BPO Launch & Ramp-up

Onboarding 500+ Employees Across 10M+ Scale-up Initiative

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Case studies are invaluable for project managers and Agile practitioners. They?provide real-world examples of complex project execution and the adjustments needed for success.

In this edition of The PM Playbook, we examine the challenges of scaling a?BPO subsidiary?in the?healthcare industry, including?resource optimization,?stakeholder alignment, and?offshore operations. The case study demonstrates the power of?strategic project management?and?executive leadership?in overcoming these challenges.

Analyzing this project’s outcomes will give you insights into?performance metrics,?risk management, and?cross-functional collaboration. The challenges of aligning?global teams?highlight the need for?adaptive leadership?and?clear communication. You’ll also learn key lessons in?change management?and?organizational transformation, empowering you to fine-tune strategies for?optimal results.

Case Study Author: Chad R. Parker, PMP

Introduction

Effective?Project Management?at every level of an organization is essential to capitalizing on?large-scale portfolios, driving production changes, and seizing?growth opportunities. This case study outlines the journey of launching an offshore?Business Process Outsourcing (BPO)?subsidiary, onboarding?500+ employees, and rapidly bringing them up to speed across?20+ medical service industries?within a single year.

Throughout the process, we faced challenges and discovered deficiencies in our existing approach regarding our operational model and project management strategies. We witnessed firsthand the positive and negative compounded effects of key business decisions and project directives. Ultimately, however, we achieved our objectives.

Given the scale of the work, the available resources, and the time constraints, it was critical to adapt our?business?and?project management?strategies to address the unique challenges and opportunities we encountered.

Note: We initially partnered with an organization experienced in launching BPOs in the region, but given the specific demands of our unique?business?context, this partnership proved less beneficial than anticipated.

Background

A Healthcare Revenue Cycle Management (RCM) company that had merged/acquired multiple medical practice management companies over 30 years sought to expand by consolidating low-level operations from 6 offices in the United States to a single large support office offshore to increase profit margins. According to data from the Healthcare Financial Management Association (HFMA) in 2024, outsourcing Revenue Cycle Management (RCM) can typically lead to a 5% to 15% increase in profit margins for healthcare providers through improved collections and reduced administrative costs. Margins are even more significant when outsourced offshore, as labor costs are 50-70% lower in the Philippines, provided you can circumvent the steep learning curve to gain the necessary knowledge and skills.

To transfer?knowledge?and get new teams "up and running" and "on the same page," we needed to share standard?Policies,?Processes,?Procedures,?and operational?KPIs?to measure performance. Unfortunately, we had no such baseline standards. Our offices all operated independently, with different tools, and our subject experts had trained 1:1, but never at a scale of 1:20.

We were tasked with building, training, launching, developing, and sustaining a new expanded operational model based on best practices harvested from otherwise disparate functional teams.

Challenges

• Executive-Led Project Management: With limited trust, authorization, structure, and formal practices for middle managers, executives were stretched thin. There were significant variances in understanding success criteria, conducting projects, and gaining sign-off.
• New Facility: In the lead-up to the project, choosing a location, drawing up?blueprints, and contracting and overseeing the work of a?construction company?located across the ocean.
• Training Programs: Capturing knowledge from 6 offices merged/acquired at different times and agreeing on uniform operational (and project management) best practices.
• Upskilling Employees: Interviewing, hiring, onboarding, training, and engaging 500 new employees, team by team, across multiple subject areas (with few experts) in a remote location (with limited in-person engagement) to meet minimum expectations.
• Outfitting & Managing Operations: Preparing the environment with all necessary equipment (desks, chairs, computers, supplies, TV conferencing, phone, internet, etc.), connecting IT support, overseeing operations from startup to scale-up, and enabling new team leads.
• Global Laws & Cultural Expectations: Meeting the demands of owning and operating a business entity in a foreign country by satisfying all legal requirements and exceeding expectations for working with and conducting business across different cultures.

These challenges required a strategic approach to project management, balancing business upgrades while maintaining regular operations. It called for continuous collaboration, coordination, and communication, staying aligned with people, regularly updating process documentation, and learning new tools such as Learning Management Systems (LMS) and project tracking software.

Solutions Implemented

1. Executive-Led Project Management: We followed executives with the greatest visibility, a clear understanding of the ends in mind, and an in-depth comprehension of the challenges across all levels and locations. These executives were profoundly involved and desired to be hands-on, retaining control wherever possible.
2. Construction by Recommended Contractors: We visited various sites nationwide, split building costs and workspace with our consulting partner, but ultimately decided to purchase the entire space. We selected a recommended construction company known for keeping us well-informed on progress, and after requesting minor touchups, we signed off on the work.
3. Developed & Facilitated Training Programs: We formed the S.O.S. Team (Simplified, Optimized, and Standardized) to align operations between the six offices. We further developed training programs, software navigational videos, online teaching materials, and a working knowledge base.
4. Staffed & Trained Employees: We facilitated on-site training for each team, tailored to industry, company, and position needs, and connected regularly with the stateside office for virtual Q&A sessions. This enabled consistency and allowed for the replication of efforts through a working knowledge base.
5. Jumpstarted Operations: The VP of Global Operations (working all hours), a Special Projects Assistant (mainly night shift), and a Coding Manager made visits to prepare the site, conduct training, and remain on-site for 2 months to 1 year to ensure the smooth turnover of operations.
6. Satisfying Global Laws & Cultural Expectations: We followed legal advice, utilized foreign notaries and consulates, and ensured compliance with banking and other regulations. We hired cultural experts with ties to American and Filipino cultures for special projects to bridge governmental and cultural divides.

Results

• $15.5M/year in Revenue: The company eventually grossed enough, Year-over-Year (YoY), to achieve the desired Return on Investment (ROI), which was constrained by the extensive use of executive time.
• $15M+ in Incurred Costs: The initial investment in the new facility exceeded $10M, while mismanaged programs and inefficiently diverting skilled workers to assist the unskilled added another $5M+ in unnecessary expenses.
• $5M+/year in Savings: Operational cost reductions resulted in significant savings.
• 50-70% Reduction in U.S. Staff: Resource allocation was optimized based on wages, but this came at a significant cost to the experienced home base support staff.
• Epic Launch to Mediocre Business: The launch initially sparked excitement in the?new work culture abroad, with enthusiasm about the country's expanding possibilities. While the BPO launch was successful initially, over time, it became clear that it wasn't managed and supported for long-term success. The issue arose because the U.S. teams were diminished, leaving them unable to effectively manage U.S. operations, let alone handle the offshore operations.

Key Takeaways

• Company Secrets: Confidentiality stifled collaboration, focusing attention on the bottom line rather than promoting the best ideas. This resulted in poor morale, bad working conditions, delayed ROI, loss of work, lack of recognition, and hindered individual and team potential.
• Fear vs. Faith: Leading businesses and projects with fear rather than faith may yield short-term gains, but it ultimately fails to drive the best work or produce long-term financial results.
• Strategic Project Management: Organizations that seamlessly integrate?professional project management?at all levels alongside their?operational model?are better positioned to advance their business. They do so through?strategic initiatives?and continuously improve and mature?project by project.

Conclusion

Tailoring your approach to your current business and its unique needs is essential for?optimally integrating change?and?project management?to expand to?higher-level operations.

Trust starts with organizational leaders. The sooner your organization recognizes the challenges ahead, the sooner it can prepare for scale-up. The larger the scale-up, the greater the stakes. However, it’s a hollow short-term victory if you must let go of half your team after they’ve done everything you’ve asked. Your people are your greatest asset. Don’t betray them with promises you can’t keep!

Next,?be transparent. The more open you are, with a shared?Vision,?Goals, and transparent?business and project plans, the more your organization can trust you, prepare for change, and progress rather than resist. This transparency enables individuals and teams to pursue excellence.

Finally,?empower middle managers. The more capable your workforce is of setting and meeting current and future?operational standards, the better they will be at supporting?future initiatives. Remember,?functional?and?project management?are very different. Transforming a business from one operational state to another requires a distinct set of?knowledge?and?skills.

In this case, it became evident that?successful implementations?required better upfront?operational Key Performance Indicators (KPIs), more explicit?project definitions, and?Success Criteria. More?precursory scientific method research?to prove theories, especially in?setting up organizational project management, and more?preemptive measures?to simplify, standardize, and optimize processes onshore before expecting?success at scale offshore were also needed.

This is, in part, a cautionary tale: If the sole goal is to increase the bottom line, outsourcing work is a plausible solution. However, if the goal is to promote loyal workers to higher roles and compensation contingent on company or project success, be clear about the requirements (both in and outside your control). Don’t over-promise. Otherwise, expect toxic work cultures, high turnover, and minimum contributions across all work sites.

More About Chad R. Parker, PMP :

Chad is a project management professional (PMP) with 15+ years of experience developing people and companies by leading project teams to implement, administer, and sustain professional, departmental, and organizational improvement programs as part of strategic initiatives.

He also owns Storyboard PM and is the Creator of the 3-in-1 Storyboard PM System of Program Guides for Professional, Team, & Organization Development Success.

Chad Parker's Contact Details:

• LinkedIn Newsletter: Storyboard Project Management Newsletter
• Website: Storyboard PM Website

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