It’s exhausting trying to stay the course with conflicting strategies changing daily and no resources or support. Complex Clinical Audit is a mess. We can’t keep up with the work, it’s chaotic, salary is horrible, pushing Cost of Care so much it’s become a nightmare. Leadership has no answers other than dig in your feet and think outside the box. Praying for a new opportunity soon…interviews are steady.
10 replies (most recent on top)
Carelon is a disaster. BW means well but is outgunned. She’s ethical and I’m shocked she has lasted as long as she has. I wouldn’t trust the rest of them as far as I could throw them
Carelon Insights is a career ender. Not only is it run in total chaos but the tech, the processes, programs are extremely outdated and are of no use to other companies outside of prehistoric Elevance.
Anyone talking about Carelon IT and Elevance IT dynamic that has created a poor accountability model for the business?
It’s shameful, really, that so many leaders, staff VP and above aren’t leading by example but simply taking orders.
Meetings after meetings to discuss concerns as opposed to solutioning with meaningful intent.
This whole organization is a pathetic joke.
HBA is Hospital Bill Audit…CCA (Complex Clinical Audit) under Payment Integrity for Carelon Insights. It’s DRG, Implants, Percent of charge, HBA/IBR and medical review with/ without medical records pre and post pay auditing.
What is HBA? Honestly I understood the rebranding of all the Carelon companies, but I can’t keep any of them straight anymore
HBA is a hot mess and always has been even the first time around several years ago. The company does not fund the right technology and has too many antiquated systems to support the needs for a robust platform to meet all the different needs from front end to back end for the claim cycle. Leadership is always looking where to outsource next because they know internally we can not meet the demands even though they push every team past max capacity and blame the managers for not being resourceful enough and not building better predictive modeling…isn’t that a kicker.
It’s a nightmare everyday. I’m looking and interviewing too. I didn’t want to take this route because of all the years I have been with the company but it’s not going to get any better even if I move to another department.
That’s great you’re getting interviews, OP. Good luck.
💯 agree. The whole of HBA is barely treading water and nobody knows how to make it run better.