Output: you can present in memo format, leveraging flow-charts, spreadsheets, diagrams, and whatever else needed to convey your point. The end-goal is to present an operational scale-up plan that is detailed, rooted in numbers, and implementable within 30-days.
You are a General Manager (GM) in charge of 100 Athelas Revenue Cycle Management (RCM) accounts representing $10mm ARR in aggregate to the company ($200mm in total claims collected for practices - 5% take rate). Most of these accounts are mid-sized healthcare practices, focusing on a certain specialty. Assume that the average dollar per-encounter for our customer is $200 (of which we collect 5%).
Assume that the software automations of the product are not built out at all, and everything is to be done manually using our labor-force in India and manual submissions into insurance company portals. Assume that we have full access to the doctor’s EHR, along with all necessary insurance portals.
Assume that all 100 accounts will all onboard over the course of 1 quarter (3 months), 10 in the first month, 30 in the second, and 60 in the third.
Assume customer SLAs of submissions being made within 5-days of a doctor’s appointment, and denials being worked within 3-days of response from payer. Additionally, the customer will expect a dollar approval rate of 90% for the charged amount across all encounters.
Assume the target margin profile of the business is ~60% gross margin.
Process and Org build-out:
Talk us through how you will scale up the entire operation: hires necessary in the US, manual labor-force in India, for extracting + submitting, claims, quality control, measuring metrics, customer service, etc. Should include capacity planning, manager / pod structures, tools and systems you want to use, meeting cadences, metric ownership etc.
Assume you have 1 month to do the requisite hiring in the US / India prior to the start of the quarter, and then hiring may continue through the quarter.
Ensure that customers have access to necessary information and are happy with the delivery of service, and describe the process / hires / systems by which this is ensured.
Go over the necessary capacity planning, quality control models, and overall scale up + monitoring of the process.
Metrics and KPIs:
What are the key metrics you are tracking to judge performance of onboarding, implementation, and ongoing operation of the accounts? What metrics matter to you as the GM, along with your direct reports.
Describe in detail (feel free to use something like [login to view URL] or [login to view URL] to create a whiteboard diagram) what metrics dashboarding you would use, and how would you set it up?
Execution:
The next step is to clearly describe what you would do in your first 7, 30, 60, and 90 days in setting up this operation. Assume the India office has to be built out from scratch, and our first customers are ready to go. How are you structuring your days, and what are your first steps?
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