Pharmacy Benefits Industry

Pharmacy Benefits Industry

The health industry has undergone many changes within the year. Catamaran is a pharmacy benefits company that serves health plans, Medicare payers, managed and fee-for-service state Medicaid plans, residential care facilities, unions, third-party administrators and self-insured employers. Catamaran is formerly known as SXC Health Solutions who is the fourth largest pharmacy benefits company. This company is one of the fastest growing companies according to Crane's Chicago Business but this is turning to be the company's greatest weakness.

The new health care law in full swing only means more business that is going to be available. This became a huge problem in the clinical department as to where prior authorizations for medications are processed. Unfortunately, the director of the department, assistant director and a supervisor has just been fired due to losing a Medicaid client. The department quickly starts to spiral out of control. The department is taken over by a temporary director who has no knowledge of pharmacy benefits and the culture of the department.

The employees moral in the department are low and the work in the department is becoming unorganized by each passing month with claims getting Employees are getting promoted out of the department into new areas within the company which is great. However, the employees that have gotten promoted are not being replaced but instead mandatory overtime is being demanded to recover the lost bodies. More work and demands are rolling in and people are exhausted from not having the help that is desperately needed to keep up with the flow of work coming into the department. Upper management is forcing management to write people up for mistakes and not working the mandatory overtime required in order to keep up with the amount of work. A pharmacist is told she cannot have any time off to celebrate her religious holiday with her family which she has placed a request for a month ago.

Employees are being forced to work thru the holidays such as thanksgiving and Christmas. Employees are trying to change their schedule to accommodate their children and upper management is saying no. A handful of productive and key employees have left the company for good or transferred to another department. It wasn't until this fall with winter approaching that upper management decided to hire a ton of people to replace the existing people lost in the department. Unfortunately this was a dollar short and a day behind because the ripple effect is already in motion.

Preliminary Problem Statement

The department and staff in it are not valued by upper management. The department culture and values is not being taken into consideration by upper management. The poor communication among employees and management causes more chaos among the clients serving and employees on the floor. Catamaran must take responsibility for the direction of failure the department has gone thru. The upper management in the clinical prior authorizations department must unleash control and understand the department's organizational behavior. I will be studying the leadership and organizational behavior in modern workplaces. Catamaran being an HPO has undergone a lot of risks within the structuring of the department. However, I will analyze the organizational behavior that has affected the performance of work output and morale among employees.

The article called "Conflict at the Top: Its Impact on the Organization" does a great job explaining the ramifications of having an unstable top management. The article explores the damaging effects of having an unstable management effects the company externally and internally. The chaos from top management will eventually affect the customers and outside contacts. This is also true that having an unstable top management clearly has damaging effects internally on lower management and the employees of the company. The management staff not only becomes affected thru confidence but also work performance is affected. The lower management lacks no self-confidence and evidentially displays a lack of motivation to support the policies set forth to support a healthy work environment. The article is able to validate how a company with conflict in top management may disrupt the whole organization internally and externally thru the Parkinson's Law or the Peter Principle.

The Peter Principle consists of five principles' that show what happens when and organization experiences top management chaos to the rest of the organization. The first principle gives a picture of how bad news travels fast and affects everything going downward in a negative manner. The second principle states how people that the top especially top management that have been with the company for an extensive period of time look for reasons or excuses as to why there is low productivity and complaints. The third principle points to the non-team playing at the top of management and how this trickles down to lower management. Team playing in the company becomes taboo and chaos starts to break out along with conflict among employees. Unity among the company goes out the window and the environment shifts to a hostile workplace. The fourth is how to [management becomes enemies of each other. Top management struggles to trust and help each other on projects. This causes a struggle for on projects for everyone which ends of taking projects longer to complete if this task is even able to complete. Lastly, the mushroom management is implemented throughout the company. Instead of high profile projects taking on a priority the opposite happens. People within the company no longer take risks or think out of the box in order to resolve problems or tasks. Situations are escalated with longer resolutions times if a resolution is able to be found. Conflicts are at a growing high and ideas from staff are not brought to the surface to be considered. All of these factors play an impact on the disorder and disruption internally and externally in the company caused by the turmoil from upper management.

The article "Motivate, Engage, and Involve Your Team" brings up the point that it isn't a person or group that makes up a company but