Capability Resource Map
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Capability Resource Map

Benefit Management

Broker

Programs

Customer

Communication

Group And Broker

Service

Network Development

Care Management

Claim Adjudication

Member Service

Accounting

Administrative

Services

Altemate Punding

Enterprise

Architecture

Contract

Development

Commercial Sales

Lead Management

Group Installation

Network Management

Community Health Management

Claim Adjustment

Provider Service

Accounting payable And Receivable

Business Analytics

Community Rating

Application

Development

Filing And

Regulatory Approval

Customer

Communication

Prospect Management

Member Enrollment Management

Interplan Network Management

Disease Management

Claim Receipt

Broker Service

Actuarial

Contracts And

Procurement

Exper ience Rating

Infrastructure

Support

Product And Pricing Strategy

Govermment Sales

Campaign Management

Member

Management

Pharmacy Admin

Healthcare Policy Management

Claim Triage

Group Service

Budgeting And

Forecating

Corporate Admin

Medicare Risk

Adjustment

Portfolio and

Demand

Management

Product And Sevice Development

Renewal

Management

Customer Data Management

Provider Operations

Medical Utilization Management

Claim Warkflow

Claims Based Billing And Invoicing

Corporate

Communication

Rating And

Underwriting

Project Management

Product Lifecycle Management And Implement

Sales

Operations

Loyalty

Management

Provider Pricing

Quaility Health Informatics

OPL And COB Processing

Collections

Document Services

Risk Management

Information Securuity

Product

Management

Sales Performance

Management

Marketing

Analytics

Provider Quaility

Management

Wellness

Reimbursement And Notification

Payments

Premium

Reconciliation

Human Resources

Data Management

and Integration

Marketing

Resource

Management

Provider Reimbursement

Support

Reserve

Manafement

Qualilty And Data

Govermance

Provider Relations

Taxation

Telecom

Treasury

Products

Sales

Marketing

Member

Mgmt

Provider

Network Mgmt

Health

Care Mgmt

Claims

Processing

Customer

Service

Finance

and

Requlatory

Support

Business

Functions

Pricing &

Risk


Information

Tech

Capabilities Map

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publish time: 2021-09-18
Lisa Anderson

A business capability defines "what" a business does at its core. This differs from "how" things are done or where they are done. Business capabilities are the core of business architecture. As shown in the below business mapping diagram, business capabilities provide an abstraction of the business reality in a way that helps to simplify conversations between interested stakeholders. Defining business capabilities supporting components (roles, processes, information, and tools) provides a business context for those supporting components. Creating a business capability model for the enterprise promotes a common understanding of the business, and a Business Analyst can choose tools like EdrawMax or EdrawMax Online to create factually correct business capability resource map diagrams.

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