Opportunities for RTs with Health Insurers

jakki-grimbal-opportunities-rts-health-insurersJakki Grimbal

Fifteen years ago Jakki Grimbal, MA, RRT, AE-C, ran across an advertisement in the newspaper for an asthma/COPD program administrator with BlueChoice HealthPlan of SC and thought she’d be great for the job. As an RT since 1979, she had a wealth of experience working with this patient population and she knew she could translate that experience to the disease management arena.

Just one problem: the ad was seeking a nurse for the position. Most therapists would just turn the page and move on, but Grimbal decided it was worth a shot and sent in her resume anyway. “After three interviews I was hired for the position, but it took some convincing that an RT was the best person for the job,” she recalls now.

In her new position, she was responsible for developing interventions, performing health education calls, implementing the interventions, and reporting data and outcomes for the asthma and COPD members enrolled in BlueChoice HealthPlan. “As my role evolved I changed the staffing of the asthma and COPD programs from primarily graduate assistants to Registered Respiratory Therapists and hired two full-time and one part-time RRTs,” says the AARC member. ”I also became involved with motivational interviewing and health coaching.”

All that hard work and effort paid off. On September 28 of this year, she was promoted to disease management supervisor at the health plan, a position that encompasses all of the disease management programs operated by the insurer, including cardiac, diabetes/metabolic syndrome, asthma, COPD, migraine, and the ER diversion program.

“This includes supervising a staff of 13 nurses, respiratory therapists, certified diabetes educators, health educators, a dietician, and a social worker,” says Grimbal. “We are now working toward preparing the staff to become Nationally Certified Health Coaches, and the RT health coaches are now cross-coaching across all disease programs.”

Grimbal says the challenges and rewards have been many. Keeping up with the constant changes in health care is always a difficult task, and staffing can be an issue as well. But she is always buoyed by outcomes data showing how her programs decrease inpatient and ER visits and increase medication utilization for controller medications and decrease those for rescue medications.

“The best reward is to speak with a member who has made a behavioral lifestyle change that has made a difference in controlling their disease, lost weight, or developed healthy eating habits,” she says.

Grimbal counts her ability to prove the value of respiratory therapists in this alternative work setting among her biggest accomplishments and says she has presented on the success of the program at a national “Best of the Blues” conference. She’s also proud of her work to convince the plan that RTs are knowledgeable across all disease processes.

What advice does she have for her fellow therapists who would like to branch out into a nontraditional work setting such as hers? Grimbal offers these tips —

  • Be persistent, if the employer is advertising for a nurse, take a chance.
  • Be knowledgeable about other diseases/illnesses; stop working in the respiratory silo.
  • Learn about health coaching, case management, motivational interviewing, and the Stages of Change Model. Health care is now all about being patient-centric and prevention of disease progression.