Show:
My Performance Summary
Quality Report
Verint Report
Attempts/ Contacts Report
Performance Conversations
100
What day of the week does the My Performance Summary (MPS) refresh and what day of the week does it become available to all care managers?
What is it refreshes on Monday and becomes available on Tuesday.
100
How often is the Quality Report Refreshed?
What is Weekly. *The Quality Report is refreshed on Sunday night with a new report available on Monday morning.
100
How often is the Verint report refreshed?
What is Weekly. *The Verint report is refreshed on Mondays; available on Monday afternoon.
100
How often is the attempts/ contacts report refreshed?
What is Weekly. * The contacts and attempts report is refreshed on Wednesdays. Coaches are expected to review it weekly for members that fall outside of MOC and UTC compliance and as supplemental data to provide insights to My Performance Summary. Coaches are expected to work with their HCM's to ensure that they attempt an outreach on members outside of compliance; work on ways to make contact, or close the member.
100
You have an associate who has been showing a decreased trend in MOC compliance on the MPS > 2 weeks. Your associate also has low talk time however they report working long hours. What supplemental report might you use to understand the differences in their call patterns and work hours?
What is the Verint Report. *This report may be used to investigate the following types of scenarios • Pattern of very short calls – Prompting Coach to listen to calls to assess added value to member. • Pattern of very long calls – Prompting Coach to listen to calls for opportunity to improve and give member and associate back the time. Wanting to find out is the time spent with the member really of value? Monitor for long calls which can often lead to member feeling they do not have an hour to talk and not answering the next call receivd. • Pattern of distinct gaps between calls – Prompting Coach to explore these patterns – are they flexing time daily without informing Coach and deviating frequently from their work hours that are preferred member times to call? Does the associate have an opportunity to better manage their time and work more efficiently based on patterns observed? • Unexpected/unusual “first/or last call” times – This can often mean the HCM is doing a great job in meeting the member where they are.
200
Where in the MPS would you click to drilldown to the overdue MOC calls at the member level?
What is the blue hyperlink (link) next to overdue MOC %.
200
What tab within the Quality Report would you use to see all of the coach quality scores on your COM team?
What is Quality Scorecard Tab. *You can also view your individual HCM's overall scores on this tab as well. (Don't forget to adjust the date range!).This can be used to determine who is preforming high in particular section and who may be someone that others may benefit for sharing their best practices as well as who may be struggling in a particular area.
200
When calculating average call time / talk time in the Verint Report what calls should be excluded?
What is all conversations that are non member facing / related to member needs. *You will want to use additional research to determine quality related to conversations and documentation through call and documentation review.
200
What tab within the attempts/ contacts report would you use to identify specific member data for members outside of compliance for their MOC call?
What is Member Level Tab. *Make sure to turn off slicers for Transitions, Engagement Hold and Priority Roster if you’re not on the coverage team. Rostered associates should click “no”. Focus on members who have had no attempts in 31 days (challenged LOI) and 15 days (HS tele LOI) as well as the greatest number of days without contact (why hasn't an attempt been made? If UTC why is the case still open, was the UTC process followed appropriately before the member went to RIT, if that is where they are now? Are we aggressively trying to reach that member or close the case?). You will want to utilize CGX/ hCAT/ Verint to gain more insight.
200
You have an associate who is trending below minimum expectations for the 13 weeks in more than one LOI. What LOI would you focus on first?
What is the most overdue that is associated with Timely MOC Call % *When an associate is "red" in multiple LOI's we should focus on the most overdue and work that one first. You will want to consider whose roster shows the most overdue with the most cases. Double-click the blue numbers for Overdue MOC Call% to open the member drill down. Look for the highest number of Overdue Days and then look to see when the last UTC call was made on those members. If there are members that don’t have recent UTC call activity, this could be an issue that needs to be addressed.
300
What is the purpose of having the peer reference point on the MPS?
What is to allow our care managers/ leaders visibility into how their peer group is performing. *This should not be used during coaching conversations as a goal to strive for (Alison-IDK if we want this here or not? Maybe you can re-word it better? :))
300
You have been coaching one of your HCM's on care plans. What tab within the quality report would you review to identify trends in progress in the care plan section?
What is Drilldown Tab. *Don't forget to use the filters on the right hand side of the report to select the individual HCM that you are reviewing. This view Allows leaders to see the average score by question based on criteria selected. Each item listed begins with the section and is followed by the question. Review baseline / minimum expectations with your associate.
300
What tab within the Verint Report would you use to identify patterns with the # of calls made at certain times of the day (either by the team as a whole or down to the individual HCM level)?
What is the performance trend tab. *Use this tab if Coach of COM wants to investigate aggregate information for an individual or potentially their team. Charts can help coaches quickly identify opportunities. 1. The graph shows us a clear quick view of: • The hour of the day the first call and last calls were made • The number of calls made in each hour of the day • The amount of time spent on the phone for each hour of the day
300
What tab within the attempts/ contacts report would you use to trend your team's overall MOC compliance and average days since attempted / contacted?
What is Clinical LOI Tab. * Look to see how the team is trending. Select filter for yellow to yellow on attempts and contacts separately. Identify trends. In the graph you can get a visual breakdown of each LOI and how many days outside of compliance each LOI is. You can also drill down to the care manager level.
300
You have an associate who consistently exceeds minimum expectations for quality scores in the quality report. What report will you want to use in conjunction with the quality report during your performance conversations (one to one meetings)?
What is The MPS. It is great that we can verify that this associate is having quality conversations/ documentation. They may have some best practices that they can share. However it is also important to utilize the MPS to confirm that we are also reaching our members and addressing alerts in a timely way. We want to look at the entire picture of the care management that we are providing.
400
You are reviewing the MPS with a care manager and note that the quality score has been on a decline for 2+ weeks. What supplemental report would you review to identify opportunities to review with this associate?
What is the quality report. **There is no supplement for listening to calls and reviewing documentation. If you have quality concerns take a deeper dive and review additional calls and documentation.
400
How Frequently should leaders be reviewing the Quality Report?
What is weekly. *COMs and Coaches are expected to review this report each week to assess performance. Use this tool during one to one and performance conversations. Review trends, baseline, and minimum expectations as well as areas of proficiency (celebrate and encourage sharing best practices).
400
What are the 3 main elements that you can review in the Verint Report?
What is Time Between Calls, Time of Call, and Time spent on Calls. *Things to consider -Time between calls o Over 30 minutes? o Was the gap during Lunchtime? o Was the gap at the end of the day indicating the associate left early? o Was there an exceptionally long call before (need more time to document?), o Did they start their day 30 minutes early or stay 30 minutes late in an attempt to compensate -Time of Call o First call a. Compare when expected to start making calls for the day b. Any known factors around why associate started early or began late? c. Starting early to make up for longer breaks noted during the day? o Last call I. Does it align with expectation around ending workday? II. Making up for any long breaks during the day? -Time Spent on Calls o Normal calls should last approximately 15-20 minutes o Short calls – i.e. last less than 1 minute (probably voice mail or no answer) o Long calls – i.e. over 30 minutes (possibly inquire with associate)
400
You're researching a specific member that is outside of MOC compliance and want to use the attempts/ contacts report to view the last action on a specific member. What steps do you take to do this?
What is go to the member level tab, double click on the corresponding number next to the H# (underneath the last attempt/ last contact columns). *You can also see the mbrs LOI, the last attempt date, and last contact date.
400
You have an associate who is meeting/exceeding minimum expectations for the 13 week metrics in all care management fields on the MPS. You review this weeks report and they are red for the 1 week look back. Do you reach out to your associate to have a coaching conversation?
What is No. Continue monitoring performance to see if a two-week downward trend appears. You should not plan to formally discuss this downward trend with the associate until you truly determine that it is a trend. This involves monitoring over time. Create a culture where our associates can: • Manage their own quality practices. • Plan for the delivery of care to individual members. • Control conversations around their own performance. **If you do see a downward trend for > 2 weeks and your associate has not reached out to you then you will want to explore the data trend and use My Performance Summary and other reports to determine the root cause of this trend. Be inquisitive and curious. Use your report portfolio, not just single report, to get holistic view of what is causing trends. You want to consider all the factors impacting this downward trend in performance
500
When reviewing the MPS with an associate you note that their MOC compliance has been trending down. The associate reports working long hours and spending additional time documenting. What report would you use to validate working hours and review opportunities with time management?
What is the Verint Report. *The Verint report assist leaders in identifying specific coaching opportunities related to pattern and duration of calls as leaders evaluate an associate’s trends in performance over time. It is important for effective time management so that our associates can reach as many members as possible every day.
500
What is the purpose of the Quality Report?
What is to improve member experiences and improve member health outcomes. *This tool helps leaders identify and highlight associate strengths as well as any opportunities for continued growth and development as we drive towards excellence and building productive relationships with our members. This report can also help leaders guide teams and associates on: a. Providing specific, actionable feedback, regardless of score. b. Emphasizing calls and member outcomes instead of scores: What value did the associate provide to the member? c. Celebrating consistently high performers and those who need to improve
500
What is the purpose of the Verint Report?
What is provide insight into call patterns, and gaps between calls when associates are struggling to meet minimum expectations for managing roster, or for new associates developing these skills. *The Verint Report - • Can assist leaders in identifying specific coaching opportunities related to pattern and duration of calls as leaders evaluate an associate’s trends in performance over time. • Important for effective time management so associates can reach as many members as possible every day. What’s important to keep in mind is that we should be assessing patterns and trends over time. Leaders should never provide feedback on only one day’s worth of data, or focus in on gaps too aggressively, which could be used as a detriment to our associates. Instead we want to have an overall picture of how our associates are performing during a coaching conversation. This report should not be used to track every minute of an associate’s time and drive coaching solely for that purpose. This report is best used to further understand how an associate is managing their calls, specifically the patterning of their calls. When we have an associate who is visibly struggling or having a difficult time keeping up with their roster, this report may provide insights into what they could do differently to work more efficiently.
500
When reviewing the clinical LOI on the attempts/ contacts report you should only select the LOI's that our HCM's care for. True or False?
What is False. Use slicers to filter o Use the Clinical LOI and Program slicers to ensure that all members on your rosters are with the correct program and LOI (i.e. HCM-RNs should NOT have “Live Healthy (aka at risk)” or “HS LTIH” clinical LOI members on their rosters o If the Clinical LOI is “Undefined”, then the member will fall to the bottom of the roster and not be placed in priority to be called. This will require assistance (i.e. ticket, outreach to our Business Improvement leader). It is important to remember that although we have the MPS if a member is incorrectly showing as having an unidentified LOI they will only populate on the attempts/ contacts report so we must continue to use this report and research members out of compliance.
500
You are preparing for a one to one conversation with an associate who is meeting/exceeding expectations in all LOI quadrants on the MPS however you have noted that their quality scores are consistently below minimum expectations. What report would you use in conjunction with the MPS during your conversation with the associate?
What is the Quality Report. *There is no substitution for listening to multiple calls and reviewing documentation. If you have quality concerns, take a deeper dive and review additional calls and documentation.