CMCS Connections

3 C M C S c o n n e c t i o n s 1 s t q u a r t e r 2 0 1 4 by July Holbert M ary Etta Keller, Team L e a d o f U t i l i z a t i o n Management at CMCS, is the ultimate multi-tasker. In fact, several years ago her staff gave her a garish pink hat decorated with ribbons, buttons, and a giant purple and green flower to repre- sent all of the different hats she wears. She proudly displays the hat right above her desk. On any given day Mary Etta, a Registered Nurse (RN) and Certified Case Manager (CCM), might be testing QNXT upgrades, reviewing claim appeals, updating staff on Milliman care guidelines, performing Healthy Indiana Plan (HIP) ambulance reviews, or even helping her team enter authorizations. As a Team Lead, Mary Etta has 16 employees, including support staff, in her charge. She is responsible for all payroll and scheduling for the UM Department, as well as being a resource to both staff and customers for any UM question or issue. She laughs and says, "Just keeping track of who is covering phones and faxes could be a full-time job." Mary Etta celebrated her 5th anni- versary with CMCS last summer. Her diverse background makes her the perfect fit to lead the UM depart- ment at CMCS. After receiving her baccalaureate degree in nursing from Ball State, Mary Etta went to work as a surgery nurse at a small Henry County hospital. After 12 years as a surgery nurse, Mary Etta moved into psychiatric nursing at Community Hospital North where she worked with persistent and severe psychiatric patients for 8 years. With a strong clinical background from over 20 years of direct patient care, Mary Etta decided to give case manage- ment a try. For the next decade, she spent time developing her case management skills in different lines of business. She learned the commercial business at Anthem and Principal Healthcare, but feels she really learned the language of insurance working as a Case Manager and Team Lead for a private medical management company called Indi- vidual Care Management (ICM). She thoroughly enjoyed getting down to what she calls the "nitty- gritty of case management" at ICM, as she worked very hands- on with self-funded plans. She recalls on-site visits where she would provide disease education to employees and also remembers finding out about upcoming proce- dures from the members themselves and then contacting the provider to do auths. Before starting at CMCS, Mary Etta also got her foot in the door with Medicaid as a case manager with Care Select. Rosemary Fowler, a co-worker of Mary Etta's, describes her as extremely knowledgeable and giving. "She is a joy to work with," Rosemary explains. "Everyone appreciates her sunny disposition and good atti- tude." Mary Etta gives her mother credit for the way she treats people. Her mom was not thrilled when her daughter told her she wanted to be a nurse because of her own bad experiences with nurses in the past. She made Mary Etta promise to "always treat every patient you come into contact with as if you are treating me." Mary Etta keeps that promise every day. Mary Etta and her husband of forty years, David, enjoy spending time with their two daughters, two granddaughters, one grandson, and two dogs. They all live within a few of miles of each other outside of Anderson. She loves to travel and includes Amish Country in Northern Indiana and Hawaii as two of her favorite destinations. Mary Etta is known around the office for her delicious baking and bargain shopping. Mary Etta is looking forward to the future at CMCS. "I value the people I work with," she states. "We're still small enough that it feels like family. I like the fact that not only do we practice external customer service but also internally with our own staff. It really sets us apart." CMCS is grateful to have Mary Etta as part of the CMCS family. "She's a joy to work with. Everyone appreciates her sunny disposition and good attitude." – r o s e m a r y f o w l e r Mary Etta Keller, A Great Resource Mary Etta Keller, Team Lead of Utilization Management

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