Automated service level objectives for batch data

A method of implementing one or more Service Level Agreement (SLA) requirements comprising:

• receiving the one or more SLA requirements for one or more health plan eligibility and claim adjudication processes for adjudicating pharmacy benefit claims or determining pharmacy benefit eligibility via a batch administration form associated with an enterprise workflow platform, wherein the batch administration form that is displayed includes a first field for receiving information specifying data sources for the one or more health plan eligibility and claim adjudication processes, a second field for receiving information specifying a schedule for the one or more health plan eligibility and claim adjudication processes, and a third field for receiving information specifying the one or more SLA requirements, and wherein the one more SLA requirements include a job name, a schedule, a start time, and an end time for each of the one or more health plan eligibility and claim adjudication processes;
• persisting the one or more SLA requirements in a knowledge base associated with the enterprise workflow platform;
• executing at least one Application Programming Interface (API) on a periodic basis, via a batch monitoring tool, to regularly retrieve the one or more SLA requirements from the knowledge base associated with the enterprise workflow platform;
• persisting, via the batch monitoring tool, the one or more SLA requirements that are retrieved in a source repository that is communicatively coupled to the batch monitoring tool, each time the one or more SLA requirements are retrieved, to create a periodic SLA data sync between the knowledge base and the source repository;
• identifying, via the batch monitoring tool, a failure in processing of a health plan daily eligibility file by the one or more health plan eligibility and claim adjudication processes resulting in erroneous rejection of at least one pharmacy benefit claim;
• measuring, via the batch monitoring tool, performance of the one or more health plan eligibility and claim adjudication processes;
• identifying, via the batch monitoring tool, a delay in the one or more health plan eligibility and claim adjudication processes by comparing the performance of the one or more health plan eligibility and claim adjudication processes against the one or more SLA requirements;
• persisting information relating to the failure and the delay in a log shipping tool using the batch monitoring tool;
• and
• notifying responsible parties of a potential issue of compliance with the one or more SLA requirements via a dashboard coupled to the log shipping tool using the batch monitoring tool.

A system for implementing one or more Service Level Agreement (SLA) requirements in batch processes, the system comprising:

• a display device configured to display, via a user interface, a batch administration form for scheduling one or more health plan eligibility and claim adjudication processes for adjudicating pharmacy benefit claims or determining pharmacy benefit eligibility, the batch administration form including a first field for receiving information specifying data sources for the one or more health plan eligibility and claim adjudication processes, a second field for receiving information specifying a schedule for the one or more health plan eligibility and claim adjudication processes, and a third field for receiving information specifying the one or more SLA requirements, and the batch administration form configured to receive input of the one or more SLA requirements for the one or more health plan eligibility and claim adjudication processes including a job name, a schedule, a start time, and an end time for each of the one or more health plan eligibility and claim adjudication processes;
• an enterprise workflow platform coupled to the display device, the enterprise workflow platform configured to receive the input from the batch administration form and to persist the one or more SLA requirements in a knowledge base associated with the enterprise workflow platform;
• and
• a batch monitoring tool configured to:
• execute at least one Application Programming Interface (API) on a periodic basis to regularly retrieve the one or more SLA requirements from the knowledge base;
• persist the one or more SLA requirements in a source repository that is communicatively coupled to the batch monitoring tool, each time the one or more SLA requirements are retrieved, to create a periodic SLA data sync between the knowledge base and the source repository;
• identify a failure in processing of a health plan daily eligibility file by the one or more health plan eligibility and claim adjudication processes resulting in erroneous rejection of at least one pharmacy benefit claim;
• measure performance of the one or more health plan eligibility and claim adjudication processes;
• identify a delay in the one or more health plan eligibility and claim adjudication processes by comparing the performance of the one or more health plan eligibility and claim adjudication processes against the one or more SLA requirements;
• persist information relating to the failure and the delay in a log shipping tool using the batch monitoring tool;
• and
• notify responsible parties of a potential issue of compliance with the one or more SLA requirements via a dashboard coupled to the log shipping tool using the batch monitoring tool.