Get to know Blue

Q. You’ve spoken previously about your own healthcare journey and how it informed your perspective on the need to simplify the member experience. What role can technology play in simplifying healthcare? Can you provide examples of ways Blue Cross is responding to the need?

A. For many people in the United States, healthcare is really broken. Costs are going up incredibly for employers and members. If you’re ever in the system — and as I’ve talked about openly, I have been — it’s hard.

I was carrying a six-inch binder with me to all my appointments so I didn’t have to do the same tests over and over as I got moved around. So, if I can help create great outcomes and make healthcare easier for our members across Minnesota, that’s my personal mission.

Technology is embedded everywhere across healthcare now, and when done right, it can absolutely simplify healthcare and make it more understandable.

In our ecosystem, we’ve streamlined multiple data warehouses and integration technologies. In 14 months, we’ve been able to get our data into one warehouse with one way to integrate.

This means no matter what channel a member uses to contact us, whether it’s Customer Service or through a rep or directly through our mobile app, Blue Care Advisor^SM, they’re going to get the same answer. And that’s a great experience.

I also love the operational efficiencies and simplifications we’ve created with our contact centers and our clinical nursing leaders, using AI technology that summarizes calls, provides greater efficiency and reduces administrative work so they can focus on serving members.

Q. You mentioned AI. Not all healthcare organizations are implementing it the same way. Walk us through the strategy behind the Blue Cross AI playbook.

A. Our approach is focused. It aligns with our operating model that employers trust along with the values we’re known for as a mission-driven organization. To put it simply, we use AI and predictive modeling where we know they solve specific challenges and provide real value to employers and members.

Data scientists love AI technology. They’ll dive in and just start building stuff. And at some organizations, they are being backed by billions of dollars spent on AI.

That’s not our approach. For Blue Cross, it’s never about the number of models we build. It’s about proving value through every use case and ensuring there’s clear governance. The governance component is critical and it’s why we’ve emphasized building teams of experts and industry leaders who are always front and center and accountable for decisions.

We never use AI in ways that create negative experiences, like denying claims or prior authorization requests. Blue Cross uses AI to remove barriers to care, to guide members to answers and care faster, to provide better insights into costs, and to ensure decisions are made by the proper experts. If it’s a decision a pharmacist, a doctor or a nurse needs to make, we don’t leave it up to a machine.

Our approach to technology and AI is about providing healthcare affordability and better outcomes for our members. That’s where we’re focused. And the most important principle for us is getting to a faster “yes” for our members.

Q. Can you tell us about the teams behind the technology that are providing expert oversight of our solutions?

A. I express this frequently with my team: We are business leaders with technology aptitude.

It takes a village, as they say. And in my village, there’s Software Development, which brings to life the experiences we’re creating through all the different tools our teams and customers use.

Integrations is a huge part of what we do. Every single experience requires data and getting that data from one place to another quickly and accurately.

There’s Security and Privacy. Healthcare is so personal. I want to work with a company that takes my personal information very seriously and guards it at all costs, which is what we do. Identity is a key area tied to this, making sure our associates have access to exactly what they need, but nothing more.

Cloud Operations is a component of our organization that people sometimes don’t think about. We need technology to scale quickly during peak enrollment season or for January 1 commercial market implementations because when a ton of interactions happen in a compressed period, stability is critical. But then we need to shrink down during non-peak times. Cloud Ops ensures that happens without failure.

And as we talked about earlier, there’s Data Solutioning, which includes AI and Data Science as well as teams that create advanced analytics and business intelligence across the enterprise to ensure we understand our performance — both where we're doing well and where there's room to improve.

Across the board, our teams work together to make it seamless. My team has been on a journey to foster what we call an engineering culture. Do we have the right talent? Do we have the right systems? Do we have the right telemetry and monitoring so we’re finding technical issues before a member ever does? That’s our goal.

Q. Please tell us a little more about you and your interests outside work.

A. (Laughing) I’m really boring. I’ve been married 28 years and we have two daughters. One will be a junior at St. Kate’s and she plays basketball. The other one just graduated from St. Olaf and works at Epic Software in Madison. I love to spend time with them. I’m so lucky.

When they ditch us, my husband and I love sports, so we go to a lot of different games. We’re big basketball fans, all the local teams, especially the Timberwolves and the University of Minnesota.

I now spend more time at the gym. When my kids started college and then when my daughter moved out, I was like, “Whoa, I have a lot of time.” In high school, they were both three-sport athletes and I was always in a booster meeting or at a game. But I’ve met some great friends at my gym. And my husband golfs more than he used to.

Working out is so good for my mental health. I mean, I need to stop eating candy. That’s a side topic. But being at the gym — it’s great to just sweat it out.

Thank you, Melissa!

Read more about the portfolio of innovative AI and predictive modeling solutions Melissa oversees at Blue Cross and how these solutions produce measurable results to help safeguard member health outcomes, improve experiences, increase efficiency and flatten the cost curve.

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