what upset me is new hire HCM making more than me and i have been here 10 yrs. That is wrong, the existing ones should be at least brought up to the current hiring rate for my job....raises are far and few and when you get it being 2% -3% is not even close to the cost of living raise per year. Come on, plus you increase our COST of coverage on insurance it is a joke. Pay HCM what they are worth you cheap a$$ company
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I think health care dumb down the field of SW. MSW with a clinical licensure can diagnose mental illnesses and charge insurance for the services. At HAH social workers are used as customer service representiave anyone can give a member phone numbers and resources that don't work. Humana don't use the MSW to their full capacity plus to do that they would have be less production driven.
I like this thread! @1fep nailed it...
It is bad enough that Humana is disrespecting us and our roles, don't do it to each other on this post. The majority of HCM-RNs respect all of our colleagues.
Honestly I wouldn't worry about who was "downgraded" or absorption of roles and duties. This is part of healthcare. It changes constantly. In my 20 years as a nurse, in every single position I held, there was a clause at the bottom of my job descriptions, something like "job duties can change at any time." I believe there was one here too with the HCM RN role. I can't tell you how many times I had to do someone else's role because they quit or the company was downsizing. Insurance is heavily regulated and we are rated on a STARS system with CMS. If we get a high rating, we get millions more dollars from the government. If we get a lower STARS rating, we can actually lose money and pay a penalty. Not to mention the scores are public online for anyone comparing policies. And who are we going to "get back at" this year? The HCCs were probably phased out to streamline our business model, help us strategically compete in the industry, and help to reach "five stars." Your duties may change again in six months. I have been an HCM since the program began and processes are always changing. They gave us wellbeing and took that back, they let us flex and took that back. Then we worked tirelessly on Saturdays during the winter holidays to try to contact the UTC members. Things will always change in health care it is to be expected. Be thankful you haven't been laid off yet. If what you are being asked to do is beyond a registered nurses' scope of practice, then we have a problem. I would recommend to know what your specific state's Nurse Practice Act details and if you are concerned contact your state or national nursing organization. What we are being asked to do may be frustrating, but we can still pay our bills at least one more day.
The HCC's were replaced because of CMS guidelines for the interdisciplinary team. CMS.gov has all the information you ever wanted to know (and don't) about the federal guidelines for managed plans if you want more information. I actually wanted to know more about it, asked my coach and was pretty much blown off and told I didn't need to know more than what was needed for my role so I had to do some research myself. The MSW and RN are a part of the interdisciplinary care team because of licensure. HCC's held degrees in health science fields but not specifically an RN or MSW
So the HCM SS has now basically been downgraded to the HCC role as the HCM RNs have now absorbed the SS role in addition to their own duties. And, the SS still get to refer to a RN for assistance because it is beyond their scope. I wonder which role will next become obsolete like the HCCs?
Oh by the way there is a direct consult line to a live HCM SS so no one waits for anything if it is an emergency. Please use it if you are not aware it exists.
Social workers will not be expected to provide disease management-education on disease like managing blood sugars or pain. This is where the interdisciplinary team approach comes in. If there is a member being managed by an MSW who needs a nurse consult, this will be done in the same manner as the dietician or the pharmacist is consulted. The social worker case manager collaborates with clients to plan, implement, monitor and amend individualized services that promote clients' strengths, advance clients' well-being, and help clients achieve their goals. Social workers have an extensive education and should be utilized more than providing resources on housing and food. They have more education than nurses, yes, not on "disease treatment" but in more areas that can help many of these members that are not medically a mess. They should be doing much more than providing resources and making UTC calls anyway. They are more educated than many of the HCCs that were doing this role. Besides...who does education on calls anymore beyond telling members what advanced directives are and tasking a CHE, telling someone to remove throw rugs, clutter, and use a night light to promote safety, go to bed at the same time every night and don't watch TV in the bedroom to help with sleep (this is common knowledge anyway), ask about socialization and offer community resources and ask about depression. You do not need an RN license to ask a member what their health goals are and type them up in an outcome note. And when they are low risk and all they want is to find out about dental or food resources, this is not out of the scope of the RN to open up the CRD and provide phone numbers. This is the same as you looking up a phone number on your own using Google-do you call a social worker to do this for you at your home? If a member is truly in need of finding food, why would you even want to task a social worker to do this and make that member wait a week for help? Many HCM RNs are not doing much case management for members other than filling out a survey and telling them someone will call in a few weeks.
"DISRESPECT" is truly the word to be used! :(
It will be great to work as a team, to have the interdisciplinary teams we previously had! Nurses doing nursing work, SW's doing SW! Why was it changed? Why? Why? It is overwhelming and the poor members are not getting any good services because we are all so busy filling out questionnaires.... I hope management is reading these posts and realize how unhappy we all are with such ridiculous changes!
I am a nurse with immeasurable respect for my social worker colleagues.... they are well trained and dedicated. Expecting them to do disease management and nurses to assess social needs is a tremendous disrespect to both our PROFESSIONS. Our members need and deserve INTERDISCIPLINARY care. We are all caring and capable, but our degrees and expertise allow us to serve in unique ways.... it's HUMANA that does not recognize or respect this.
Don't listen to the poster that said MSW only find housing etc. I'm sure that was not a clinical person. We all know in the medical field how much training you guys go through. That is why we don't want to lose you guys.
Harsh comments here! Can we vent? I guess we can't walk out because we have to pay our bills and have not found another job!
As a matter of fact, yes, with my college and masters degree and two years of clinical supervised work before I could even sit for my license, I did....please don't assume you know what I took as course work in grad or undergrad work. Social work curriculum is more than finding food and housing....
They are not medically trained to take care of these member, yes they can find food, housing. Have the SW taken one NURSING course, one Anatomy and physiology course? Humana didn't force anyone in, you're free to walk out like you came in on your own free will.
Guess the question is what is the care management that the SWs are doing....I would think since it's the Lower risk folk, it's appropriate, but the higher risk medically folk the Rns are doing, either way, the snp sw didn't ask for this change in their roles
Social workers are very competent and able to care manage. Here is a link to the National Association of Social workers guide to case management https://www.socialworkers.org/practice/naswstandards/casemanagementstandards2013.pdf
Here are just a few of the standards of practice:
Standard 5. Assessment
The social work case manager shall engage clients—
and, when appropriate, other members of client
systems—in an ongoing information-gathering
and decision-making process to help clients
identify their goals, strengths, and challenges.
Standard 6. Service Planning, Implementation,
and Monitoring
The social work case manager shall collaborate
with clients to plan, implement, monitor, and
amend individualized services that promote
clients’ strengths, advance clients’ well-being,
and help clients achieve their goals. Case
management service plans shall be based on
meaningful assessments and shall have specific,
attainable, measurable objectives.
Standard 7. Advocacy and Leadership
The social work case manager shall advocate for
the rights, decisions, strengths, and needs of
clients and shall promote clients’ access to
resources, supports, and services.
Standard 8. Interdisciplinary and
Interorganizational Collaboration
The social work case manager shall promote
collaboration among colleagues and organizations
to enhance service delivery and facilitate client
goal attainment.
Standard 9. Practice Evaluation and Improvement
The social work case manager shall participate
in ongoing, formal evaluation of her or his
practice to advance client well-being, assess the
appropriateness and effectiveness of services and
supports, ensure competence, and improve practice.
Standard 10. Record Keeping
The social work case manager shall document
all case management activities in the appropriate
client record in a timely manner. Social work
documentation shall be recorded on paper or
electronically and shall be prepared, completed,
secured, maintained, and disclosed in accordance
with regulatory, legislative, statutory, and
organizational requirements.
...not quite sure what you mean by a loophole and that the Hcm ss should be glad, since the role is out of scope of practice, both rn and msw are not happy with the changes in snp....but loophole and glad?!?
The case load is different for HCM SS and HCM RN, they are not managing the kind of members the nurses are managing. I think the HCM SS should be glad they found a loophole and was allowed to stay, because care planning is a RN job.
I agree. If the HCM SS job duties are being redefined to match the RN and especially since the SS must hold a masters, the pay scale should be restructured to match the RN
I think all Hcm ss need to have a masters degree at this point
I don't know what the coaches make but they must make more than we do. You can see why they are always on managents side. I do not think that is right but I bet if they leave Human they would have a cut in pay. We know that upper management above coaches make a lot of money. I love the HCM Social Workers also. Looks like we are all working hard for our members. Let's see what the future holds for Humana and continue to see what is available in the outside world. Don't let Humana get you down. The company is not worth it. From the RN with 30 years experience
I think MSW in the SNP program need to ask for an increase because of change in roles.
I know that the WAH along with flex hours was a big draw for a lot of us HCM-RNs. Most were looking for a way out from hospital/shift work. Some were going back to school, had families, and wanted to enjoy the weekends. I came from the hospital so I was making more per hour and also took a cut in pay. I depend on our HCM-SS for so much and have worked with some who go the extra mile for our members. I have had FCMs who have contacted me about some of my members for possible referrals for LTIH after in home surveys. The member agreed after making that contact with the FCM due to the personal touch of meeting someone in person. Robo-calls and Autodialer are not what our members want or need, I am very discouraged.
Is the HCM SS required to have a master's degree to make 58? It is heart breaking that someone with an advanced degree makes so little. And now doing pretty much if not the same role as the nurse. HCM RNs only have to hold a bachelor's degree. They do not get paid more for a masters. At least that was what I was told when I was hired. I too took a substantial pay cut to work here, but I have sacrificed a lot for this work at home job. The pay cut was worth it to me at the time. HCM RN at 68 with 20 years as a nurse. And as someone else mentioned, after taxes is about 40.
Field FCM here for 5 years, Fl. $69915/yr. Started out at 58,000 with annual raises. Hoping not to encounter lay off as several Field FCM and 1 SW was laid off. I agree that our focus has gone to "check the boxes" and away from Members. Member Surveys are seen as an Inquisition. Then complaints of too many "autobot" calls from Humana that aggravates them. I understand being computerized but most of my Elderly clients can't afford nor have internet. They don't want to hear prompts when they call Pharmacy they want real people. Now it seems I spend more time with my face in an IPAD then looking them in the eye.
Addendum... and the HCMSS at 58? That is so horrid and way too low a pay scale for what your education and skills deserve! . I love social workers and the heart and soul they give to help people amidst brick walls and obstacles. Socials workers are sorely underpaid and under appreciated!
I have heard as well, as an RN it depends where you work. However I started in a high paying state ( another job not Humana ) and when I came to Humana , the state I now live in is a cheaper poorly paying state for RNs so took a pay cut, but I needed the job.
Last year I asked my manager if I were to move back to the state with the higher cost of living and that state also has a higher pay scale for RNs, I asked , would I get a pay raise to equal the cost of living and average pay for RNs in that state? And she checked with HR who said........ NO
I would not get a pay increase to correspond with the cost of living or higher average RN pay scale in that state. That I would simply keep my same pay and have to do all the usual stuff to get raises.
Wow, the RN who has 30 years at 68.....so sad, we RNs who have years of good experience, make pittance while there are millionaires running the show..... and we RNs are the voices and helpers who do all we can to help these seniors and Medicare members live better lives and we are the ones who get these members to please please please stay with Humana. How many times have I hung up from a member in tears because of how the insurance company copays are too high for their asthma medicine or their MRI or their special insulin that has been proven to help them etc etc etc. I just don't know , it is a bad situation not just Humana but health insurance and profit oriented health " care'... and back to that RN at 68,,,, yes better than the average hard working American, but way lower than what is deserved.
Not comfortable at 68 after taxes,annual take home is around 40 a year, It's a struggle. United start their RN at $37 hr
Haven't heard of SW layoffs, was told there weren't going to be, on,y restructuring because of CMS regs....can you switch to another program?
I have been with Humana more than 3 years as HCM-SS in SNP. My pay is about 58k, which is high for a social work job, and truly the only reason I have lasted this long since MF came along. They have changed our schedules and our duties without our consent or input. I'm looking for something else. So sad that HAH program used to really care about our members, and now I'm completing surveys on an auto dialer for Humana's benefit, not to help our members. Feel like I've sold my soul, can't continue. I was hoping to be laid off- if anyone knows of any cuts of the HAH social workers, please share- I can only hang on if possible to get a severance in the next quarter.
Can't answer much but have been with Humana < five years. Took a pay cut but loved Humana until MF came and the environment changed. I have been looking for other jobs I will have an increase in pay when I do leave. I'm waiting to see what happens in the second quarter then if I don't lose my position I will quit.
Not to be too intrusive poster, but did you start at that rate or did you start at another rate and get raises, and how long have you been with Humana, if you're comfortable answering?
I have 30 years of experience and make 68. RN
Probably 60-70k
Also depends on region where you live... I have heard
For the SNP telephonic
For what position or role or program? Humana seems to have a matrix for pay scales based on degrees, specific experience, role, etc....there is no set answer to that...I think most people are hired in at a certain range