Strong focus on your billing/revenue making duties. Billing Expectations are high and no adjustments for your sick time, time off, meetings, non billable required activities. Strong push to bonus, which requires working extra hours or “over billing”. Bonus amounts are below minimum wage for your travel time and below your hourly wage for your professional time. Must self advocate and decline work or you can work 18 hours a day! Management tries to get employees to over bill, the assistant manager told me to over bill for “me time” and explained how to select a line item that ‘no one checks (for accuracy) ’. There is no team, it’s every employee for themselves with a supervisor only to assist. This can also be a pro. Travel expectations were more and further than described in the interview. Focus is on finishing tasks on your file, checking boxes, and no concern for the actual deeper value add activities of a nurse case manager. All about keeping the case manager billing and making money any way possible. Supervisors review for billing per contracts and little concern for the skilled critical thinking and value that the nurse case manager added to the client’s case outside of revenue. The documentation system is antiquated. You are required to manually attach every email received and sent to the clients case which is a time consuming and poor use of RN time. The contracts for customers are all different and there are no rules written into the documentation/billing system. Expectations are to constantly check your billing against contract allowances, these change without communicating to the staff. Your supervisor checks your billing every month against the contract and then a billing team checks. So many mismanaged resources! You have no voice to contribute to improvements. You have no contact with senior leadership. You must be self directed & teach yourself how to do most things. You will be asked to take cases within 1-2 weeks of hire and just figure things out the best you can. Basic email etiquette norms not followed here. Patronizing language in communications and care planning selection choices. “Compliance”. Lack of gender affirming pronouns/word choice in all letters being sent out to clients, customers, providers. Lack of inclusive language for providers, assumption is that they are all doctors or physicians instead of Nurse Practitioner or Physician Assistants.
