Number of Disease Management nurses

SWRN84 · Nov 14, 2005

I did disease managment with Optum (division of UnitedHealth Group) for a few months. I had to leave, though, due to some personal issues at home and am back in home health, doing visits. I worked with CAD and DM patients. They have a great program for the younger population. It was a great place to work but definitely a different form of nursing.

renerian, BSN, RN · Nov 14, 2005

SWRN yes I agree it is different. When you were at your previous job did you have a productivity scale per hours/day etc? What happened if you did not meet your productivity? I have alot of different diagnoses and programs and have both adult and peds clients.

renerian

SWRN84 · Nov 14, 2005

When I was working in my position from home they did have a productivity standard. We had to be in billable status 87% of the time. They could track our activities and gave us feedback if we weren't in billable status. They did cut us some slack when we were new and learning. They would evaluate us by doing silent monitoring, along with looking at our productivity, and give feedback during evaluations.

My position with Optum was not so much focused on productivity related to the number of calls per day we made. They really focused more on the quality of the calls other than the number of calls we made. The productivity standards were more enrollment based. They wanted so many new enrollees into the DM program per day. Some days you made it and some days you didn't. It all came out fairly even in the end. So the experience differed quite a lot between the two companies and what they expected. The positions themselves were quite a bit different, as well as the DM programs they offered. They did both have productivity standards, though.

renerian, BSN, RN · Nov 15, 2005

SWRN that sounds almost identical to the productivity I am held to know. Tracked through the phone (in the computer), billing time etc except our productivity is around 80% but new software should be used soon which will greatly speed up the process/ I hope.......

renerian

emeraldga · Mar 3, 2006

I work in Disease Managment for a large (very,very large) insurance company. I have worked there for over 2yrs and enjoy it, however I'm making the transition to case management. The company is making some significant changes in how we are monitored and I can't go along with them. They will be monitoring our computer screen as well as our phone calls. We are also held to productivity standards. We have to talk to at least 40 patients per week.

gr8rnpjt, RN · Mar 3, 2006

I worked for DTCA (Diabetes Treatment Centers of America, now known as American Healthways) when they came into town in 1999. They had a new contract with Highmark in Pittsburgh. I helped open the office in Pittsburgh, learned everything I could about diabetes in a 6 week crash course. I learned a lot about starting up a brand new office and got a lot of good experience with presentations and p&p. I worked on site doing chart review at a large teaching hospital here in Pittsburgh. When they lost the contract with Highmark, they went to a dialer system, and started talking about productivity ratings, etc. and I got the heck out of there. I now work for a large healthcare conglomerate in Pittsburgh and I am now working in UM. I let my CCM certification lapse, so now I guess I have to take the test again, but I will only do so if needed.

wincha · Mar 5, 2006

I recently turned down an offer from AH, yes they are on dialers, they wouldn't tell you what shift you would work until AFTER you started and sounded very inflexible. They were very nice to interview with though but use to work with the RN that interviewed me. I have been a telephone triage nurse. I am going with Optum. They seemed very flexible, the pay and benefits are excellent. They also encourage you to get your case management certification which I would like to down the road. Anyone know how to go about that for education? I am looking forward to this position and do have a background in cardiology.

emeraldga · Mar 7, 2006

Does anyone know anything about a company called HMC out of Virginia? I think they use a dialer system as well as monitoring each nurse's phone calls and monitors computer screen movement to make sure you are following on the computer screen what you're telling the patient. My company that I work for now works under HMC so I have lots of changes to get used to. We also have to work until 9pm some nights and one Saturday a month.

What are the hours most of you work, and how does this compare to your disease management companies?

Mijourney · Mar 11, 2006

I know a little of HMC. They are part of Anthem/Wellpoint bluecross blueshield. I guess my reservation with this company is that they're cutting back on their benefits. Especially retirement benefits. But, that seems to be the way of the future.

Yes, they monitor very carefully to make sure you're sticking with the script and that you stay productive. They do require nurses to start out working the evening shift and will pay differential for that and working a Saturday a month. They seem to regularly advertise for help. I don't know if that's due to growth or management problems. Anthem just sold out to Wellpoint I believe in the last year, so maybe that explains all the changes.

CseMgr1, ASN, RN · Mar 11, 2006

I work in Disease Managment for a large (very,very large) insurance company. I have worked there for over 2yrs and enjoy it, however I'm making the transition to case management. The company is making some significant changes in how we are monitored and I can't go along with them. They will be monitoring our computer screen as well as our phone calls. We are also held to productivity standards. We have to talk to at least 40 patients per week.

I also worked for a mega MCO for 4-1/2 years...the first 2-1/2 years as a Case Manager, and the last two in Utilization Management. At first I loved it, but became increasingly burned out as The Powers That May Be kept raising our productivity standards and their monitoring activities. By the time I left last May, there had been a complete turnover of staff in my department.

Other departments were suffering as well, with nurses leaving in droves...with some not even bothering to give notice. They just logged off their phones and walked out. The stress was horrible, with our workload equally horrible and our efforts unappreciated. My job just wasn't worth waking up with another migraine, so I quit...and haven't looked back.

wincha · Mar 17, 2006

I work in Disease Managment for a large (very,very large) insurance company. I have worked there for over 2yrs and enjoy it, however I'm making the transition to case management. The company is making some significant changes in how we are monitored and I can't go along with them. They will be monitoring our computer screen as well as our phone calls. We are also held to productivity standards. We have to talk to at least 40 patients per week.

Did you mean 40 a day or week? Because if you work 40 hours a week thats only 8 a day. I previously worked telephone triage and took 4-5 calls an houir. h