Thread regarding Humana Inc. layoffs

How about auditing the auditors

Does anyone have any insight on to what degree these call reviews matter when it comes to deciding who goes and who stays?

I keep noticing "mistakes" on these reviews, like the reviewer is on auto-pilot, completing form in a cookie-cutter fashion, and not actually listening to the call. Just received a review where reviewer, after supposedly "listening" to a call where I am calling to inform a member that they are "graduating" from the program, in which the reviewer claims "missed opportunities to schedule a follow up call." Umm....yeah. That's because I just got through informing member of graduation - she understood there would be no future calls, Einstein. Were you even listening to the call? Or maybe checking FB or watching TV while completing audits?

This is just one example, but my question is, do we need to take these very seriously - or with a grain of salt - when it comes to job stability? (Or is this a moot point considering job stability seems to have gone out the window regardless)?

It's enough that we are being micromanaged like I have never experienced before in my professional life, but we also have to worry about incompetent, likely unqualified, reviewers (no offense intended if you are a reviewer who actually tries to listen and provide constructive, useful feedback - all I seem to get are the ones looking to take off points for insignificant nonsense, like I'm a kid in grade school and they've got the red pen in hand. They are not actually listening to each call's unique circumstances, rather trying to fill out a cookie-cutter form and find things wrong, without taking into account the bigger picture - how you are actually trying to help someone. Not good for morale, having an incompetent hit squad over our shoulders).

by
| 1810 views | | 20 replies (last ) | Reply
Post ID: @OP+NcprSMJ

20 replies (most recent on top)

The hit squad is likely under pressure to meet quotas in finding mistakes. This entire company has reached a Dysfunctional level that will likely cause its demise. Everything seems backwards (negative) and we will all soon see the end.

by
| | Reply
Post ID: @1elk+NcprSMJ

I'm a Phc me severs of my teammates have scored a 100 for what it's worth.

by
| | Reply
Post ID: @1gsk+NcprSMJ

I was told by my supervisor that no one gets 100. The scores are weighed in that 80-85 is considered good. I imagine they created an evaluation tool that made it impossible to be perfect. If you think about it, it's not always appropriate to do a survey or "coordinate care" etc. So without those points, it's not possible to score 100. Eye roll.

by
| | Reply
Post ID: @1zeh+NcprSMJ

80 or above

by
| | Reply
Post ID: @1xfu+NcprSMJ

What is considered a "good" score for audits?

by
| | Reply
Post ID: @1xde+NcprSMJ

I may be wrong but I was told that coaches from other teams do some of the audits. I finally received a "positive" audit since these new rules, MI, and new audit form went into place. I feel robotic at times and we have spoke up about asking the member every month about our contact, nurse line contact, and best time to call. I document best time in alternate info because it saves me time each month and helps out the rest of my team if they help me with calls, So, with autodialer, is the preferred time of day put into play? AD calls are not documented in CGX 2.0. A lot of members are not responding to it too.

by
| | Reply
Post ID: @1ptr+NcprSMJ

I agree that the call audits are ridiculous now. I'm Not sure exactly how important they are as far as layoffs are concerned. I also agree that this site has been a great place to get information. Everyone has different ideas and thoughts and I appreciate reading them. Without this site we would not know all this was going on and I would still think it was just me not doing a good enough job for 3 1/2 years . My metrics are excellent by the way but no matter how much you work it's never enough

by
| | Reply
Post ID: @1wev+NcprSMJ

To the poster who commented on the b-hing....I think we are all just trying to understand and since things aren't so clear, sharing experiences helps. We are told that the survey scores matter, but it is frustrating, the scoring and how it's done....so if they do impact layoffs, and is it a fair tool? I think that was the point posters were making

by
| | Reply
Post ID: @1ssc+NcprSMJ

To the person who complained that we are just complaining. Well, when you can't win for losing...and your calls are incorrectly audited (and who ever heard of a 31 point scale?), and your honest opinions are critiqued after double-speak meetings..you start hoping for a lay-off notice or start looking for another job. I encourage all of you to remember that there are options. Like one poster said, all there is, is a stick, but no carrot. Please remember to take care of yourselves first. I have enjoyed reading the various posts because it lessened the isolation. My coach and co-workers were the best people I have ever worked with. I have moved on.

by
| | Reply
Post ID: @kxv+NcprSMJ

To the below poster, whining about what the posts should be about, the question was about whether reviews impact the layoff decisions. But even if it weren't, you are free to scroll on past if it upsets you.

by
| | Reply
Post ID: @hjf+NcprSMJ

I thought this was about Layoff's not just b--ching..

by
| | Reply
Post ID: @prt+NcprSMJ

I got points off in an audit when a member asked me for a number and I didn't ask the member if she wanted it because she told me she did. I disputed it and lost because the expectation was that we offered...even if they asked. I didnt meet the expectation

by
| | Reply
Post ID: @zvu+NcprSMJ

I have quit chasing the Carrot. I have tried to get both good numbers and audits and be positive and take on extra projects and mentor and serve in champion rolls and do my coach's work and fill out my Talent Center. The truth is there is no carrot here. There is only a stick and it is used at random.

I could give a flying f### what my audits say anymore. They know that their current audit forms focus on minutia and don't measure what we need to know: 1)Did the call address the clinical needs of the member, HEDIS and build rapport. Will the member have less unhealthy days and hospitalizations? Did the the health coach facilitate behavioral change with MI? We are jumping through outdated hoops. People are checking out.

by
| | Reply
Post ID: @xbz+NcprSMJ

Annual increased! Are you serious?

by
| | Reply
Post ID: @dwl+NcprSMJ

Haha - to the poster below - maybe reviewer has never had the "oppurtunity" to learn how to spell. Ugghhh..... I once received a review of a call during which I was following up with a member after I helped him get his medications. He was going without meds for weeks and was scared to call Humana Pharmacy himself because he has trouble communicating with anyone unless they speak very slowly and loudly. I took care of this for him and followed up.

Upon follow up, he told me he had his meds and felt great, "like a different person!" I thought it was a great call - I really helped him! It made me feel pretty good.

However, the reviewer thought differently. Apparently, I did not get the best time to follow up (except for the fact that I already knew that his member volunteers at a senior center and I already know to call him after 3 p.m.), I said "might be recorded" instead of "may be recorded," (yeah, maybe I was concerned about how he was doing and messed up one word), and I didn't perform a survey (this was a follow up call to make sure this man has his meds - not an interrogation).

So the reviewer took off points, tore the call apart, and never said anything positive about how I actually helped this man.

Beneficial? Will I use the feedback to better help members? No. It just has me looking for another job. I'm sick of feeling like everything I do is wrong.

by
| | Reply
Post ID: @ifc+NcprSMJ

I will never forget the call auditor who wrote several times that I missed the "oppurtunity." Yes, I got audited by someone who did not know how to spell the word. Even though there is a response form, you are just supposed to accept the scores.

by
| | Reply
Post ID: @ygn+NcprSMJ

Yes these scores are also used in your performance summary and will affect your annual increase.

by
| | Reply
Post ID: @rpk+NcprSMJ

I have seen more sloppy reviews lately too, and a few of my colleagues have mentioned it.

by
| | Reply
Post ID: @xlk+NcprSMJ

After talking to many people, it appears both layoffs were very random and not quality based. Both layoffs eliminated people who presented truly quality work and hit metrics consistently. I really think the reviews are a scare tactic for people solely focused on numbers who might be skimping on quality. The goal at a company that big is always to keep people in line. Do your best, try to hit metrics and remember what you DO matters - not how you say it. And if it makes you truly miserable - begin looking elsewhere! Best of luck.

by
| | Reply
Post ID: @ehn+NcprSMJ

I do think we need to take these seriously, and have been told you should request to have your review corrected if it is not accurate. I cant imagine listening to calls all day long-I would go nuts! I'm sure there is a degree of autopilot after a while. Good luck!

by
| | Reply
Post ID: @oyp+NcprSMJ

Post a reply

: