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Celebrating the Nurses Who Support Our Clients and Members

This is the week Blue Cross and Blue Shield of Texas’s (BCBSTX) Clinical Accounts Management Services team celebrates its nurses who work as clinical account consultants and medical account coordinators.

They are among hundreds of nurse employees at BCBSTX helping members get the care they need to improve their health.

During National Nurses Week, May 6-12, the team will receive inspirational quotes, participate in team appreciation activities and celebrate virtually to recognize the value each brings to the work done for BCBSTX, their clients and our members.

The small but mighty team provides clients with clinical reviews, analysis and account management oversight for almost 200 accounts representing nearly 3 million members. They help sales and account executives by assessing employer clients’ health care costs and workers’ needs and offer possible mitigation strategies.

“We present the clinical value story, explaining how the various products we offer can help mitigate cost while improving their members’ overall health and well-being,” says Rosie Rouse, one of the team’s managers. “We help set up why a new product may help them and help get their members engaged in it.”

Almost all the team’s members have acquired business acumen besides clinical experience, and they have advanced degrees or are pursuing them.

“I am part of a phenomenal team,” Rouse says. “They are all such hard workers and go above and beyond every day to make sure our clients are supported and their needs are met.”

Here are a few of their stories.

Pam Arriazola
Clinical Account Consultant
Clinical Account Management Services

By eighth grade, Pam Arriazola had her path figured out step by step — candy striper, nursing assistant and nursing school. As a captain in the U.S. Air Force Reserves, she deployed to the Middle East to serve during the Gulf War in Operation Desert Storm.

Arriazola’s career has prepared her for almost every role imaginable, whether it’s in operations, teaching or clinical.

“I’ve had the best of all worlds,” she says. “One can never stop learning. If you have knowledge, share it. It makes for a better future.”

At BCBSTX, Arriazola has also worn many hats. As a clinical account consultant, she collaborates with sales and accounts teams to explain to employer clients their health care costs and workers’ needs. She analyzes health care data trends and recommends strategies and programs to improve plan performance and employee health.

“We need to be a concierge service and respond to client requests so they can make good use of their health care dollars,” Arriazola says. “We want to be good stewards of our clients’ money.”

Pam Arriazola, nurse

Pam Arriazola

She knows when she’s making a difference because her colleagues consider her a trusted teammate and seek her input. “The greatest compliment is when someone is asking for your help and tell you they know you have good ideas,” Arriazola says.

Catherine Koltes
Clinical Account Consultant
Clinical Account Management Services

Catherine Koltes was the neighborhood kid who parents trusted to babysit their children. As a young adult, she started spending time with her grandmother and then caring for an elderly friend who was nearly 100 years old.

“I was always the responsible one,” she says. “And I didn’t mind hanging out and listening to the elderly folks. I just enjoyed people.”

The empathy and compassion she developed helping others led Koltes to a nursing career that included roles caring for patients with traumatic brain injuries and behavioral health needs. Since joining BCBSTX 13 years ago, she has held roles in case management, training, oversight and process improvement that helped her find fulfillment in assisting employer clients as a clinical account consultant — while working on a master’s degree in health administration.

“I think that I’m always focused on making myself better to make everything around me a little better,” Koltes says. “I’m always learning so I can grow as a contributor.”

Catherine Koltes, nurse

Catherine Koltes

Koltes’ work with sales teams and other stakeholders in analyzing clients’ benefit plans help employers control costs and improve workers’ health care.

“Caring for people has always been in my heart,” she says. “Our programs really do tell the story of how we work to care for our clients and members.”

Tiffany Booker
Clinical Account Consultant
Clinical Account Management Services

Growing up, Tiffany Booker and her grandmother volunteered at the same hospital. As a candy striper, she mostly delivered flowers to patients, but the experience of being around patients and the medical staff profoundly influenced her decision to become a nurse.

However, after years of work in clinical settings, Booker developed an interest in the business of health care delivery and went back to school to get a master’s degree in business administration. Her first role at BCBSTX as a case manager also made her think more broadly about how she could influence members’ health.

“I was talking to our members and really seeing the difference in how our programs and outreach help them lose weight or prevented hospital readmissions,” recalls Booker, who went on to become a medical account coordinator and now a clinical account consultant. “I get to look at clinical data and create a story from that data.”

She analyzes information to determine whether group members are using tools and products available to them. If so, is the employer client seeing a return on the investment? If not, Booker recommends changes and develops a business plan to present to the client.

Tiffany Booker, nurse

Tiffany Booker

“Nursing is very dynamic,” Booker says. “There are a lot of different skills that nurses have. There is something you can bring that will make you successful.”

Andrea Flynn
Medical Account Coordinator
Clinical Account Management Services

After graduating college with an equine sciences degree, Andrea Flynn could have been a ranch manager. Instead, she ended up eventually going back to school to become a nurse.

The decision proved to be a good one, providing Flynn opportunities in surgical settings, orthopedics and as a travel nurse. Since joining BCBSTX, she has held roles in case management and utilization management. As a medical account coordinator, Flynn reviews high-cost claims for one client that represents roughly 500,000 members.

She helps her team and others manage the client’s costs by identifying ways to reduce spending and better coordinate care for members of that plan who could benefit from case management and become healthier.

“We document what we did, how we did it and how we managed it,” says Flynn, who’s pursuing a master’s degree. “That’s the type of information we want to pass along to the client.”

Andrea Flynn, nurse

Andrea Flynn

In her roles at BCBSTX, Flynn knows she has helped many members get the care and services they needed to thrive, especially those who had difficulty accessing resources from their covered benefits.

“I really do feel like I made a difference,” she says. “I helped people navigate the system and get referrals and support they hadn’t had. They were very, very appreciative.”

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association