Nursing Professionals

Part 1 - Primary responsibilities

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BRIAN W: We educate members, and that’s our focus.

JULIE M: Sometimes people just need a little extra encouragement or a little bit of extra information, which from a clinical point of view, doesn’t seem like it’s earth shattering, but it’s very holistic.

GLENN P: You know a lot of time members are at their doctors office and they say ok your blood pressure is a little bit high and you could stand to lose 20 pounds and ok then the member leaves the office and they say ok how do I lower my blood pressure, how do I drop 20 pounds?

LUCI P: They are always saying well how come my doctor didn’t tell me that? A lot of times the doctors don’t have that extra time to give to them, so they may have questions that they weren’t able to ask at their doctor’s that they will ask us that we’ll provide the information for, or tell them, I always tell them, you know, get a pen and paper, write it down, and take it to the doctor’s.

BRIAN W: Mostly we empower that member. We want that member to understand that you need to talk to your doctor. You need to go talk to them because you’re going to be the one to give them the most accurate information about how you feel.

BETSY F: I had a member that said they were taking all these meds and they just didn’t know how to, um, make sure they were taking them correctly and, and I know I sat at my supervisor’s desk and I said, “If I could just go to their house, I could show them, I could show them how that we could lay these meds all out and get it all set up so that they wouldn’t be confused anymore,” and my supervisor said, that’s a great idea, but now we have to figure out how you can do it from your office. 

JULIE M: That commitment to caring about the members is one of the things that I think is a really important difference, because it’s not, you do have that ongoing relationship with them, and they depend on that.

DAFFANY W: No matter what we do, if we focus on that customer, we’re-we’re going to succeed and we’re going to be right in line with Aetna’s values.

Part 2 - Skills needed

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BRIAN W: You have to have a strong clinical background. You have to understand the processes, the disease processes that you’re talking about.

BARNEY L: The most important characteristic is that they are good critical thinking, good problem solving, enjoy teaching – and doing that telephonically.

LUCI P: The biggest challenge probably was all the computer work because, as a supervisor in my last position, I didn’t do any type of work with computers.

BETSY F: Having strong computer skills is, um, really a plus when you’re coming into an environment like this.

BARNEY L: But we look for other things, too, which I think are equally important.  We look for system-savvy, people that can come in and actually learn how to use the system, um, we look for a team player, somebody that really wants to be part of a team,

BRIAN W: I look for interpersonal relation. You know, how well do they relate to others? That’s something very, very important. When we don’t have the physical contact, we don’t have those nonverbal cues, all of the other communication skills become much more important.

BARNEY L: And we look for people that have really good critical thinking skills, good problem-solving skills, and, most importantly, can, uh, adapt to change.

BRIAN W: We’re always getting new work-flows. We’re always getting something added in to what we do. We don’t go about doing those things lightly. We don’t want to add more work, we just want to make things better.

BETSY F: You have to be very good at interviewing, using motivational interviewing and really listening to what the member has to say, and then, um, a lot of times repeating it back to them, so that, um, you can make sure that you understand exactly what they’re going through.

Part 3 - What to expect as a nurse at Aetna

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BRIAN W: I’ve had nurses come in who were just so excited to be there and in the end they really missed that hands-on clinical experience with their patients.

GLENN P: You know, you go from normally being on your feet most times to, to, you know, normally not being on your feet most times, so that’s a little bit of an adjustment.

JULIE M: My biggest challenge was definitely going from a clinical setting, where I was quite active and rarely sat down, to sitting for eight hours during the day, at, at my desk, and that was a huge change for me.

DAFFANY W: It’s a position where you’re sitting at your desk, you’re not moving around, interacting with different people all day.  You are sitting at your desk, you are on the telephone queue, and you are responsible for answering the calls that come in. 

BRIAN W: You’re going to spend probably 80 or 90% of your day on the phone, at your desk, working on your computer.

BETSY F: Not only do we use it to document, but we also use it for all communication. So we’re trying to move from not only phone calls, but to e-mails, possibly looking at text messages, um, the, there was even talk about, you know, chat rooms.

DAFFANY W:  We have technology available so that we can remote into their computer, get them to show me their screen and, um, I’ll see where they’re having problems and I can even take control of their computer and help them through that problem, so, technology has really helped us manage teleworkers.

BARNEY L: For the individual that wants to be primarily coaching and teaching individuals by phone on chronic illness, this is a terrific job. 

JULIE M: Come aboard! 

Part 4- Why I like working at Aetna

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JULIE M: I’m  really a firm believer in the power of the disease management program in impacting people’s lives.  I feel like it’s the core of what my beliefs are in nursing.

DAFFANY W: Aetna will have to peel me out of here.  I love my company,

BRIAN W: Working for Aetna is a great opportunity. It’s really doing what you’ve always wanted to do, which is help people.

BETSY F: Aetna is a wonderful company.  Um, I think that they do a lot of things around wellness and health that I think it’s really where we need to go in the future with healthcare. 

DAFFANY W: For me to grow to managing a department of two hundred and fifty employees, um, I think that was pretty significant and still see that there are still opportunities.  I haven’t reached my top potential.

BRIAN W:  Work at home is certainly a possibility. We have some very strict guidelines around it. You have to be here for a year or more. You have to be meeting your productivity metrics. Your quality has to be good.

BETSY F: When you’re at home, even though we push that you need to be using I.M. to, um, talk to people, if you’re really stuck you can’t just walk up to your supervisor’s desk and ask them to help you find what you’re looking for, um, cause you’re, you’re at home.  So we need to make sure that you’re ready, um, to be able to work at home and be successful. 

DAFFANY W: I supervise, out of the over two-hundred that I have, probably a hundred and fifty employees are at home; that includes frontline nurses, that includes customer service, and that includes supervisors working completely from home.

BRIAN W: I see information coming down from upper management that says you know what? Disease management is providing value. We’re adding value to Aetna. They talk about us, they recognize us, and they tell us how important we are to the overall picture and the important role that we play in helping our members.

JULIE M: To me it’s very holistic, and you’re always looking at the whole person.  You’re looking at, not just their disease – like, they might get sort of that slant in the physician’s office – you’re looking at how that disease process or condition affects their whole life.

BARNEY L: And it’s a win-win for Aetna, because we are able to save Aetna money by helping people live a more productive, healthy life.

JULIE M: People are much more honest with you when they can’t look at you, and they know that you’re not judging them, they know that you’re a clinician, and they can’t see your facial expressions and react to what they’re saying, so they share very intimate details of what they’re feeling, and how they’re doing with you.  Which, I find really rewarding.

Part 5- How our work is measured

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JULIE M: We get a lot of feedback, which I really love.

BETSY F: Performance is measured on I would have to say four really basic things; one is production, which is really how much work you can do in a day.

JULIE M: The day flies by, it really does and I’m busy from the time I get there until the time I leave.

BETSY F: We also look at engagement, that’s your ability to keep our members engaged and, so that they find value within our program. 

GLENN P: With the knowledge we are able to provide our members, the education we are able to give our members and educate them on a proactive approach to health, we are definitely and advocate for our members.

BETSY F: We also look at quality, um, really, and we’re really focusing our quality back to, um, motivational interviewing, and your ability, um, to talk with the member, evaluate change, um, and move the member through the different levels of change so that they get to the ultimate, um, goal.

LUCI P: You get to spend more quality time educating members which is nice, lthat’s what they lack from doctors.

BETSY F: And then we look at other things like your attendance, um, your, um, team work – we all need to be a team and work together, we look at, um, are you flexible? Sometimes it’s hard for nurses to understand that you do have metrics in a hospital, I mean, you come in and they say you have six patients today, and if you think about those six patients you need to give them meds, make sure they have their baths, you need to check the doctor’s orders and you may need to get them ready for discharge and do all their planning, do their case plans, um, and when you look at it that way, that really is a metric.

BRIAN W: So I’ll take some time, sit down one on one with my staff or maybe even listen in on a phone call.

JULIE M: We definitely have a lot of monitoring ability and a lot of feedback.

DAFFANY W: We have a results manager who aggregates the information, she puts it all together, she puts out a tool called the dashboard, and she shares it with the supervisors. And then mid-year we have what we call a ‘scorecard review’, you sit down and have a formal discussion about how you’re doing; any goals for the end of the year, so we work toward those goals towards the end of the year, and at the end of the year we sit down and have a performance  review, where you’re actually given a score on how you’ve done for the year.

Part 6 - Guardian angel

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LUCI P: One gentleman, he was approaching his 65th birthday, he was a heavy former smoker so the assessment tells you, you know, to have the member discuss being tested for the abdominal aortic aneurysm with their doctor. His blood pressure was fine, his labs were fine, everything seemed okay. The doctor decided to test him for it and he had quite a large aneurysm that needed to be operated on right away. And, because it’s not something you have symptoms with, really, He called me “his guardian angel”, I was just doing my job, but he said “doing your job saved my life”, so it made me happy.

Part 7 - Disease Management Program

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BRIAN W: I decided to come to Aetna and join the disease management program because it really gave me the opportunity to do something that I enjoyed, which was teaching people. I tell nurses that working for Aetna in our disease management program is a great opportunity. Disease management is providing value. We’re adding value to Aetna.

BARNEY L: Well, it’s actually the best of all worlds, uh, in the disease management department at Aetna because we have the opportunity to provide clinical education and teaching, which, in other settings right now for nursing, is really fairly limited

DAFFANY W: Now, in disease management, there’s a lot of interaction with members.  You’re talking one-on-one with the member rather than the provider, you’re teaching the member, you’re able to provide a real value to them and get real-time feedback from them, and you can see that member improve

BRIAN W: In a clinical setting, a hospital or some of those clinical settings that we’re very used to as nurses, we’re moving all the time. We’re going from room to room, from patient to patient, from, you know, from one room to the next and doing things, hands-on, you know, going and getting something for somebody. Here at Aetna, in our disease management program, we try to empower that member to go and do those things.

BETSY F: In disease management and here at Aetna there’s lots of training opportunities that you can go through, we do a lot of, um, training on motivational interviewing, um, a lot of it is, um, technology-based so it’s through, um, courses on the, on the Aetnet or the internet-type approach.

DAFFANY W: Disease management, in my opinion, is the best place for a nurse to make the transition from the hospital to the manage-care industry. So it’s a great place to start, it’s a great place to get in the manage-care industry and start learning about the industry, while remaining connected to a patient.