent and operations more predictable. Most importantly, the organization could meet its Medicaid redetermination challenge without compromising coverage for its members.
With a unified delivery model, the insurer is better equipped to respond to regulatory change, scale services, and continue advancing its mission: protecting coverage for the communities that depend on it.
Impact delivered at scale:
reduction in external spending
strategic engagement across 3+ years
of roles staffed in under 90 days
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