Mastering a change vortex at Horizon BCBSNJ

Three years ago, Doug Blackwell, the then-new CIO of Horizon Blue Cross Blue Shield of New Jersey, didn’t only have to deal with US healthcare market changes ripping through his business. Hurricane Sandy also came in and damaged his building, displacing 400 employees.

And you think your job is tough.

How do you move forward successfully in such turbulence? For Doug, the answer was to go big before going small: Understand the big picture, and then translate it into comprehensive changes on the ground.

The big picture:

The Affordable Care Act (ACA) has fundamentally disrupted the traditional insurance business, shifting the industry's business model from business-to-business to business-to-consumer. At Horizon BCBSNJ, capturing the new customer drives the development and support of new products and services. And as you can imagine, the impact to its IT organization has been substantial.

Going from the big picture to a plan of action:

To understand the broad organizational implications of the ACA, the company established an internal Office of Healthcare Reform, a team staffed with people from across the enterprise. With IT playing a key role, organizational implications were identified and then translated into comprehensive and necessary process, people and technology changes in IT.

Organizational implications:

What did that mean to the people in IT? Although Gartner says that less than 30% of IT orgnizations do so formally, Doug and his team took a strategic view of their workforce. They assessed the skills needed for the future and then either built them internally where it made sense or increased the strategic use of external partners.

Tightening the link between business and IT especially in tumultuous times is vital. At Horizon BCBSNJ, key business-facing roles, such as enterprise architecture and business solutions, were redesigned. The focus shifted to interfacing with business leadership on more strategic issues, and leading their thinking on technology instead of simply reacting to business requests and queries.

Process changes:

Time was short. The government-mandated ACA compliance deadline for insurance companies was not going to move, so two process shifts were made to deal with the accelerating pace of change.

First, the company moved to agile software development, an iterative and incremental methodology. Second, to both ensure the accuracy of what was being developed and keep up with the government’s own last-minute changes, the testing process itself was put on steroids. Always easy to drop and regret later, testing instead was heavily invested in across the board.

Technology upheaval:

This raft of changes -- erncompassing industry, regulation, business model, customer, product, services, people and process -- required a complete system overhaul, including the comapny website. Almost nothing was untouched -- including the building.

In the middle of all the ACA-mandated IT changes, a major facility was destroyed by Hurricane Sandy. And in spite of this and all that was thrown at them, Doug and his team were successful.  All of the industry, enterprise and technology driven changes were put in place on time.

To get through this type of disruption, the company needed more than a plan. Strong leadership and a background in change were critical.

A career in change:

To be successful in these scenarios, it helps to have a background like Doug’s. In addition to having a broad and deep portfolio IT experience, he has also moved across industries and company sizes, and even has been through an IPO. All of this experience builds a sense of personal agility, perspective and urgency, all of which carries into Doug's current leadership position.

I also fancy myself as someone who has been through a lot of change and can manage it. In my current position, we are implementing a major Oracle system, redoing our business and IT strategy, and building several substantial new capabilities in the changing healthcare market - all at the same time.

But our business model and customer haven’t changed.

And our roof has stayed on.

I feel like such a slacker!

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