Open/Close
This is not a qualifying condition. Member is managing well and has no additional interventions needed by CM at this time.
Close!
I need to join the dialer and be ready to take calls by 9:30 (10:30).
False - 15 after :)
What two things can you never eat for breakfast?
Lunch and Dinner
NO!
Only discuss mail order pharmacy with a member if they have the pharmacy alert.
No :) Even if the member is already getting meds through mail order, check to see if there are others that they aren't getting and see if they'd like to get those switched as well.
You followed up from previous outreach, but member still needs additional interventions to reach goal.
Leave open!
I can flex all the time I want during the week, as long as it's made up.
False - can flex up to 2 hours during a week without taking PTO (as long as it is approved)
What has a face and two hands but no arms or legs?
A clock
The organizational minimum goal is 4.3 contacts/day.
WRONG! These averages are different per day depending on your schedule. Minimum goal for 5x8 schedule is 4.4
I have to sell the idea of mail order pharmacy.
Wrong. We need to discuss the benefits in a positive manner because it can truly be a huge help to the member. The pharmacy team can also be a big help with this one.
This IS a qualifying chronic condition not included in the plan. Member is managing well and will work with provider if any needs arise. No additional interventions needed at this time.
Close
I need to request at least 24 hours in advance in order for my time off to be considered scheduled.
True
What goes up and never comes down.
Your age.
Metrics is all that matters at the end of the day (year).
wrong! :D We want to provide the best service we can to our members. Quality and other goals (MOP, PDMR etc) are also factored in.
PDMR is important to complete during a post-discharge and should be addressed as part of the post discharge call completion. Bringing it up at the beginning of the call as an expectation and asking the member to begin gathering their medications improves success rates of completion.
YESSS - if we wait until the end and ask if they'd like to do it, most of the time they're going to decline.
This is a qualifying condition included in the plan. Member is managing well and needs no additional intervention by CM.
Open - include specific details as to how being managed.
I can request time off for Monday on a Saturday because I'm still requesting 24 hours in advance and there is an automated system for approvals.
False
How much dirt is there in a hole that measures two feet by three feet by four feet?
There is no dirt because it's a hole!
I'm having problems meeting my metrics and I don't know why. I need to figure this out on my own.
WRONG! Ask for help. Let's work together for the good of you, the members, our team and Humana!
Mail order pharmacy always automatically refills medications.
If my power goes out, I don't need to call the attendance line until it's been more than 30 minutes.
False - 15 minutes
What word in the dictionary is spelled incorrectly?
incorrectly!
Getting more calls per day is always better.
If a member has gaps in their medication refills, I should discuss with member what system they have in place to take their medications on a daily basis.
YESS!! Make sure the member has something in place as a reminder to take their medications and know when they forgot. Pill organizers are PERFECT for this.