Brooke Smith, case manager
As Brooke helped a Medicare member transition home after a COVID-19 hospital stay, her first priority was helping the member manage feelings of depression from being quarantined and unable to return to work.
After convincing the member to join a telephonic counseling program, Brooke tackled her second priority — helping the member better manage her chronic health conditions.
“I shared how depression and stress can affect other health concerns,” Brooke recalls. “It was eye-opening for her to hear this.”
The member is now more physically active and has enrolled in BlueCross digital care management. She sent Brooke a message that read, “I hope this will be my start toward good health.”
Those are ideal words for a case manager like Brooke to hear.
“I feel like I made an impact for this member,” she says. “I want her to always feel like we’re a benefit to her.”
Catrice Walker, care coordinator
Catrice works with BlueCross members at Chattanooga’s Erlanger Primary Care, helping them schedule preventive screenings or receive care for chronic conditions. Her role is part of our Medical Home Partnership program.
As a nurse, she knows it’s important to identify and overcome barriers in getting that care, as she did with a member who had a recent diabetes test.
“It’s not healthy to miss meals, especially when you have diabetes,” Catrice says.
She located churches with food pantries and drive-through service in the member’s area. She also coordinated hot meal delivery with another church.
“When you say ‘nursing,’ people think clinical, but what we do is often much broader than that,” Catrice says. “It’s rewarding to help people in every aspect of care.”
Ashley Aaron, care coordinator
Ashley connects elderly or disabled members in the BlueCare CHOICES program with support and resources that help them live safely in the community.
A member recently texted to inform her that he was waiting for COVID-19 test results after being short of breath and having a fever. In follow-up calls to see if his respiratory symptoms had progressed, Ashley learned the member’s doctor had prescribed him a nebulizer and medication to help him breathe better.
“With all of the urgency and questions around COVID-19, he was scared about not being able to get these,” Ashley says.
Ashley offered to call his pharmacy, and in doing so made the process of acquiring the medication that much smoother.
Testing later confirmed the member had bronchitis, not COVID-19. Both the member and Ashley were relieved to hear this news, and Ashley is thankful she could help in this trying time.
Cindy Wilson, transition of care nurse
Cindy contacted a 66-year-old Spanish-speaking member who was hospitalized for COVID-19 and ready to come home. After that first call, Cindy recognized an opportunity to make the process more efficient, and enlisted the help of our translation service to communicate more effectively.
As Cindy built the relationship over several calls, the member revealed anxiety about his wife being isolated from him upstairs while she waited for results from a COVID-19 test.
“This is still a very new situation,” Cindy says. “When someone leaves the hospital and still has to be quarantined, that doesn’t settle their nerves.”
Cindy tried to relay calmness with her tone and advice. She discussed options for physical activity at home and the importance of eating well while isolated from his wife. After several calls, Cindy sensed his anxiety was lessening.
“Having a case manager can be like having a nurse in the family,” Cindy says. “I told this member that if he needs answers, he always has a direct line to me.”
LaSanda Turner, clinical management supervisor
The member’s mother and grandmother both tested positive for the virus, and a home health nurse was quarantined due to COVID-19 in the nurse’s family. The member’s father became sole caregiver much of the day.
“This member needed a high level of care,” LaSanda says. “It was a strain for one family member to do so much.”
Finding another nurse when a home has residents with COVID-19 was a challenge. She worked with the home health agency and BlueCross medical directors to offer a single case agreement.
This provided additional pay to the nurse assisting this member who wouldn’t have full-time hours. This nurse would not be able to care for any other members due to COVID-19 being in the home.
“I never want my members to go without care,” LaSanda says. “My team and I always want to make a difference in someone’s life.”