What is up with the quality audits for HAH Case Manager RNs? It has gotten to be unbearable. Now just before the end of the year they role out another process to grade us on our calls- and management says that they know this will affect our overall scores. Then why do it now when it will afffect our MPS and ultimately or incentive pay, unless that was there plan.
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Quality Dept loves auditing case managers. If the audits are bad, the quality team gets higher bonuses. We love to lie to Medicare about programs and processes that is what our Managers instruct us to do. Fail the audit; it is better for Humana.
It's really sad that some of us are not yet enlightened to the fact that most big corporations do not share their wealth as easy as they may say it should be. It's set at a purposeful standard that's just a bit too high, to limit incentives to employees and keep their pockets lined. It's just business.
It's really sad that some of us are so self absorbed that we actually believe tools and processes and the timing of their release is intended to keep us from getting bonus.
Agree. We just got a new audit tool recently and now it’s changing again. This will most certainly effect our bonuses. To much Humana math at play on the MPs as well.
It appears to me that some departments have more stringent guidelines than others. Perhaps this is why there are differences of opinion here. It is evident that the quality controls are not as stringent in my department.
Good point, poster. But we could do better care planning without the cookie cutter choices! 🤫
Previous poster, YES! 1000 times YES!
You comparing a hospital care plan to ours isn’t an equal comparison. If you consistently gave the wrong meds or falsely charted in a hospital you’d be out the door and if you falsely document here or can’t properly chart a care plan with the multitude of resources then you should be out the door here. Do you ever discuss the why? Why is the company focused on quality? Why is the care plan important?
I agree with the last poster, I do the same things each time, and one review will be scored differently than another one. One can almost predict if you get a review done by some reviewers what the score difference will be. The consistency is in the subjectiveness
Obviously, there are different opinions on this subject and we should all be respectful of each other. Yes, there need to be audits. I do not think anyone is disputing that. My issue is the changes in what is expected and how the quality Audit team is not consistent with scoring. For example, you may receive 1 audit and not be penalized for something, and then on the next one be penalized for the same thing. There is marginal room for error and no one is perfect. The drop down choices in CGX are not good. I usually receive good scores, but I spend a lot of time on care plans.
The difference is, when we worked at in patient settings or did field work, our charts were audited but werent held against us, we just fixed them. With humana they expect us to be robots, and their expectations are so high, it limits our ability to reach the bonuses. They hold it as a carrot that is most of the time just a little bit too far to reach. And they know that, and it saves them from paying out.
What would we do if we did not complain about everything I often wonder if the last job people came from was so great then why are you here? Makes no sense
I'm sorry but this is a totally ridiculous post. All companies have quality audits and from my perspective, I can see that some of them are done, not only to improve our work but also to fill in some gap time since some are low on hours. This way, we can spare some of our best people. Incentive pay? Really? I want some. Why would you complain about incentive pay? If anyone does not want some extra money, please, by all means, raise your hand. I will give you my routing number and account info. I'll take it. So they are planning on keeping as many people as they can and bribing them with incentive pay. You b--tards! And the staff you do keep, you expect them to work for their pay. How could you? I am going to look for something REAL regarding how our company is doing. Have a nice day.
Every business must maintain profitability. Period or there is no business.
Until they lay you off- I will take exposure to infectious disease instead of big business and job insecurity
You should be more worried about how you can help your company succeed than working up conspiracy theories on how they want to take from you. Humana has such great benefits. Work at home, 401 k, Vitality, WOW, EAP, etc. tell me where you get the same perks for the astronomical amount of money they invest into their staff? Tell me a role where you aren’t tearing your body down, exposing yourself to infectious diseases? Because I personally adjust my practice to my businesses needs because that is what I need to do instead of being offended each time something changes. Humana is a great place to work. Every job has negatives. Nothing is perfect.
I agree, this post is ridiculous.
Why is the post ridiculous? I completely agree with OP.
Always follow the money. Likely for the incentive purposes.
This post is ridiculous. LOL
Yep.