The University of Nebraska Medical Center (UNMC) Genetic Counseling Education Program afforded its inaugural class with opportunities to participate in several different clinical rotations, both in Nebraska and surrounding states. While some placements were in the traditional settings of cancer, prenatal, pediatrics and adult clinics, our program expanded our experiences through a partnership with a major insurance company, Blue Cross and Blue Shield of Nebraska (BCBSNE).

During this unique placement, each student spent four weeks with the Chief Medical Officer of BCBSNE. We accompanied her to meetings and learned more about the roles of case managers, customer service team members, and hospital social workers, while also having the opportunity to develop partnerships with the team. Our experiences strengthened our knowledge of the prior authorization process, and we gained an appreciation of what this looks like from the payer standpoint. These are skills we can directly translate into clinic settings or further incorporate into other non-clinical genetic counseling roles.

This rotation allowed us to explore the creation of genetic medical policy. BCBSNE contracts with Concert Genetics to evaluate their genetic medical policies and ensure coverage for members. Throughout this process, we were able to connect with and learn more from genetic counselors at Concert Genetics, including past NSGC president, Gillian Hooker. We researched genetic conditions, investigated the genes involved, and discovered testing methodologies. We developed a presentation on our medical policy to propose to the BCBSNE team. These presentations instilled great conversations between genetic counseling students and insurance payers as we utilized our skills as effective communicators and genetic educators.

One of the more striking differences between this placement and a traditional clinical setting is that we did not meet with patients every week. While we did not obtain core cases, we were able to develop several practice-based competencies including educating clients on genetics, establishing interdisciplinary relationships, and recognizing our role in the larger healthcare system. We learned about this insurance company, and they were able to learn more about what genetic counselors have to offer. Overall it was a great experience for us and for BCBSNE, as shared by our supervisor and Chief Medical Officer:

“This year has been our first year having Genetic Counseling students with us at BCBS. I hope the students have learned from us because we have certainly learned from them. This collaboration has allowed us to interact with soon-to-be genetic counselors and understand the rationale behind a genetic test request. Their presentations have been stellar and have helped us develop policy.”
– Debra Esser, MD, MMM, FAAFP

We feel so fortunate to have had exposure in a variety of healthcare settings during our training at UNMC. As practicing genetic counselors, we will incorporate the lessons learned from this industry rotation, regardless of what setting or role we take on in the future. We know the roles of genetic counselors will continue to expand, displaying a significant need for programs to expose students to more placements like the one we had the opportunity to complete at BCBSNE.

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