Newsroom | Collaborative Care

Every day, teams of dedicated nurses employed by Health Care Service Corporation coordinate access to the care that members need to improve their health outcomes.

Nurses who specialize in assisting members in Medicare and Medicaid health plans often encounter especially complex health needs along with social and economic barriers to care, including food insecurity, homelessness and unemployment. 

The role includes helping members find providers, offer health condition education and get authorizations for care and access social services. It also requires having compassion and patience to gain trust from members reluctant to accept help after negative experiences with the health care system. 

The nurses are quick to deflect personal praise and credit their successes to their teams, which include social workers and counselors. They try to treat each member the way they would want to be treated.

But members and their families often thank the nurses for their expertise and dedication. 

Teresa Griffin

“Even more than her professionalism, what stood out most was Teresa’s heart. Her kindness and empathy brought us comfort and reassurance in times of stress and uncertainty.”

Griffin, for her part, recalls that the member was “near and dear to my heart,” adding that she helped resolve billing issues with providers after his death. “I do what I can for others to lift their burden. I can make phone calls. I can get authorizations. That’s my way of helping.”

Clarissa Hyneman

“I’ve seen a lot of kiddos age out of the program and seen them grow into young men and women,” Hyneman says. “If I have to be the bearer of bad news, I am going to come to them with a solution. I know how hard it is to navigate this stuff.”

Karin Wheeler

Anne Bielby, Katie Shomer and Rose Rie 

Adrianne Oprins, a member care unit manager, shared that three nurses on her team have received gratitude from members with especially complex needs who previously called to complain.  

Anne Bielby, Katie Shomer and Rose Rie worked hard over the course of years to develop trust and empower them to address their health. 

“These are not just members with medical case reviews,” Oprins says. “They have mobility issues. They have social and economic and mental health issues. They just need reassurance that we’re going to do what we say we’re going to do.”

The goal is to help members find solutions, develop independence and improve their quality of life. “They’ve been battling chronic conditions for years,” Rie says. “They need help, but they just don’t know what else to do. We want to help them be happy and enjoy their lives.”