Managing diabetes, with an assist from Empire Blue Cross Blue Shield

JULIAN DAVID :: Medicare Advantage member, Harlem, New York

JANET KENT :: Empire Blue Cross Blue Shield nurse care manager, Brooklyn, New York

As an Empire Blue Cross Blue Shield nurse care manager, Janet Kent, R.N., has always worked closely with her members. She approaches all her cases in the same way — by listening.

“Sometimes that first call with a member may take an hour,” Janet said. “But we may be the first health professionals in a long time who have taken the time to truly listen. Doctors have very busy schedules. That’s why really listening is such an important facet of this job.”

Janet and our other nurse care managers act as advocates for senior members, coordinating their care with physicians, helping them navigate the system, and connecting them with needed community resources. They are an important part of WellPoint’s Custom Care Connection program, which proactively assesses each member’s health and health care needs, and then offers customized health solutions for optimal results.

In the case of Medicare Advantage member Julian David, Janet was fortunate. She was able to work closely with his daughter Wendy to coordinate his care. But many Medicare members do not have such strong family ties.

“Sometimes our members have no one else in their lives,” Janet said. “Either they have no family left or the remaining family members have become estranged. This patient population often suffers from multiple, very serious conditions. They have a great number of things working against them.” Janet said that most members are delighted to learn that their benefits entitle them to the services of a personal nurse who can help them resolve their health problems. Once she has won a member’s trust, the rest follows naturally.

“If it’s coaching they need, I’ll coach them, if it’s cheerleading, I’ll be a cheerleader,” Janet said. “I really look forward to coming to work each day and talking to my members. It’s very fulfilling.”

 

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