HC
Healthcare Plan Operations
MS Concitus Case Study
Healthcare • 2021
● Healthcare • Plan Operations • Gov Contracts

Stabilising a US Healthcare Plan Operations Portal for Agents & Policy Workflows

Delivered critical production bug fixes for a US healthcare plan operations management portal used by healthcare agents, stabilising core policy workflows and protecting a key recurring revenue stream tied to US government contracts.

Role Senior Software Engineer
Org MS Concitus, Dhaka, Bangladesh
Industry Healthcare • US Health Plans

The portal was used by healthcare agents to manage enrolments, policy changes, and day-to-day plan operations under US government programs. Instability in these workflows risks compliance issues, member dissatisfaction, and loss of contract revenue. My work focused on diagnosing and fixing production issues so the system behaved predictably for agents and stakeholders.

Problem → Solution → Impact

Problem

  • Agents hit intermittent errors in enrolment, changes, and terminations.
  • Edge cases in policy rules created UI/back-office mismatches.
  • Manual, high-stakes releases risked regression in regulated flows.

Solution

  • Shadowed real agent scenarios, instrumented logs, and reproduced failures.
  • Hardened validation and business-rule handling across policy workflows.
  • Shipped smaller, tested fixes aligned with QA and compliance teams.

Impact

  • More predictable enrolments and mid-year changes.
  • Fewer user-visible errors and data correction tickets.
  • Lower deploy anxiety; steadier service for members and agents.
Enrolment stability
Before: session errors under load After: guarded flows, fewer retries
Policy change correctness
Before: edge-case regressions After: validated rules & logging
Release risk
Before: manual, stressful deploys After: smaller, QA-paired drops
Observe & triage

Mine logs and shadow agents to isolate the noisiest failure cases in policy workflows.

Patch & guard

Tighten validation, rule handling, and data sync; add checks that mirror real-world edge cases.

Release safely

Ship smaller changes with QA pairing and better logging to keep regulated flows calm.

Impact spotlight
  • Agents complete member workflows without rework or escalations.
  • Members see accurate coverage updates sooner.
  • Compliance and revenue risk lowered through steadier operations.
Overview

Introduction

MS Concitus provided engineering support for a US healthcare plan operations management portal. The application supported a network of healthcare agents handling policy enrolments, changes, terminations, and exceptions across multiple plans and member populations.

As a Senior Software Engineer, I focused on production reliability: understanding how agents actually used the system, finding the most painful bugs in live workflows, and delivering fixes that kept the platform stable while respecting tight regulatory and contractual constraints.

Background

Context

US healthcare plan operations must comply with strict rules around eligibility, timelines, and documentation. The portal was at the centre of this:

  • Agents used it daily to process member applications and policy changes.
  • Data flowed downstream to billing, claims, and regulatory reporting systems.
  • The platform’s reliability influenced satisfaction of both members and government partners.

When agents encounter portal errors in the middle of a policy workflow, they often have to redo work, rely on manual workarounds, or escalate to support — all of which increase cost and risk for the health plan.

Challenge

Problem

The portal exhibited recurring production issues in critical flows such as:

  • New member enrolments and plan selection.
  • Policy changes (address, PCP, coverage level) mid-plan year.
  • Terminations and reinstatements triggered by life events.

These bugs showed up as:

  • Intermittent errors after long agent sessions.
  • Incorrect handling of edge cases in policy rules.
  • Data inconsistencies between UI and back-office records.

The challenge was to fix these issues without destabilising other parts of a large, mature codebase and without interrupting daily operations.

Operating Environment

Constraints & Requirements

  • Regulatory sensitivity: any change had to preserve compliance with US healthcare regulations and government contract requirements.
  • Limited maintenance windows: downtime directly affected agents and member service levels.
  • Legacy complexity: core workflows were implemented across multiple layers and had evolved over years.
  • Contractual stakes: reliability issues could impact satisfaction scores used in contract renewals and bonuses.
Execution

Implementation Highlights

1) Production incident triage

  • Reviewed production logs, error reports, and support tickets to identify patterns in failing workflows.
  • Worked with business analysts and QA to reconstruct real agent scenarios that triggered bugs.
  • Prioritised fixes for issues that impacted core policy operations and contract KPIs.

2) Targeted bug fixes in policy workflows

  • Corrected edge-case logic in policy rule evaluations (e.g., special enrolment periods, age cutoffs, and dependent relationships).
  • Addressed state management issues that caused stale data or duplicate submissions during long agent sessions.
  • Fixed data mapping problems between UI forms and back-end records to keep member data consistent.

3) Defensive coding & validation

  • Added input validation and clearer error handling around high-risk operations to prevent invalid policy states from being saved.
  • Introduced guardrails for common agent mistakes (e.g., incomplete required fields, conflicting changes) with actionable error messages instead of generic failures.
  • Helped refine automated tests for critical flows so regressions could be caught earlier.

4) Safer releases in a regulated environment

  • Collaborated with QA and release teams to bundle fixes into controlled releases with clear rollback plans.
  • Ensured that each change was traceable and well-documented for audits and compliance reviews.
  • Assisted in monitoring post-release behaviour to confirm incident reduction.
The focus was not on rewriting the system, but on making the existing portal feel “boringly reliable” to agents: fewer unexpected errors, clearer messages, and more predictable behaviour in day-to-day policy work.
Outcomes

Impact & Outcomes

While exact metrics are confidential, the reliability work translated into clear operational and business benefits:

  • Reduction in production incidents related to core policy workflows handled by healthcare agents.
  • Fewer support escalations and manual workarounds during enrolment and change periods.
  • More stable operations during critical windows tied to government program deadlines.
  • Protection of a key recurring revenue stream linked to US government contracts by strengthening the platform’s reliability story.
Reflection

Key Learnings

  • In healthcare, reliability and compliance are core product features — not “nice to have” technical qualities.
  • Small, well-targeted fixes to critical workflows can deliver outsized value when those workflows sit under government contracts.
  • Partnering closely with support and business teams is essential to understand how bugs affect real agents and members.
  • Investing in defensive coding, validation, and safer releases pays off in fewer incidents and smoother contract renewals.