Elevance Health: standing up UX in a 70-year-old insurance giant

Getting product and operations leaders involved in user research took longer than training the design team. Most had backgrounds in insurance and operations, not product discovery. I tried bottom-up first: train the team and hope the practice spread. It gained traction when a senior product partner started requesting research on his own initiatives. Given how the org worked, we needed a product sponsor, not just design team training.

Executives responded more quickly to design sprints. They saw them as a fast, high-intensity way to validate concepts when they needed to move quickly. They also liked that the format kept them closely involved: a flat process with few layers between leadership and the work. Maya was the first major project where we used that approach end to end.

In parallel, the team committed to the core Design Thinking stages:

• Empathize — Interviews, observation, and other methods to understand user needs
• Define — Turn those insights into clear problems and personas
• Explore — Sketch and pressure-test multiple directions before committing
• Prototype — Test feasibility and viability with low-fidelity models
• Test — Validate or invalidate decisions with real feedback
• Repeat — Refine understanding and solutions as you learn

Before this, designers were often asked only to build frontend mockups for already-scoped, unvalidated products. That limited how much user-centered work we could ship. By moving discovery earlier, UX had a role in product decisions before mockups were due.

Maya was the clearest example. Elevance partnered with Lurie Children’s Hospital in Chicago to explore remote post-operative care for pediatric patients: discharge sooner, recover at home, and reduce the cost of extended hospital stays while giving parents and clinicians a way to monitor recovery.

The default path would have been top-down direction from a VP, a business analyst gathering requirements separately, a PM scoping from that handoff, and UX designing screens against the scope with a small budget for guerrilla usability testing at the end.

Instead we started with a design sprint. Senior executives and Lurie’s clinical leads worked in the room with us. We left with a basic direction and buy-in. From there we wrote a research plan, ran clinician interviews, and built the product from what we learned.

Supporting artifacts

• Design sprint documentation
• Research plan
• Project scope and estimates
• Clinician interview guide

When I took over the team, we were three people covering five products across three scrum teams. We could not embed a designer on every product team. We did not have the headcount for a decentralized model, and the org was not asking for one. UX was expected to deliver screens on scoped work without slowing delivery. Structure was secondary as long as PMs got what they needed. I was not hired to reorganize anything. The question was how to keep a lean team productive. I kept designers on a central team that flexed across scrum teams and put these habits in place:

• Brought in two vetted design agencies to add temporary capacity
• Ran bi-weekly 1:1s to stay close to each person’s goals and blockers
• Set strict prioritization rules: any new request had to outrank existing work
• Improved work-in-progress tracking
• Sketched a lean team structure that could cover multiple scrum teams plus ad hoc work
• Started recruiting senior hires first

Within three months, the team was six full-time internal members, two full-time contractors, and two part-time contractors.

Each designer and researcher worked across one or more scrum teams, so knowledge spread and we covered more surface area than two embedded soloists could. We did not announce a major reorg. Most of the change was operational: prioritization rules, WIP tracking, agency support, and hiring.

Designers at Elevance had been pulled into sprints when a production task came up, then released when it was done. Dual-track agile would keep design running a sprint ahead of development. Product owners used to the old model saw that as extra overhead. We had to get five product owners comfortable with the new cadence before the framework could hold.

To stand it up, I worked with a senior UX architect and an Agile coach on a semi-traditional Scrum setup for the UX group: two-week sprints, standups, planning, grooming, reviews, retros. With product owners we:

• Ran design one sprint ahead of development
• Scoped design and dev work against shared, user-centered stories

Running dual-agile, we tracked WIP more consistently, set clearer expectations with stakeholders, and handed dev finalized designs before each sprint started. Some teammates were skeptical at first. They supported it once the cadence held for a few sprints.