• Job Description

  Req#: R0367420

  Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
  
  Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

  Exit Interview Summary:

  Personal Factors for Terminating Employment with MinuteClinic

  The biggest personal factor was work-life balance and the need for a more regular schedule. In addition, I have always wanted to try full-scope primary care in a health system with interconnected resources where I am able to manage my own panel of patients.

  Work Factors for Terminating Employment with MinuteClinic

  Uncertainty regarding the future of MinuteClinic and what changes will look like as RQL and at the clinic-level

  Mixed messages from leadership

  i. Changes in leadership with restructuring of RQL role

  As a newer RQL, I feel that the role training could have been better defined (this is thankfully a current initiative). When I started, there were intranet resources but most of the links did not work initially. It was difficult to balance and somewhat confusing to understand the scope of my role when there were competing priorities with RQL management vs regional SPM priorities for the RQL role.

  Abrupt change and restructuring MN regions from three to two. This was a difficult transition with an increase in number of clinics and staff within the region in addition to having to split the role and admin time with another RQL. This was the catalyst that made me to start applying for new positions (Working 30 hrs per week in the clinic and >10hrs RQL time per week was tiring. Less schedule flexibility.)

  ii. Messaging surrounding primary care practice in MinuteClinic. Rebecca and you both have said that you don’t think MC is headed fully toward primary care but the messages that we are hearing from upper leadership is that MinuteClinic will be transitioning to primary care.

  Lack of trust that necessary resources and network will be in place to support transition to primary care or other future changes to practice.

  i. Lack of trust originates from a track record of making assurances but not delivering.

  For example, staff were told that there would be a team of care coordinators that would own the referral process, but this never came to fruition.

  Referral process is now owned by providers (with minimal support from care coordinators). Furthermore, the referral process feels like wasted time creating more admin work for staff when one goal was to eliminate admin tasks for providers.

  Another example is assurances of additional time for interpreter services. Patients were supposed to be able to schedule additional appt time for interpreter services and we were told about this potentially very helpful change almost a year ago and it has still not happened.

  PCAs were brought in to address the need for more support staff. While we had some amazing PCAs, patient scheduling was never adjusted to reflect the more limited scope of PCAs. Instead of simplifying provider tasks, the verbal order process created work for providers and providers ended up using work-around processes to keep up with volume when working with PCAs.

  ii. Feeling as if staff concerns are not consistently heard/acted upon.

  First of all, I have to say that I think SLC is great although I think the individuals that fill these roles need more hours allotted for these duties and additional compensation as well. I do see MC trying to incorporate staff feedback through surveys, SLC, and SPMs.

  At times, the SLC “wins” feel like a consolation prize (small changes that while nice, could be addressing larger issues).

  For example, providers have been frustrated with the reduced time for sports physicals since last fall when the time allotted was decreased from 30min to 20 min. The average time to complete was somewhere between 23-25min which means providers would, on average, be running behind schedule whenever they had sports physicals. MN, unfortunately, was not able to participate in the online forms which seems like it would have helped with time. SLC feedback forms were completed, one provider voiced concerns at a round table, other RQLs and SPMs were aware that providers were frustrated by the number of sports physicals and the decreased time allotted for them. No changes were made and in fact, patients were incentivized to schedule sports physicals d/t $10 discount special. Providers were told to hand out flyers encouraging patients to schedule more sports physicals. Th

  iii. Responsiveness to missteps: Changes are pushed out to the team quickly but then when problems arise, it takes a much longer time to solve these problems or back-peddle. Providers and CSS are left to find workarounds in the interim which often affects morale and increases anxiety amongst staff.

  Concern for patient safety as a result of uncertainties, practice expansion, and focus on volume

  i. Although I do believe the quality and safety team as well as the education team have improved immensely and I do have trust in those teams, I do not feel that our incentives are emphasizing patient safety as a priority. To be fair, quality and safety team does contribute significantly to NTU and quality initiatives like 4Ms are great. However, there is a definite sense amongst providers that there is less emphasis on patient safety and more emphasis on incentives for closing more care gaps, increasing patient volume.

  ii. Joey and Rebecca do a good job of promoting a just culture and when a mistake is made, I have not had a sense that there is any retaliation for these errors which I appreciate. My concerns arise from the speed at which changes are made which taxes the mental load on providers and staff.

  Amount of time required to complete all tasks in clinic in the provider role as well as RQL duties

  As a clinician now with 7 yrs experience in clinic, I still struggle to complete my work on time. Staying late used to be an exception but now it is more unusual to have days that I am able to clock out on time. This issue is not isolated to me. Providers with more experience than me also have difficulty completing everything on time.

  i. Patient calls

  Follow up with labs (although we have eliminated the need to call for some normal labs) continues to take more and more time. We have so many more labs that we can do like wound cultures, various blood draws, g/c throat cultures. For example, now that we are managing some chronic conditions, there are major problems with continuity of care between providers. One provider may have ordered some labs and then another provider has to look back through that patient’s chart to reformulate a plan of care. This is less efficient than having the same provider who knows the patient manage the plan of care.

  Calling Labcorp or Quest to track down any issues with labs

  Referral follow-up

  Pre-authorization follow-up process

  CRMs

  ii. Admin tasks: A known pain point. MyWork tasks continue to take a significant amount of time to complete. Keeping the waiting room and clinic well-stocked, clean, and organized as well as completing expiration audits takes time away from patients or if left undone, can compromise quality and the professional atmosphere of the clinic.

  I know staff that come in on their days off to organize the clinic or the gray supply cabinet or stay after clocking out. Some gray supply cabinets are in hard to access places. A solo provider is unable to organize the cabinet without leaving the clinic unattended. I know multiple staff that stay over their lunches, over their 20 min breaks, or come in on their days off to clean and organize a clinic without compensation. Staff have voiced frustrating with the LearningHub course that emphasizes laws surrounding taking breaks but staff use the break time to catch up on clinic work.

  Cleaning crew comes once per month but it is definitely NOT a deep clean of the clinic. It is a quick wipe down of surfaces. This would be a great help if the cleaning crew that comes was expected to dust behind computers, tops of cabinets, move glass containers to wipe down counters (understand that they likely wouldn’t be moving equipment.)

  Front store in CVS should have a daily cleaning log and check the store bathrooms every few hours. I know it can be difficult because they have a high staff turnover.

  iii. Patient/waiting room management: Seems to be more traffic some days and the amount of patients on the schedule does not always reflect the time spent answering questions, helping elderly patients check in or find their code, clarifying patient confusion over information found on MC website vs what they heard from the call center, etc.

  iv. Cash pay process is time consuming. End of the day cash drawer reconciliation is inefficient when processing a cash payment especially in the MinuteClinics inside CVS. I do appreciate that the number of times this needs to be completed has decreased with CCOF.

  v. The number of IT issues, store internet issues, IT equipment/printer/kiosk problems, broken/nonfunctioning links (policy page for one is often down), continues to be frustrating for staff.

  Time required to finish RQL tasks

  i. There is a sense that I can never truly disconnect in the evenings since clinics are open 7 days a week and on weekdays, until 7:30pm and wanting to support my team after hours. After hours is sometimes when they need it the most.

  Feeling that if it is still a struggle for providers that have been with the company for 10+ years, new providers may struggle even more (which leads to concern for pt safety and staff turnover). New grads in particular have difficulty practicing in a solo environment so I feel that there is not enough support for them in the evening and weekends.

  If I do leave work at work, healthcare is not that same as any other business. The stakes are dire at times and mistakes can lead to significant morbidity.

  Because I am RQL, when I work in clinic, I often stay until the CVS store closes because I feel that I need to be held at a higher standard, set a good example, and also maintain the clinics that I float to. I stay to organize clinics, clean, and make sure clinics are stocked.

  With the amount of changes occurring on a weekly basis, evolving practice, staff turnover, the time needed for quality and education to support such a large number of staff that are geographically spread out could be a full time job in itself. However, the RQL role allots only 20 hours to that role and 20 hours working as a provider in the clinic. The only time that I have ever felt that I am doing a half-way decent job is when I put in at least 10-20 hrs MORE than what is expected in my role. Even when I put in this time, there are still beneficial meetings that I have to miss out on because I am in clinic.

  ii. Difficult to have a consistent schedule with RQL role

  Often cannot work in clinic on preference days d/t inconsistent availability of clinic shifts

  Major changes occur quickly which makes it unpredictable when additional hours will be necessary

  At times, there is not enough lead time for RQL to absorb process changes before release to the rest of the team sparking questions that I cannot proactively address

  iii. RQLs should not be expected to answer questions while in clinic. I honestly think this is a safety issue and akin to distracted driving. Now that there is secure chat, RQLs have questions coming in from secure chat in addition to email and work phone texts/calls.

  Other Parting Thoughts

  Perspective:

  • The nature of a brick-and-mortar MinuteClinic is that they are small, 2-3 room clinics with minimal staff dispersed across multiple locations to provide more accessible care within pt’s communities.
  • The problem: With only 2 rooms and sometimes only 1 provider and possibly 1 support staff, there are very few redundancies in the system. Fewer process/system redundencies equals fewer backups and a less reliable system. As we add more complexity to the system (expanded guidelines, more equipment, blood draws and expanded labs), there is a greater chance that something will go wrong. When something goes wrong (computer malfunctions, supply runs out, scheduling errors), it is much more difficult for the system to absorb that problem.
  • Human factors add a level of unpredictability that is very challenging to account for and can be unavoidable in healthcare (late arrivals, no-shows, emergency situations, language barriers, etc.). At MC, patient self-scheduling can be problematic as well because our healthcare system is not easy to navigate, so pts do not always know what level of care matches their need.
  • The point: This is why staff can be easily frustrated at times because small issues can take longer to fix or cause more significant delays which in turn lead to more stress placed on staff and patients.

  Facility issues continue to be a problem

  • Gray cabinets/extra supplies being stored upstairs.

  • • Solution: Can we move the gray cabinets that are located upstairs so that they are closer to the clinics?

  • “Quick fixes” that continue to cause more work. For example- Apple Valley leaky ceiling (now being addressed), the desk in Apple Valley needs replacing instead of regluing old laminate to counters over and over (I requested replacement of the entire counter since the laminate just keeps peeling after being reglued but it seems it was not approved).

  The way IT problems are addressed

  • Chat function in Citrix has not been as helpful as anticipated and staff continue to call IT for ticket numbers
  • It is good that email “receipts” are now sent BUT staff get very frustrated when tickets are marked as “closed” without resolving the issue

  Recent Scheduling and Epic Updates

  • Allowing pts to self-schedule reasons for visit has caused some anxiety among providers as there is a significant portion of patients that choose the incorrect service

  Continues to be confusion around current scope of practice and vagueness of what is within guideline.

  • Messaging from Education is that providers can treat some patients if they consult with VCC. This also continues to create confusion and then providers want to treat the patient- desire to help- but may not have the time to call VCC.
  • Still need clarification on which clinics are PCT enabled. Seems that Targets are not PCT enabled but which portion of the guideline should Targets follow?

  Providers continue to show hesitancy in calling VCC

  · Seems to be a time issue again- not enough time to call so providers tend to reach out to peers or RQL

  Transparency

  · Personally, would appreciate more transparency with what is happening from a business aspect

  · Appreciate when management and leaders are candid about mistakes and missteps rather than always calling them “opportunities”

  · Sometimes it feels inauthentic to brand changes although I know MC is a business with its own marketing and culture to build

  More time should be thoughtfully allocated for staff huddles and rounding

  • Opinion: staff should have paid time blocked in their schedules to participate in region huddles, coaching and rounding, stretch roles/committees, and blocked time to participate in meetings
  • Differential should be implemented asap for precepting
  • Opinion: As much as people do not like to drive, in-person meetings should happen more often than once per year with more focus on personal connection and team engagement.

  This is a lot of information and I am open to speaking further if necessary. There are so many positive aspects that I did not list as the aim here was to address issues that may contribute to employee retention and patient care.

  Pay Range

  The typical pay range for this role is:

  $46.03 - $99.14

  This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
  
  In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
  
  For more detailed information on available benefits, please visit Benefits | CVS Health

  We anticipate the application window for this opening will close on: 09/17/2024

  Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

  CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work. CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.

• About the company

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