HR410 Unit 3 Performance Gap Analysis Example

Seventy of Seventy-Two Against Forty-One: A Unit 3 Performance Gap Analysis for Other-Coverage Updates

[Student Name]

Purdue University Global

HR410: Talent Development and Learning

Unit 3 Performance Gap Analysis

[Instructor Name]

[Date]

Ridgemont Health Plan, its staff and every figure are composite and illustrative; the sources cited are real.

The Gap in Business Terms

Ridgemont Health Plan's internal standard for other-coverage updates is no more than 1.0 error per hundred. The audited rate since the membership system upgrade is 3.9. Representatives complete about 4,600 updates a month, so the current rate produces roughly 180 erroneous updates a month, against about 46 at standard.

Each erroneous update means claims paid in the wrong order. Correcting one takes about 50 minutes of claims and member services time, plus letters to providers asking for repayment, at an estimated $85 per error. The excess over standard costs about $11,400 a month, or $137,000 a year, before counting the complaints to the state insurance department that rose from about 6 to 17 a quarter.

The Test

Twelve tenured representatives and twelve hired since the upgrade each processed the same six scripted updates in the training copy of the membership system. Each case involved at least one of the three changed steps from the Unit 2 task analysis: a split coverage period, the reorganized reason codes or the retroactive approval threshold. There was no time limit, and the reference guide was open. With twelve representatives working six cases each, every group produced 72 cases, and a case counted as correct only if every step matched the audited answer.

Tenured representatives. 70 of 72 cases correct.

Recent hires. 41 of 72 cases correct. Their misses clustered on the split coverage period and on the renamed reason codes.

Walking the Questions

Mager and Pipe (1997) offer a sequence of questions for deciding whether a performance problem is a skill deficiency. The analysis follows them in order for each group.

Is the problem worth solving? Yes, at about $137,000 a year and rising complaints.

Could they perform with everything at stake? Tenured staff: yes, nearly perfectly, when the clock is off. Recent hires: no, not even with the guide open.

For tenured staff, is the right behavior punished or the wrong one rewarded? Yes. Handle-time scoring rewards finishing quickly, and an update done correctly with a split period takes about four minutes longer.

Are there obstacles? Yes. Unless the representative clears it, the coverage-period screen carries forward a single date from the old record, so the fast path is the wrong one.

For recent hires, did they ever know how? No. Their only preparation was the ninety-minute module, which showed the screens without practice.

Tenured representatives can do the work and are paid, in effect, to skip it, while recent hires cannot do it at all, so one program for both groups would waste half its time.

The Cause Table

Tenured staff, handle-time pressure. Remedy: an exception code that removes other-coverage updates from handle-time scoring for thirty days, then a revised target. Owner: member services operations. Cost: minimal.

Tenured staff, the screen default. Remedy: remove the default so the field is blank. Owner: membership systems team. Cost: about 16 developer hours.

Recent hires, skill deficiency on three steps. Remedy: a practice-based program with feedback. Owner: training. Cost: about six seat hours for 23 representatives, plus design time, estimated at $9,800.

Why the Two Groups Differ

The tenured representatives learned other-coverage updates on the old system, where one effective date was enough, and they handled thousands of them before the upgrade. On the new screen they know a split period is needed, and in the test, with time to think, they entered one. On a live Monday call with members waiting, the old habit and the default date line up, and the shortcut wins. Their errors are slips under pressure, not gaps in knowledge.

The recent hires never had the old habit to fall back on, but they also never practiced the new steps. The ninety-minute module showed where each field was without asking anyone to use it, and their first real split-period case arrived on a live call. Their errors are consistent across days and cases, which is the pattern of not knowing how rather than of hurrying.

What the Test Cannot Show

The test used scripted cases without a live member, so it may overstate what tenured staff do under real pressure. Gilbert (1978) argued that most performance gaps come from the environment rather than the individual, and the tenured results fit that view. Salas et al. (2012) caution that skill shown in training does not guarantee skill used on the job, which is why the program will need transfer support.

Recommendation

Fix the default and the scoring first, so trained skill is not undone. Then train the 23 recent hires on the three changed steps. Repeat the six-case test with both groups ninety days after the program to see whether the gap has closed, and compare the audited error rate with the 1.0 standard.

References

Gilbert, T. F. (1978). Human competence: Engineering worthy performance. McGraw-Hill.

Mager, R. F., & Pipe, P. (1997). Analyzing performance problems: Or, you really oughta wanna (3rd ed.). Center for Effective Performance.

Salas, E., Tannenbaum, S. I., Kraiger, K., & Smith-Jentsch, K. A. (2012). The science of training and development in organizations: What matters in practice. Psychological Science in the Public Interest, 13(2), 74-101. https://doi.org/10.1177/1529100612436661