You'd think that with so many reorgs, CVS would be fully 'organized' by now. And if it's not, then why is nobody holding accountable those who are failing in their jobs over and over again and are proving again and again they are incapable of running this place?
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QNXT was supposed to be migrated to Next Gen...never happened. The Dusl eligibles...create alot of problems with accurate data
@4qck+1vfrBwrf, it's Medicaid and Medicare multiple departments sinking the health plans. The issues just expand after implementations. There's no process of handoff for operations. Once the health plans go live the disorganization of operations just stays. The regional provider relations are completely incompetent. They don't train prls in regulatory data, claims, contracting, data collection, QNXT relational databases, training providers on onboarding etc but network management give them all the power for initial and maintenance data, data outreach projects when they can barely scratch together spreadsheets (Excel skills barely beginner level). Everything they do is manual. All of their ssrs reports are outdated and not maintained so they don't have bulk reporting and they rather search qnxt records one at a time.
Then we have incompetent network and development negitiators. All of the intake applications to the network need a complete overhaul they're so outdated ie they don't require providers with more than one MPOs and state specific regulatory data requirements, in reality this large of a company should be on one Portal only for provider initial and maintenance data to get away from of these outdated applications and rosters. It should also be taken out of the hands of network management (contracting and PRls) for maintenance refreshed provider Data outreach. But both of those departments live off each other's operations dysfunction. They like it that way out of fear of losing their FTEs.
Same goes with Informatics if the data was standardize, accurate, fresh, and loaded correctly (state files) their only job would be keeping up with the adequacy scripts, claims scripts, data warehouse, and dash board reporting. Ie report monkeys essentially. Then if the standard operations and the data they could actually achieve network data integrity, get us of of caps, and contract new providers etc. But everyone is too busy chasing their tails and competing against each other for "operations" ie MPOS. Since the 2020 centraliztion layoffs theirs been knowledge gaps in "operations" that just sinks the health plans so yes ky, la, oh, il,va,md,wv,FL,my, KS,TX all suffer with rando bots flipping qnxt data/claims and multiple departments flipping QNXT data like pancakes because Aetna does not know how to operationalize and govern. And all theses departments and teams all think they know best and it's a tidal wave of sh-t in QNXT with constant projects that don't do sh-t but just adds more dirty hands in health plans data.
@1tac+1vfrBwrf. Medicaid is dead man walking in my opinion. We are so thin on talent and many of the plans are at risk, Illinois and Kentucky come to mind. The leadership is inept at best and there are way too many vps and Ed's that provide little to no real value.
Yep. They are done. Layoffs based on the last reorg already underway. Smaller batches. Mostly DDAT. Skeleton crew to handle CMS rules. Look at titles and pay grades.
So do any of you left or have colleagues still there give any insights into departmental reorgs? Specifically Aetna.
kfe+1vfrBwrf what's wrong with an internal employee staying on? She's no different than the other 27 CEOs, all the health plans are caps and in trouble. ABHKS problems started two years before go live January 2019. I can honestly say none of the CEOs and COOs at the health plans have any control. They don't do the RFPs, they're not implementatios. They're not in charge of contracting and development, provide relations, another words they have don't have control over network management. They also don't have control over their regulatory data especially since MPOs.
Jane Brown is just another CEO who transferred internally and took over Tim Mullens job because he got his boys club mentality shovenist self in trouble with HR and suddenly resigned. Let's not forget stupid Time came from our competition just two years ago and didn't do sh-t. He didn't care to learn about Aetna and the employees. I say good bye don't let the door hit you in the a-s.
Hopefully Jane Brown can bring a bit of health plan perspective but the job description describes her function as "innovation" which I highly doubt otherwise she would of never settle for health plan CEO.
Is she friends with Lisa V ? Maybe only time will tell. None the less she's not the "reorg" of this thread.
Right. Love how the CEO that failed to keep the Medicaid contract in Kansas got promoted to a VP.
It's so disheartening to see that happen time and again throughout the whole org at all levels. You can't win at a place this steeped in nepotism.
they should really gut the Aetna digital product organization, they are such a bloated team and do absolutely nothing for the business other than play politics
Another reorganization would be nice. Maybe get a new DL. Wishful thinking I know.
It's mostly not skill driven but rather buddy driven.
Ok since nobody is being specific. Are the reorgs coming to Aetna commercial, Medicare, Medicaid, each individual health plan?
I really don't care about the pharmacy side.
So basically the contractors are running CVS ?
I work with a fake resume contractor from TCS, it was pathetic. His TCS buddies cover up for him all the time
Facts
@bre+1vfrBwrf Yep. Contractors got hired because they did the jobs of the people they reported to. Even if they had no experience in the business versus an FTE that had 20. Those contractors now have staff. So we now have a mix of people who wanted their as--s kissed and their contract to hire lackeys.
Exactly where are this reorgs taking place? Which businesses? Which departments? CVS is a large company with 300k employees, get a little more specific with timelines.
Ex contractors are now running the show and hiring spouses, TCS, Telgu, infosys crowd. It’s simple- top to bottom incompetence
Because they are all buddies and have each other's back