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CORE TENETS OFCRITICAL THINKINGWith explanations and real-world workplace examples
CORE TENETS OF1. Clarity2. AccuracyCRITICAL THINKINGWhat it means: Your thinking must be easy to understand, with the problem, goal, and reasoning clearly stated. State the issue, question, or goal in plain, unambiguous terms. Why it matters: Lack of clarity leads to misunderstandings, misaligned expectations, and incorrect decisions. Clear problem statements prevent misalignment between teams such as Eligibility, Medicaid Operations, Managed Care, and Finance. Example: A project team member states, “We’re getting too many complaints.” Clarity means specifying: “We’ve received a 30% increase in provider complaints about claim adjudication timelines in the past two months.” This ensures everyone is solving for the same clearly defined issue. What it means: Use verified, reliable information — not assumptions or impressions. Why it matters: Accurate data is essential when reporting to leadership, external agencies like CMS, or when making decisions impacting policy. Example: Instead of assuming a county office is experiencing higher error rates, accuracy requires verifying the actual eligibility error reports from NC FAST and confirming whether the trend is real or localized. This prevents decisions based on guesswork.3. Precision What it means: Be specific and detailed. Avoid vague or generalized statements. Why it matters: Precision helps pinpoint root causes and design targeted solutions. Example: Not precise: “There are delays in processing applications.” Precise: “Application processing times increased from an average of 12 days to 19 days specifically in counties using a new verification workflow in NC FAST.” Precision directs toward the true root cause.
CORE TENETS OFCRITICAL THINKING4. Relevance5. Depth What it means: Focus only on information that meaningfully impacts the question or decision. Why it matters: Irrelevant details waste time and can derail Medicaid operations or cross-department collaboration. Example: When evaluating a policy change for EPSDT services, staff feedback about unrelated transportation challenges is not relevant. However, data showing increased denial rates due to documentation gaps is relevant. Relevance keeps discussions focused and productive. What it means: Explore underlying causes, complexities, barriers, and systemic factors. Why it matters: Depth is critical for high‑impact decisions, especially around compliance, federal reporting, or payment accuracy. Surface-level thinking leads to solutions that don’t fix the real problem. Example: If beneficiaries are losing coverage during unwinding, a surface-level explanation might be “They didn’t return verification documents.” Depth reveals: Some counties mailed incorrect requests Beneficiaries didn’t receive notices due to address mismatches Verification windows were shorter than usual Call centers experienced long wait times Depth uncovers the real systemic barriers.6. Breadth What it means: Consider multiple perspectives: viewpoints, business units, stakeholders, agencies, counties, providers, plans. Why it matters: Breadth prevents siloed decisions that could unintentionally burden other areas and stakeholders. It helps design solutions that work across the organization. Example: Before implementing a new provider enrollment requirement, consider impacts on: Providers (workflow changes) Managed care plans (contracting timelines) County DSS offices (increased verification inquiries) Beneficiaries (access to care if providers delay enrollment) Breadth ensures statewide alignment.
CORE TENETS OF7. Logic8. Significance CRITICAL THINKING What it means: Ensuring your reasoning follows a reasonable and coherent thought process where conclusions naturally follow from evidence. Why it matters: Logical reasoning is vital in policy interpretation, issue triage, and advocating a position/ decision. Example: Logical reasoning: “Prior authorization denials increased by 18%. Concurrently, guidance updates were unclear and provider support sessions decreased. Therefore, revising and re‑communicating the guidance may reduce denials.” Logic guides sound conclusions What it means: Prioritize issues based on impact - not every problem or detail is equally important. Why it matters: Significance keeps focus on high‑impact work that affects beneficiaries, compliance, and operational success. Example: IF both the following issues occur: A minor provider portal glitch A spike in beneficiaries losing coverage due to reapplication confusion. THEN, the second issue is significantly more critical and must be prioritized. Significance helps allocate limited time and resources effectively.9. Fairness What it means: Reason objectively, without bias, personal preference or assumptions influence judgement. Why it matters: Fairness is crucial for equitable beneficiary treatment, policy development, provider relations, and internal decision-making. Example: §When evaluating a Managed Care plan’s performance, fairness means using the same standardized metrics (timeliness, accuracy, grievances, compliance), §Not personal impressions or anecdotal experiences from a single county. Fairness ensures consistency and trust.