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Meet the employees who enhanced how we serve our members

Every year, BlueCross presents its Pinnacle awards to outstanding employees who go above and beyond our mission to serve our customers and communities.

This past year, more than 200 employees were nominated by their co-workers in seven different categories. Here are the 2021 winners of the Pinnacle Awards:

Team Award (from left in photo above): Iris Lounds, Tasha Smith, Tracy Bilotta, Tonya Bedford, Lynette Carter, Jennifer Robert, Kristi Marter

While almost all BlueCross employees worked from home during the pandemic, some individuals were deemed so essential that their presence in the office was required. 

Part of what was dubbed the “Lights On Team,” several employees from the financial transactions team did exactly that. Beyond posting and issuing payments, they learned new skills and closely coordinated with remote team members to become the financial lifeline for both internal and external customers.

What’s more, they made such an incredible amount of responsibility seem almost effortless — always courteous and eager to provide professional and prompt customer service, even during the darkest, most uncertain days of the pandemic.

“Without these amazing employees with their incredible skills, we wouldn’t have been able to continue to provide the kind of excellent service we strive for,” says Financial Analyst Kim Blevins, who nominated “the magnificent seven.”

“I’m so thankful we have such a knowledgeable and trustworthy team willing to go that extra mile.”

BlueCross Karissa HyrchukMember Focus: Karissa Hyrchuk

Members with behavioral health concerns require capable and compassionate specialized care. For Karissa Hyrchuk, who’s worked as a licensed clinical social worker on the behavioral health care management team since 2019, going above and beyond for her members is the norm.

“Karissa follows through with all of her cases with a strong sense of ownership and excellence, and it shows in all of her cases,”  says Tabitha Miller, LCSW, behavioral health clinical manager. “This is not only apparent to her team and supervisor, but also to our members.”

Tabitha cites as an example a member who’d been referred to the behavioral health team. The member’s child was receiving treatment for a serious behavioral health condition — and the member was extremely concerned about her child being discharged from a treatment program based on the authorization process.

“Karissa is usually given cases like this due to her strong clinical and care management skills, as well as her ability to relate to both our members and other stakeholders,” Tabitha says.

“She quickly reached out to the mother, assessed the situation, and began liaising between the family, treatment providers, and our internal behavioral health utilization manager and medical director to ensure this member’s treatment needs were met while helping prepare the family for the child’s transition home.”

She also brings that member focus to BlueCross operations. Karissa is quick to identify obstacles and volunteer to help fix the problem — such as her work in our digital care management platform, CareTN.

“This drive has led to a number of workflow changes for our team that’ve enhanced the behavioral health care management experience for our members,” Tabitha says. “Her work continues to shape our digital program which in turn, continues to improve our service to members.”

Demonstrate Excellence & Agility: Yuan Li

BlueCross continues to work toward interoperability — a means of ensuring all our internal technology processes and systems are aligned  for the enhanced convenience for our members — while navigating evolving requirements from federal agencies that regulate the health insurance industry. Yuan Li’s contributions have proven instrumental every step of the way.

As lead architect, developer and analyst consultant on the interoperability project, Yuan has become an expert in Fast Healthcare Interoperability Resources (FHIR). These are the standards for exchanging information in electronic health records.

She regularly helps her team understand what they entail and what’s needed to achieve them. That can-do attitude is a big advantage, as Yuan has a talent for making “impossible” requests a reality.

“When we realized some of the software we purchased would not meet the full requirement and could hamstring us in the future, Yuan was able to design and develop a service that would make us completely compliant and flexible going forward,” says Jeff Jacobs, enterprise information technology team lead. “She helps everyone on the team be the best they can be at their jobs. I can’t stress enough what an asset she is.”

BlueCross Kathy BeckDrive Positive Change: Kathy Beck

They say technology should enhance, not replace, human interaction. That’s exactly what Kathy Beck had in mind  when she created a set of tools and reports that allow the clinical nurse managers and nurse supervisors to quickly identify performance issues in the BlueCross Medical Home Partnership program.

The result has been less time poring over case files to manually identify issues and more time providing exceptional oversight and leadership to clinical nurses.

As manager of clinical operations for West Tennessee’s medical home, Kathy wasn’t tasked with developing these tools, explains Nancy Muldowney, provider programs manager.

“She took it upon herself to create them to help not just her colleagues, but our program as a whole,” Nancy says.

Kathy was also instrumental in the 2021 implementation of CareTN. This care coordination resource helps BlueCross partner with its members to manage chronic conditions like diabetes, CAD, CHF, asthma and COPD.

“Because of Kathy, we can tell a better story and demonstrate the value we’re providing our members with chronic conditions,” Nancy says.

BlueCross Robin McFarlandDevelop Our People: Robin McFarland

Her title may be business analyst, but for those who work with Robin McFarland, that designation doesn’t begin to describe her contributions to BlueCross and its talent.

In 2020, Robin was tapped for a new position to help combine two customer service teams under one supervisor. Because it was a new position, there was no blueprint for her.

This change occurred during the pandemic, at a time when working from home was the norm for most BlueCross teams. She was also charged with onboarding new employees, in addition to keeping the current ones motivated.

Despite the challenges, quality improved tremendously over the past two years. In fact, the now-combined East-and-West-Tennessee team has not scored below 98% in the last year. Colleagues like Member Account Specialist Beth Anderson credit Robin for this achievement.

“Robin has an extremely nurturing presence despite the lack of face-to-face contact,” Beth says.

“Somehow she transcends the circumstances presented by the pandemic and keeps both new and tenured employees on track  with quality measures, all while fostering a feel-good environment.”

Deliver Best Value: Lisa Moses

In recent years, requests from self-insured groups (those who pay for their employees’ health care themselves but use BlueCross networks and services) for insights into the medical management of high-cost claims has skyrocketed. To respond, BlueCross created a new role filled by a clinician.

As the first clinical review manager, Lisa Moses set a new standard of service, providing unparalleled clinical expertise and relationship support for discussions about these costs.

Lisa was tasked with creating the entire reporting process from scratch. This meant she had to design the reporting template, identify the stakeholders who needed to be involved, and establish the format for the calls.

She also plays a key role in these discussions with our customers, often leading the calls to identify cost savings or intervention opportunities.

“Lisa routinely takes conversations that could easily become heated and calms the situation immediately, allowing all involved to move to the next topic seamlessly,” says Dr. Ian Hamilton, medical director, account management.

Dr. Ian Bushell, medical director in account management, adds, “Lisa has been an invaluable asset as we support our largest commercial customers. She combines the best of her nursing and business experience to help improve the health of their employees and families  while also keeping a keen eye on the group’s medical spending.”

BlueCross Jamie JanewayEthics & Trust: Jamie Janeway

Change should always strive for the better. But when it’s still in process, change can sometimes create confusion and mistrust. It’s an everyday challenge Jamie Janeway faces as a senior business analyst on the Member Benefits Administration performance improvement team.

Jamie helps her team navigate change, such as a recent shift to a new database that houses customer reviews which the team then uses for to identify additional training opportunities.

Despite Jamie’s full plate and being pulled in multiple directions, she manages to work efficiently, all while upholding the highest standards of conduct and making time for others.

Cheryl Hunter, who has worked with Jamie for five years, says when change leads to uncertainty — and the occasional grumbling — Jamie’s quick to respond with patience and positivity.

“When I think about an ideal employee — someone honest, hard-working, driven to excellence, and committed to our values —Jamie immediately comes to mind,” Cheryl says. “She’s always cheerful and friendly with everyone. She is truthful, which is why our team respects her so much. It may not be the answer you want to hear, but it’ll be truthful and aligned with the BlueCross mission. This is the reason our team so admires and trusts her.”

BlueCross Kaitlin CarlsonPeace of Mind: Kaitlin Carlson

As a CHOICES care coordinator, Kaitlin Carlson was responsible for overseeing the care of a group of BlueCare members in an assisted living care facility.

Her job typically centers around patient assessments — reviewing medications, checking in with patients and modifying care plans. But increasingly, Kaitlin’s assessments were uncovering serious quality-of-care concerns, from medication issues to patient abuse, to a lack of transparency from facility operators.

What happened next is the reason Kaitlin received the Peace of Mind award, BlueCross’ highest employee honor.

In addition to reporting the concerns to the Tennessee Department of Health, Kaitlin stepped in to advocate for members who were residents of the facility, ensuring their physical, emotional and medical needs would be met with the quality and dignity of life that each of them deserved.

Her diligence ultimately resulted in BlueCare terminating its contract with this provider and facility.  Shortly after, the Department of Health permanently closed the facility, removing all residents immediately due to imminent danger.

Kaitlin also took the time to contact their families, providing guidance to help them navigate this unsettling situation, which sometimes entailed conversations with state and local law enforcement.

“Kaitlin’s assessments and thoroughness when evaluating our BlueCare members and their environment allowed numerous inconsistencies and quality-of-care concerns to be recognized,” says Leigh Wooding, care coordinator supervisor.

“This attention and advocacy on behalf of members demonstrate her strong commitment to our organization’s mission and values.”

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