The new metrics for SNP care managers are 5 MOC calls per 8 hour shift, with support calls excluded from this total. While productivity is important, these new expectations do not reflect the full scope of our responsibilities. We’ve now been directed to make every call a MOC call including post discharges, calls from the RIT report, medication gap alerts, and return calls from our members. However, if a MOC call was completed within the last 2 weeks then that allows no time for member to work on previous goal or receive literature in the mail. Repeatedly conducting MOC calls simply to satisfy a productivity requirement risks turning a meaningful educational process into a numbers-driven exercise rather than an opportunity to improve member outcomes. When care managers must prioritize countable calls to protect our performance, there is a real risk that necessary support and follow-up will receive less attention. We respectfully challenge upper management to evaluate whether these changes will accomplish the intended purpose or simply encourage behavior that improves reported metrics without improving actual members service. Company morale was already poor due to no raises last year, then required overtime due to increase in enrollment, increased micromanagement, etc. I also ask leadership to establish a process for obtaining feedback from frontline associates and direct supervisors before future operational changes are finalized as it is obvious the management that implemented this lacks the knowledge of what HCMs do on a daily basis.
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@k6 there is no way. Plus, it is rare for it to be a 30 min call these days. 😂 I just think we should all just not meet the metric and call it a day. The care coaches won't be able to do it either , honestly
Where do you take a breath for gods sake
@OP Lets do the math by Humana’s calculations, policies, and requirements:
8 1/2 hour day @5 calls a day
2 1/2 hour talk time (30 min per member)
5 hours documenting (1 hour each member)
15 minutes before shift (pulling up programs, check assignments, emails)
15 minutes end of shift (check work, email, share points. Policy emails, log time , request PTO adm work)
30 minutes mandatory unpaid lunch
= 8 1/2 hours
Where do we take our 2 -15 minute breaks per policy?
@jg If an email is not email sent to CMS, they most definitely will not care…because they would have no knowledge if the injustice.
Does that answer your question?
Will CMS care?
Email from 🐭 and this link have been sent to CMS.
@hj Totally agree with this. We employees can no longer trust leadership on any level. They have lost all credibility and cannot be trusted.
And this is coming from a positive person that Humana’s leadership has since over time turned jaded.
@hh To the OP, ignore this post as it is a middle level leaders trying trying set you up.
And do not bother even reporting or discussing with management. Whatever you do, just report it to some entity OUTSIDE the company that has the ability to investigate the matter and bring about consequences.
The leadership at all of these corporations will always only have the company’s best interest but that does not necessarily mean to fix a wrong they committed. It is to cover it up and stifle those that might cause waves.
@OP how did you deliver this important message to upper management? I'd like to know what they say
@f0 My apologies then. There are some Humana middle level leaders that feel the need to constantly badger and “defend” this lousy corporation as though it is some honorable thing, well knowing that this corporation had pushed out military veterans to replace with non-American citizens Indians.
In what world is that right?! Sorry for the digression.
Forgive the “no thumbs” post, as I thought you were a middle level leaders trying to (what they think is) set a clever trap.
@ey I'm not for sure why you are being defensive and degrading towards my comment, but I was sincerely asking. I was already aware from a remote fb group about the horrible centene layoffs that occurred, and I am no longer employed with Humana. Was just simply asking 🤷♀️
@es I take it that you don’t have link clicking capabilities? My apologies in advance if you were born without thumbs and my question came across as insensitive.
Very interesting that you did not inquire about Centene as well. But then again, you and rest of Humana probably already has a direct connection with leaders over there, seeing as how they used to work at Humana not too terribly long ago.
@eq what has happened with elevance and Cigna?
I have noticed the last couple of days that 4 of the 5 major health insurance corporations (e.g., Humana, Elevance, Cigna, Centene), but not UHG, there is a growing unrest amongst their employees. I think employees are finally saying in unison “ENOUGH IS ENOUGH!”
It will be very interesting to see how things unfold. I think maybe these corporations have crossed a line and tested the waters as to how far they could push their employees…perhaps just a little too far.
These corporations, I think, are either going to lose all their good people, or have created an atmosphere of “quiet quitting”, or have a lot of lawsuits against them.
This is just too much. They are gonna lose all of their care managers and care coaches. 🐭 may be the worst upper leadership I have ever seen. We should all take short term disability/FMLA for mental distress
@dx not true for all ADs.
@ej both
Does anyone have a copy of the email.
Does this apply to care coaches too, or just care managers?
It is obvious they have introduced this unachievable metric in hopes of most associates either leaving on their own, or the associate receiving a PIP for not meeting the metric and being let go. They will also use the metric against the associate to reduce the AIP or say no AIP at all due to not meeting metric. It is a very egregious business practice and is quite shameful of them.
@dx I’m hoping the ADs will challenge this and stand up for your HCMs. I know for my team over half of us have already applied for other jobs. This includes the nurses that have been here for over 8 years because we remember metrics being 5 calls and 2.5 hours and that was difficult then and we didn’t have to do nearly as much then as we do now. That also included support calls.
@dx Oh, of course we believe you. Just like we believe everything that you tell us. Lol
Please know this was a surprise for managers & ADs also. I'm still in disbelief. I'm hoping that email was crafted by A I and not proofread, and that there will be some changes. However , there might not be so we are kind of stuck.
@a1 will they actually do anything? I feel stuck that there is nothing we can do
@da This post will probably provoke some middle level leader post slop, where they erroneously call the below “AI slop” because they want things both ways, “AI is good!” Oh, but here “AI is bad!”
Best words for persons (aka leaders) that want to blatantly try to convey that they can do “whatever they want!” are as follows:
The best word for this is hubris (excessive pride and dangerous overconfidence) or impunity(acting with the full expectation of facing no punishment or consequences). Other fitting terms depend on whether you mean the attitude or the person.
Key Terms and Definitions
- Hubris: Extreme, arrogant pride or self-confidence that often blinds a person to the reality of rules or a coming downfall.
- Impunity: Exemption from punishment, harm, or consequences, often paired with a bold or reckless attitude.
- Cavalier: Showing a lack of proper concern or treating important rules and safety with arrogant indifference.
- Audacious: Daring and bold in a way that shows a shocking disregard for rules, norms, or authority.
- Blatant: Doing something obvious, shameless, and offensive in plain sight because you feel untouchable.
@d9
class action suit when?????
@d8 Yeah, surely the company has to know what they are doing is outright illegal.
Makes me wonder if the executives figure that either the company will be sold, bankrupt, or the specific executives will be long gone before reckoning day.
My wish and prayers would be that any executive onboard with these decisions would some day be locked up and it would all be made very public as they get led away in handcuffs on national news media.
But somehow I doubt that will occur. Although, regardless, I do think that a day of reckoning will occur by a divine being that sees everything and is in control of all happenings. So, that brings me peace, even if my small prayers do not get answered in this lifetime on this passing world.
@cv how the care coach is even legal is beyond me. Talking to members about their health under a federal medical plan, funned by tax payer dollars, by someone who doesn’t have an American medical degree and is offshore. What they are doing is attrition, by making it so unbearable to work here. They start counting your idle time after 60 seconds. It’s absolutely
Insane
I was instructed not to redo a MOC if not needed per the processs. I’m on a dedicated PDC team and many calls are SNP support when not requiring a MOC. So I asked management, should we just do the MOC always now? Was told not to just go get a number for metrics. 🫠
Try having those same metrics and being on one of the PDC only teams
Original poster hit the nail on the head. It will become a numbers game just like mail order pharmacy. Im all for a talk time metric. And how do the care coaches, who work with low members have the same goal. Their calls take far less time. I swear, a certain leader hates the very people he leads. Its obvious. Its just not doable every day with these complex calls.
100% correct
"it is obvious the management that implemented this lacks the knowledge"
I am done. 5 is not even remotely reasonable in some specifics states and upper management knows it. There are way to many barriers upper management refuses to address that keep us well below 5— codi not working is huge barrier all in itself. Some states have 5-6 required assessments and 5-6 required care plans. That takes time and they pretend it doesn’t. Humana does not care about the members, they want the program to look god one paper. That is all they care about. Not their members and not their staff. I am quietly quitting.
Yes. Last straw for me.
Please send this to the CMS Integrity Office Director.
Center for Program Integrity
Jeneen Iwugo
Acting Center Director
Email
jeneen.iwugo@cms.hhs.gov
Phone
410-786-4274