Data Driven Decision Making—C207

Task 1

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 B. Describe a real-world business situation that could be addressed by collecting and

analyzing a set of data.

When working for a health insurance company that serves government programs such as

Medicaid and Medicare, there are times where a customer such as a member and/or provider

feels as though their requests for services are not adequate. If a customer feels as though they

have been wronged by a decision being made, they have an opportunity to file a complaint with

an appropriate State Regulatory Body Agency. In 2017, it appears that the top three types of

complaints received are those of customers receiving services from Managed Long Term Care,

Behavioral Health and Medicaid services. It is important that complaints are received and

resolved within established timeframes of either an urgent (48 hours) or non-urgent (15 calendar

days) basis.

B1. Summarize one question or decision relevant to the real-world business situation you

will answer by collecting and analyzing a set of data.

Is there a significant difference in the average resolution times of non-urgent complaints

received from three specific regulatory body agencies in 2017?

B2. Explain why the situation or question would benefit from a data analysis.

This situation would benefit from a data analysis as it will attempt to show if additional

resources such as an additional resolving analyst or reallocation of resolving analysts is required

to ensure applicable 14 day turnaround time of non-urgent complaint resolution.

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 B3. Identify data you will need to collect that is relevant to the situation or question. Note:

A sample size of 30 or more is suggested to provide a statistically reliable finding.

When a complaint is received, there is a days to complete resolution time associated with

each one. The turnaround time associated with each complaint is either 48 hours on an urgent

basis, or 15 calendar days for non-urgent complaints. I will take 50 non urgent complaints each

received from the following Regulatory bodies from calendar year 2017: Regulatory Agency 1,

Regulatory Agency 2 and Regulatory Agency 3. The data that will be collected is the amount of

time that each non-urgent complaint takes to be resolved by a Complaints Resolving Analyst.

The date from when the complaint was received and the date the complaints resolving analyst

has closed the complaint is the complaint resolution turnaround time (in days).

B4. Describe data gathering methodology

When a complaint is received, the information is submitted into an Escalation Tracking

database. This database houses all relevant data for each complaint received to include the

complaint received date as well as the data that the complaints resolving analyst has received

confirmation that the complaint has been closed by the State Regulatory body Agency. The date

from when the complaint was received and the date the complaints resolving analyst has closed

the complaint is the complaint resolution turnaround time (in days). This is the data that will be

extrapolated out of the system. Data will be pulled from an Escalation Tracking System Data

warehouse which feeds an Access Database. From the Access Database, information can be

pulled into Excel to run various reports, in this case I will be pulling out all non-urgent

complaints that are from the three aforementioned State Regulatory Body Agencies as well as the

turnaround time in complaint resolution. Both are their own unique fields and both are

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 reportable. This will be a secondary method of collection, as the data to be used is received from

an output of a Data Warehouse for Complaints received in 2017.

B5. Identify appropriate data analysis technique

ANOVA will be used to test whether or not there is a statistical difference among the

average non-urgent complaint resolution times between the three State Regulatory Body

Agencies. The single factor (independent variable) that I will be utilizing is the non-urgent

complaint resolution turnaround time (in days) recorded for of the three State Regulatory Body

agencies that submit complaints.

B5a. Explanation of data analysis technique to be utilized

ANOVA single factor test as the technique to analyze the data collected will help show

whether or not there is a significant difference in the average non-urgent complaint resolution

times from three specific regulatory body agencies for the 2017 calendar year. It is the intention

that with the data provided, we can determine whether the means are all equal, or if there is a

significant difference with at least one out of the three means

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