Thread regarding CVS layoffs

@4gzg+1uVMgXQW "Medicaid is the least hot dumpster fire at CVS." this is funny. shared services is bloated and I think their leader lied on his resume. of course he is east asian, so he will never go anywhere. 70% of the department are his cousins who tell us at the plans that they refuse to complete tickets timely and we have to change our due dates with some of them taking almost a year to finish. we've also had him steal projects from the plans and present them at their quarterlies as his own, usually attempting to replace the plan product with a very shoddily implemented multi state version. leadership is completely clueless, all they need to do is look at the org chart and they can see how all the hires go to his buddies. if you don't call that a dumpster fire you must be one of the shared services doofuses that thinks they're a leader when they're only there to make Wipro look good by not knowing how to do their job

Correction ABHKS has been a hot mess when implementation missed go live and it never recovered. They laidoff the LD Service Operations 2020, and never replaced her. Left a vacuum gap where nobody was monitoring the bs going ons in QNXT and other sub processes. I want to know where the fudge is their COO in all this. Who's holding her and the LD of contracting, and prl responsible.

Kansas has been dead man walking for a year.

Below poster is correct. These are 5-7 year contracts and they look for companies that healthy, drama free and will still be around in 5-7 years. They see we are making the news every day for layoffs, lawsuits, sanctions, where leaders are leaving and other nonsense. This trend will continue.

Medicaid is a this least hot dumpster fire at CVS. Compared to the rest of CVS is a well-oiled machine. It may be the only segment to survive.

The reason we lost Kansas is due to the fact the regulators know CVS is in the background. Plain and simple.

Prior to 2019 it was run well with good Medicaid leadership but since 2019 and especially the 2020 centraliztion layoffs it's been run by the MEDICARE leadership which ran it into the ground. You know the same Medicare who fu---d us as an organization with utilization.
Medicaid makes the least profit but it's the slow and steady income for Aetna. Whenever Medicare stars is low or utilization, Medicaid is the government sector saving grace. It's also does well when the economy isn't doing so well.
It just needs to push out the ignorance from Medicare muddling in our regulators and our systems. JGD took us from tops tat 15days data tickets to one year old submission tickets. That simply doesn't work with regulators data when there's terminations (have to term in 15days), member moves (15days), and quarterly network adequacy. Medicaid is highly regulated more than Medicare with each 17 different regulations. You have to put leadership with a background in Medicaid otherwise it's a sh-t show like it's been since 2019 esp 2020. Regional network management are d-mb as rocks, everyone in MPOS fu--ing d-mb, most of IT mo--ns to the data, encounters wtf. Hopefully with Jennifer G D.at least maybe we can get back to tickets with regulators tat. Oh btw ABHKS was the first State implementation to be fully automated. It was set-up incorrectly missing half the network site locations. They never shut the cdmn automation down and it ran amuck for years as the original developer was forced to resign after the January 2019 go live date. Then the member from his team was absorbed into IT LAN's team. He's been in charge of that automation up to just a month ago when he left to a competitor for more money. Now who knows who's monitoring the automation because Aetna has a tendency of having heros and wizards they build sh-t and leave, fired, laid off and that's all the way around commercial, Medicare, Medicaid.

Aetna medicaid is a dumpster fire and i can see aetna shutting it down in the near future.

@poj+1uVMgXQW That quote was definitely interesting. "Handwritten notes showed decision-makers had concerns about Aetna’s “unresolved issues” in Kansas and other Medicaid states." When things are so bad that rumors start to swirl about the incompetent zombified company piloted by outsourcers.. absolutely disgraceful.

I was there for last six months of ABKS credentialing implementation (worked along side with implementation contracting). The national team NDQT implented that plan. It was there first implementation and there first experience with trying to fully automate the data from end to end. It was a disaster they missed there go live date. From the credentialing side I was always cleaning up there data dump. From the QNXT side it was a sh-t show they never showed the multiple service locations and I could tell they were missing a lot of the "network". Out of that implementation the Sr Executive Jacket House, Adam Berry (the tech expert), then replaced with Maurice Hill. Maurice Hill pasted less than a year before he LinkInd hero out. She was the whole reason the October 2020 layoffs of 90 percent of Medicaid PDS was laidoff, half of the health plans Directors of Service Operations were laidoff so Aetna Medicaid could "centralize" and dissolve health plan SMEs. All the years "Provider Experience" put into researching the end to end process, trainings, and documentation, centralized HUBs, that came out of ABX 2020 went to ashes. It created chaos for Dan Finke to hire JGD from Medicare side (center of excellence) to come in and make atomic bo-b on all of Medicaid the last three years.
Anyhow, implementations has a bad rep and justifiable so. They don't have a plan going into implementations and they fire everyone after every RFP. So, they constantly loose expertise. And they never get those plans setup to a good start. ABHKS was always doomed.
Great article thanks for sharing. There's a curious quote about Aetna's unresolved issues and "other states", and biasism I find most intriguing.