Nurse navigator

Megan Fry, case manager at Blue Cross and Blue Shield of Nebraska, helps members navigate the health care system. “As a nurse, I know the questions to ask, when to listen and when to push doctors. I’m not scared of them.”

Courage was what Shelley needed. The Plainview, Nebraska, woman was anxious and depressed. She had to find a new doctor to repair a knee replacement and she’d just lost her job.

“It’s really hard to find a new doctor to make those kinds of repairs on your own,” Shelley said.

Courage came in the form of Megan Fry, case manager at Blue Cross and Blue Shield of Nebraska. Case managers like Fry help members with chronic illness, trauma or life threatening diagnosis.

“We help them navigate the health care system,” Fry said. “As a nurse, I know the questions to ask, when to listen and when to push doctors. I’m not scared of them.”

Fry said every case is different. Sometimes the patient wants someone to hold his or her hand through treatment, others want to be steered to the right place and left alone, and still others just want straight talk.

Blue Cross has increased the number of case managers to help coordinate member care, focusing on the best possible outcomes for the patient to improve the patient’s experience.

We offer a free mobile app to increase engagement with patients. In real-time they can chat with a care nurse, case manager or health coach to help them stay on track with medications, therapy and additional care.

With the use of the app we’ve seen post-hospitalization medical costs decline 41 percent and communication between healthcare professionals and patients increase 400 percent. Seventy-seven percent of discharged patients attended a follow up appointment with a primary care physician, and 96 percent understood the correct dosage and use of medications after they were discharged.

“Every person facing a difficult diagnosis deserves our help,” Fry said.

For Shelley that was finding a doctor to repair her knee and helping her through the surgery and recovery.

“I just can’t believe that Blue Cross has this for me. It doesn’t cost me anything, I get this lady who has a wealth of knowledge, and it’s free,” Shelley said.

Shelley is on the mend, tutoring in her home, hoping to volunteer at the local library, getting back to gardening and spoiling her grandchildren.

“You form a bond with the patients and their families because you’re with them at the worst moments of their lives,” Fry said. “It’s essential that we’re there to care for them. I’m a nurse, that’s what I do.”

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