Insurance provider reorganizes its Jackson office
In June, BlueCross BlueShield (BCBS), the largest health insurance provider in Tennessee, reorganized its offices in Jackson. Making a clean sweep of it, BCBS let its staff of five go. Yet it did not close its operation.
What’s going on?
According to Mary Danielson, director of corporate communications for BlueCross BlueShield of Tennessee, “The staffing changes were driven by business decisions concerning needs and service capabilities. Our Provider Network Contracting Team felt it could more efficiently serve doctors and hospitals in the west Tennessee region by consolidating operations in Memphis and Nashville.”
Formerly, there were three divisions in middle and west Tennessee: Memphis, Jackson and Nashville. However, in terms of staffing, the management and contracting functions have been consolidated with Memphis and Nashville. But there is still a presence in Jackson.
In April, prior to the reorganization, BlueCross BlueShield of Tennessee appointed Marc Barclay as vice president of provider networks and contracting. He is based in Nashville, where he is responsible for the day-to-day operations associated with BlueCross’ extensive provider networks, including contracting, and continued efforts to remain the preferred insurance partner of providers in Tennessee. Barclay came to BlueCross after working with network management at CENTENE Corporation and United Healthcare of Tennessee, and provider contracting at Humana.
“Maintaining healthy, mutually beneficial relationships with healthcare providers in Tennessee is critical as payment models in our industry continue to shift from fee for service to a higher focus on quality care,” said Larry Nall, senior vice president of provider network management at BlueCross. “Our members want affordable access to their preferred doctors, and Marc will make sure we continue to be able to offer them that peace of mind.”
BlueCross BlueShield did not replace the Jackson Provider Network Contracting employees with new employees. Instead, it redistributed the Jackson PNC team’s workload to existing BlueCross BlueShield Tennessee employees, specifically contracting and provider relations employees, already located in its Memphis and Nashville market offices.
The only new person brought in was Tom Winston. In August, Winston was named to fill the vacant director position of provider contracting for west and middle Tennessee. In this role, he is responsible for defining and directing contracting strategies and negotiations for physicians, hospitals and other providers in these two regions. He is based in BlueCross’ Nashville office. Prior to this appointment, Winston served as corporate director of revenue and relationship management for Novant Health, Inc., in Charlotte, N.C. Winston has returned to BlueCross after serving as a senior financial analyst in the late 1990s.
When asked what the impact of the reorganization was on doctors and other providers who utilize the BlueCross BlueShield system, Danielson said, “The answer is simply ‘none.’ There are no discernible differences that our providers should experience due to the recent changes in our Jackson office. We are always trying to operate as efficiently as possible in order to keep costs down for our customers.”
Danielson went on to explain, “Many of the people who functioned for the Jackson office were telecommuting in various capacities. On occasion they went to an actual facility for tasks such as holding a meeting or running reports. Since the consolidation, the staff is based out of Memphis and Nashville. Yet our providers (doctors, hospitals and other medical care givers) sense no difference because so much of our business is conducted via email or telephone. Or business is conducted in person with a visit to the provider. That latter aspect remains the same, with the exception that our staff may have to travel a little further. All said, in light of our recent changes, we are able to maintain the same relationships with our providers.”
Some of the efficiencies created by the staffing changes, as cited by BlueCross BlueShield, included:
The BCBS Provider Network Contracting Team was able to take advantage of new technologies that allowed each employee to take on more provider assignments -- without affecting service levels to those doctors and hospitals they serve.
The organizational changes actually allowed one of the former Provider Network Contracting Team staffers based in Jackson to fill a newly created role that deals with improving quality for its Medicare Advantage members.
