Ep 16: Taking the Less Conventional Path

with Kim A. Keck

January 6, 2021


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Kim A. Keck
President and CEO, Blue Cross Blue Shield Association

Kim A. Keck is president and chief executive officer of the Blue Cross Blue Shield Association (BCBSA), a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies. The Blue System is the nation’s largest health insurer covering one-in-three Americans.

Keck, a respected leader in the healthcare industry, has built a reputation as an engaged, incisive leader. Prior to joining BCBSA in 2021, she served as president and CEO of Blue Cross & Blue Shield of Rhode Island (BCBSRI), the state’s largest health insurer. During her tenure at BCBSRI, she drove strategic initiatives around cost and value stewardship, convenience and comprehensive health, and led policy efforts fortifying elements of the Affordable Care Act to ensure all Rhode Islanders have access to quality care. She also combatted long-standing social issues influencing health outcomes, including childhood obesity, housing insecurity and racial inequities.


I thrive on learning and getting better. Seeing the opportunity to make a difference, have an impact and drive results is always interesting to me.



Kim Keck 0:02

At Blue Cross Blue Shield, I hope to be considered successful by not just what I’ve accomplished, but how I’ve accomplished it, and that other people lead by these values in action or these expectations–that they inculcate them into their own leadership styles.


Lan Nguyen 0:18

That was Kim Keck, President and CEO of Blue Cross Blue Shield Association, a federation of 36 health insurance companies that provide health insurance to more than 106 million Americans.


Kim Keck 0:30

When I actually took my career into finance, I just remember many times just being at tables with no women whatsoever, but I think back and reflect on all the ways she nudged me to take, perhaps, a less conventional path.


Lan Nguyen 0:45

In this conversation hosted by Dr. Joanne Conroy, President and CEO of Dartmouth-Hitchcock, and Dartmouth-Hitchcock Health, we learn about how Kim’s unconventional path ultimately led to her appointment as the first woman to serve as the BlueCross BlueShield Association’s president and CEO since the organization was founded four decades ago. So let’s jump into Her Story, a program where we explore the intersection of women, leadership and healthcare.


Joanne Conroy  1:18  

Good afternoon. I’m Joanne Conroy, President and CEO of Dartmouth-Hitchcock and Dartmouth-Hitchcock Health, and welcome to Her Story, which is a conversation with women leaders about their careers. I’m really excited to have Kim Keck here. Kim is the president and CEO of Blue Cross Blue Shield Association. She spent four years at Blue Cross Blue Shield of Rhode Island, and prior to that, she spent 28 years with Aetna, serving in a number of leadership roles. So, welcome, Kim, we’re really glad to have you. 


Kim Keck 1:53

Great to be with you. 


Joanne Conroy 1:54

So you’ve had an incredible number of leadership roles in the health insurance industry, what prepared you to move up the ladder in such a, kind of, an industry that’s pretty tough, and, and really has faced a lot of change over the last 30 years that you’ve been in it?


Kim Keck  2:10  

Well, thanks for the opportunity to speak today. You know, many, many things prepared me, but I’d started sort of a fundamental basic place, which sounds a little boring, but was super impactful to me if I could use that word. I happen to be brought up in a sort of traditional home in Rhode Island. And my dad was a small business owner, and my mom was a stay at home caregiver. And so I had this really interesting blend of two really incredible influences in my life. My dad, as a business owner sort of explicitly showed me, demonstrated, championed, what it was like to build relationships and invest in relationships, he had this incredible work ethic. And he was, he was successful in a way that was really, really subtle, but really important. My mom was even more influential in my life. And I don’t really know that I had any idea what she was saying to me when she was giving me all this really interesting advice as a, as a young person, because she grew up in the 50s, and the 60s, and she really was ahead of her time in so many ways. But she was sort of expected to be a stay at home caregiver, and that’s what she did. And yet, she would always say things to me, like, “You can do whatever you want. And, you know, you should do something that’s interesting to you.” And I’m like, “Of course, I really don’t know what you’re talking about.” And even as early as a senior in high school, when I was thinking about becoming the manager to the football team, the boys high school, boys football team versus going out to do cheerleading for the same team. My mom’s like, “No, no, the manager job seems pretty interesting to you. And oh, by the way, while you’re, you know, in high school, why don’t you take all those extra math classes, because I think you’re good at math.” And it’d be like, “Okay.” And sort of, she was really, really subtle in some of this. And I’m making it sound far more explicit than it was. But I really think back and reflect on all the ways she sort of nudged me to take, perhaps, a less conventional path for a women, a woman, right, and one maybe she was unable to take. I just thought it was a normal path, but it’s really incredible that what she really influenced, how she really influenced me.


Joanne Conroy  4:15  

So just as an aside, what type of business did your father have?


Kim Keck  4:18  

It was a family business, it was nothing to do with health care. It was construction, basically. But that was interesting in and of itself, too, because my dad, it was actually several small businesses under the umbrella of construction. But the main business was something called sand and gravel, concrete business. So just as a little quick story, my dad was also not just successful locally in Rhode Island in his business, but he made it to a board of a national association of his business, and he wanted me to go to this meeting with him and I, so I did. And I thought, okay, there’s not a single person on this board or at this meeting, who is my gender. And, you know, I think I’m just gonna go in a different path.


Joanne Conroy  5:01  

It is amazing how our parents shape us in very subtle ways. Probably the most important way was they basically said you can do whatever you want.


Kim Keck  5:20  

Yeah, absolutely. It was incredible. 


Joanne Conroy  5:22  

Now, you alluded to a few kind of tough conversations or situations. When was the first time that you stepped out of what would be called a normal swim lane for a young woman? Which, often, you know, when we were growing up was, there were less opportunities that were always presented to us. 


Kim Keck  5:43  

It’s unfair to say this, but I do think growing up, becoming a math major, and then a finance to get my Master’s in finance. It wasn’t completely unheard of, of course, that women would excel in those fields, or I didn’t excel. But I actually took that path, but it was a little less common. So I felt a little bit reminded. And then again, when I actually took my career into finance, I just remember many, many times just being at tables with no women whatsoever. So I had a sense that it was a little bit unconventional. I think the first time I really remember being in a situation where I was explicitly the only woman and I felt a little uncomfortable but was a time many, many years ago. And I was in finance. And I was doing M&A. And I remember being on a telephone call on a, probably, Sunday evening. And it was a time when there weren’t any such things as cell phones. And we did have a cordless phone, it was called, but the mute button wasn’t really that accessible. And I remember locking myself in a closet, because I was the only female on this call, and just trying to conduct this call. And my two-year-old at the time pounding the door, screaming “Mommy!” And I remember thinking, okay, this is a little awkward, and having to deal with trying to find that mute button really fast, and try to excuse myself from all the men to take care of something I needed to do. But it felt very different. Because I just felt not everyone had to pause and to do that. But I just had to do what I thought was right at the time.


Joanne Conroy  7:16  

So you can actually really appreciate what a lot of our employees are doing right now, as you’re Zooming from home.


Kim Keck  7:22  

I can’t even imagine. So we’re empty nesters now, but I have one of my associates, one of my direct reports, who has three children in three different schools with combinations of hybrid and in-person learning with a spouse working with an extra family member living in her home. So yeah.


Joanne Conroy  7:38  

Now let’s talk about opportunities. So we say that women have to have both mentors, and we can talk about that in a little bit more detail, but also sponsors – people that put your name forward. Talk a little bit about the sponsors, you think you’ve had number one, and number two, that position or the opportunity that you stepped into, that was, maybe, one that felt like a pretty large step, and how you actually embrace that and manage that.


Kim Keck  8:08 

So I absolutely was so fortunate to have an incredible sponsor in my career, and in, to this day, I try to channel what I learned from that particular person. So I was at a company called Emma and years ago, this is all public information, years ago, 20 plus years ago, the company at the time was losing a million dollars a day, which is actually an incredible time in the company’s history. So long story short, Joanne, I was responsible for managing the rating agency relations and getting capital markets, getting funding for the company. And when you lose a million dollars a day the rating agencies get really cranky that you can’t pay your debt holders or pay your claims. And they demanded, really, to see the number one and then number two person of the company fairly frequently so they could be assured that the company was going to survive and thrive and it did. But during that time, I had the opportunity to work with, well, who was then the number two person at Aetna and he apparently saw something in me while I was in this finance function and said, “You know, I want to pull you out to finance and have you do something different because I think you have some capability of some, some kind.” And he was very intentional and explicit. And he put me in a role that was well beyond my comfort zone. And it was very hard. And it started, I recall, really, specifically on a Friday evening and happened to be Good Friday. I’m not terribly religious, but I remember being in his office about 8pm that evening, and, and he said, “Can we do all these analyses? And oh, by the way, can I get an update on Sunday?” And I thought, “Does he know that’s Easter Sunday?” Anyway, the point – it was hard. So that’s, I guess, one point. But it was stretching me in ways not just because of the time commitment, but stretching me in ways I had never imagined. I was well past my comfort zone. And it was some – the most learning I had ever done, even though I had at that time been at the company for probably over 10 years. So it was really an interesting pivot point for me.


Joanne Conroy  10:10  

Yeah. How did you manage that? I mean, they’re both emotions as well as energy level.


Kim Keck  10:16  

Yeah. Well, not that well, I would say in the beginning In fact, about two or three months, perhaps into this role, the CFO of the company, was noticing that I just was probably barely able to keep my head above water. And he literally said to me, the CFO said, “Hey, we have this role for you in finance, if you want,” sort of wasn’t exactly my old job, but it was like, “If you want to come back to finance, we’d love to have you.” And I was like, ooh, I would really love that. And what the person who, with whom I was really working became the president at that point, and he said, “No way, you know, there’s no way you can go back, you are capable, you’re going to succeed, we’re going to help you succeed, and you’re going to do bigger and better things, but you cannot go back,” which again, was the best thing that I did is I continued to work for him for many, many years, and he was a true sponsor, he challenged me in so many ways. And I was so fortunate to learn so much about myself, I didn’t think I had it in me to even survive, nevermind, thrive with him.


Joanne Conroy  11:16  

Talk a little bit about how you develop relationships with people you report to, and your peers. women have historically said, “Mm, you know, we’re excluded from some of the traditional relationship building.” 


Kim Keck  11:31  

I had a great opportunity to sit in so many seats. And so I always felt as though I had lots of relationships on which to build. And I didn’t even know they were there until I sort of, were, to call on these relationships, if you will, but one of them Joanne was when I was working for this President, I was the Chief of Staff, and which is sort of an interesting role, because I was really responsible for no one, maybe I think I had a staff of one. But I was sort of accountable for everything. That’s what it felt like anyway. So I had no choice but to build all kinds of relationships and collaborate with all kinds of people, because the then CEO expected me to drive results to, you know, put an agenda together for the top 10 people of the company every other week, for a full day of what the most critical issues he thought were, he thought, I thought we should discuss, and we’d had to staff them and drive them and somebody would have to own them. And again, I had no staff. And I remember thinking at the end of that, a consultant who was working for the company said, we want to write this chapter in this book, we’re writing on informal leadership. And we’d like you to, to speak about that. And I said, again, “What are you, what are you talking about? I don’t even know that term.” And he said, “Look, you drive so much at this company, and you have, you only manage this informal organization, there’s no dotted line, or excuse me, there’s no solid or dotted lines to you, you just sort of influence.” So I’m not quite sure, Joanne, how it happened, but I had, I felt I had backing from someone who trusted me and I didn’t use power, authority, or title. I don’t know that those are things I know how to use, but I just tried to find common ground to get things done.


Joanne Conroy  13:14 

That is actually a great story about how you can actually use influence to be very effective. But also it’s a really interesting story about how a role that doesn’t necessarily have a lot of FTEs or a big budget can actually teach you how to strategically think. 


Kim Keck  13:33  

It was fantastic on so many levels, from a content perspective, but from a leadership perspective, you know, had a first-row seat, right, in watching a leader run a fortune 100 company, and how he even thought about what was important. And even I remember so vividly, it was such an important gift. It was an incredible gift to me, he would stop at the end of the day in my office, my cubicle and say, “How did we do today? What worked well, today? What didn’t work well today?” And the gift was that he was open to whatever I said, and I didn’t say, “Oh, so and so said this.” And it’s of course, I wouldn’t say that. But it was, it was this incredible opportunity to have the sort of, he created the safe environment. I didn’t know that at the time, but of course now know very few people would give him candid, honest feedback in a way that made us all better. And then he took it from me. And he was, he just created that, that space. It was such an incredible lesson to learn.


Joanne Conroy  14:34 

Yeah, that’s a great opportunity. So one of our questions for Her Story is, do you believe you’re an accidental or intentional leader?


Kim Keck  14:44  

I think yes and yes. I didn’t, I’ve never really had, maybe I should be embarrassed by this. But I don’t remember having career aspirations except to be a CFO, which my sponsor cured me of that aspiration, which is a sort of along the lines of “Don’t go back to finance, I want you to stretch yourself.” And, you know, after having the opportunity to even lead, as I’ve described, this informal organization, it was really satisfying to me to work collaboratively to get things done. So I probably over time became more intentional about it.


Joanne Conroy  15:20  

Now, you had a great story about how your daughter would describe you, because there was probably a time in your life, in your life that it was a little bit crazy. 


Kim Keck  15:29  

So yeah, I had the great privilege of having a stay-at-home spouse, so I probably worked more than the average person and maybe even the average woman who might have had a lot of demands on her time. And so I worked a lot. And I remember coming home one day, and my daughter who was, I think, nine at the time, but my size literally took my clothes that I had taken off for the day and put them on and started videotaping herself. And as she was videotaping herself, all dressed in my garb, she took off glasses, put on sunglasses and said, “Look, this is Kim Keck. She’s on vacation, nothing changes, but the sunglasses go on.” And I thought, why don’t we just take the knife out of my heart, I just was a little bit heartbroken. But nonetheless, it was really an important thing for me to hear, to see. And I thought it was creating this role model of breaking barriers and showing her that she could do whatever she wanted. And instead, she just thought I was working a lot. And so gave me an opportunity to pause.


Joanne Conroy  16:32  

That’s a great story. What do you think is the edge that you have? I mean, there are a lot of talented people out there in health care. You know what, we see them all the time, but what is your special thing that actually helped you get to where you are now?


Kim Keck  16:47 

Well, besides the sponsor, because I had a great privilege and that particular sponsor that gave me lots of opportunities, including running my first P&L, which opened up even more doors and more doors. But I think, I think one of the things that I would say to anyone who is looking to build a career, to excel in a career, I guess, is, be curious, ask a lot of questions, never stop learning. I can certainly drive people crazy with my curiosity and I know as a CEO, sometimes my questions can come across as statements or directives or something like that, but I, I just thrive on learning and I thrive on getting better. And I, for me, that seemed to work, seeing the opportunity to make a difference, have an impact, drive results, was just something always interesting to me. So maybe that’s my edge.


Joanne Conroy  17:42  

Could be, moving into your new role. It is really the head of the Blue Cross Blue Shield Associations across the country, and working with a lot of powerful people and some other women. So number one, what do you think are the challenges as you step into that new role? Number two, how are you thinking about diversity, both racial and gender when you actually walk into those boardrooms? Because there’s been a long, you know, a pretty significant conversation over the last few years about how diversity makes us better, but we’re not as diverse as we should be.


Kim Keck  18:21  

Yeah, I think that that is true. In terms of the Association, Joanne, I’d say there’s a lot of what I have done in the past that, of course, I’ll, I’ll tap – the Association is in many things. One of what the Association is sort of this convener of 36 different, independent, Blue Cross plans across the country. So I think back to my comments a moment ago, into my years running the informal organization, there’s an awful lot, I think, I’m going to tap into there. I’m hoping we can find some common ground, we can solve issues together, we can have the courage to put issues on the table together, and the like, and make sort of this whole, even greater than the sum of its parts. And the parts are actually pretty darn, doing some really important work, including, by the way, Joanne, I think, on sort of racial disparities in health care, which is a really, really important topic, obviously, exacerbated by COVID, or highlighted by COVID, or both. But it’s something I can, I can come back to. I think, from the diversity perspective, though, more broadly and at the board level. I still think about it sort of the same way I think about my career I I tried to show up in the boardroom, same thing – ask questions, not inappropriate, not management questions, but bring a perspective and try to come with a different point of view. Not, not try, because that sounds almost contrived, but really understand different angles of the same issue in a way that I hope can guide and coach management if, if, in fact, you know, they’re seeking counsel, which most often they are. I do think I see a lot more diversity on boards in 2020, than I did, even, even a few years ago. I think we have a long way to go, but at Blue Cross Blue Shield of Rhode Island in my own board we have over 10% are people of color, people who identify as black, we have over 30% who are women. So we’re making some headway. And at the Association Board, we have, I believe, seven women under 36. And now maybe four men who I think identify as African American. So, slowly, we are making changes with respect to the representation component, but we have, at the Blue Cross Blue Shield board, I think lots of diversity of experience, as well.


Joanne Conroy  20:44  

It is time in the country where leaders who provide health insurance, leaders who provide care, leaders that set health policy, have got to figure out how to get to the table together. And it is really going to be a new era. As a woman leader, how do you define success?


Kim Keck  21:04

I think, twofold. You know, people and outcomes; I want to make a difference. And, and I, I, you know, if I go way back to my math and finance major, I tend to be a little bit more results-oriented. And so, it’s not the results, per se, although that is a component of it. But to me, it’s how I achieve those results, right? We have, at Blue Cross Blue Shield of Rhode Island, as many companies do, two sort of ratings of how we think we rate ourselves in terms of leaders, what we achieved and how we achieved it. So I want to be sort of measured on both of those things. And how we achieve things to me is all about the values that we, that we lead every day, I call them sometimes values and action, right, not just that, we say that we act with integrity, and that we collaborate because almost everyone says they do that, and most people do. But we have put into place at Blue Cross Blue Shield of Rhode Island more specific accountabilities or expectations of leaders, like assume positive intent. Like have the courage to put the issue on the table together, make accessible what you know. I hope to be considered successful by not just what I’ve accomplished, but how I’ve accomplished and that other people lead by this, these values and action or these expectations, that they inculcate them into their own leadership styles.


Joanne Conroy  22:28  

So that speaks to something you’re very passionate about, which is actually giving back to people in the organization in terms of mentoring, sponsoring people. As you move into this new role, how do you envision continuing that and maybe amplifying that?


Kim Keck  22:45  

Yeah, it’s something I think I want to spend more time than I have thus far in my career. Though it’s, um, it’s been something I’ve been doing for many, many years. But I know, in a less formal way. So I have spent a lot of my discretionary energy meeting with all kinds of people, not just women, but people in their careers, particularly when I was at Aetna. For many years, people used to say, I don’t know how to get things done at this company, could you help guide and it’s, I don’t know that I ever gave any secrets away, but it’s just helping people, again, understand other people and what makes them tick and how cultures work and things like that. But even, even one of the things I’ve done in some of my spare time is try to guide and coach, my daughter’s 22, she has a lot of friends her age who are looking to start their careers, and they seek a lot of my advice and what it’s like to be – one of my daughter’s friends as an engineer – and she is working with all men and her first call to me was how do you fit in? How do you? How do you get a seat at the table? What if everyone golfs and I don’t and I thought wow, those are questions I asked myself 30 years ago.


Joanne Conroy  23:57 

Yeah, they don’t change. You have better answers, we think. But they’re asking the questions earlier. 


Kim Keck  24:04  

Right? I didn’t. It took me a long time even to articulate that question. So I gave her what I thought I knew 30 years later, but yeah.


Joanne Conroy  24:10  

So what do you do outside of work? Because we all need to decompress.


Kim Keck  24:14 

I used to be a big runner. A couple of injuries later. I’m just a little bit of a runner, but I like many have become sort of crazed with a Peloton bike. Then prior to the pandemic, we used to travel quite a bit. So we’re doing a little imaginary travel, sort of planning for the future when, when, you know, we’re free to roam the country in the world which will come, I hope you would know better than I do. 


Joanne Conroy  24:37  

So final question. If you, let’s say you are 80, what advice would you give your younger self?


Kim Keck  25:05  

I think first and foremost, I’d probably say be patient. I do have this curiosity. I do have this thirst to make an impact. And you know, sometimes you have to slow down to speed up. And oftentimes, I just had one speed.


Joanne Conroy  35:19  

6000 RPMs.


Kim Keck  25:07  

Something like that.


Joanne Conroy  25:09  

Well, it’s really been a pleasure getting to know you and for our audience to get to know you, Kim. And we wish you all the best in your new role. We know you’re just going to do an awesome job. 


Kim Keck  25:19  

It’s been a pleasure to speak with you today, Joanne.


Lan Nguyen   25:22

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