• Anne Kong

Cedar: Developing an Inclusive Culture Through Training With Ethena




About Cedar

Cedar is a healthcare financial engagement platform that creates customized interactions for every patient: pioneers in the healthcare finance sector, Cedar is the only platform working with large regional and national healthcare providers to personalize patient billing and financial engagement across the care journey. Founded in 2016, they have continued to grow their customer and employee base rapidly. Since the beginning, Cedar’s founders have always put culture first. The result? An incredibly collaborative, values-driven environment that also drives results.


To maintain and build upon this culture, Cedar’s People team, led by Liz Ratto, is always thinking about how best to reinforce their values, whether they’re hiring, onboarding, or selecting a new organizational tool. Consistency in these efforts, as well as in signaling, is even more important in a remote world to ensure the team is safe, included, and enabled to do their best work and develop professionally in the ways they want.



The Challenge: Finding a solution that aligned with Cedar’s philosophy

Since April 2019, Cedar has been doubling in size on a yearly basis. As Cedar scaled, Liz found that several of their approaches to company processes, especially ones that emphasized their values, needed to be re-worked. Harassment prevention training was one of them, and Cedar needed a solution that 1) signaled to the team that harassment prevention is important to the company, 2) was effective and helped to reinforce their company values, 3) was flexible and empowered their team to learn and take action.


When Liz joined Cedar in 2019 with around 55 employees to train, her goal was to get Cedar compliant in a way that was fast and impactful. Her solution was a day-long workshop with everyone at the company, all gathered in the same room to learn about the complexities of interpersonal dynamics in the workplace. “I really wanted to send the message that the company is willing to invest a lot of resources into this training,” recalled Liz. “We will take this day from the company, which is really expensive to do, and really make sure we give it the attention it deserves.”


While this initial approach was helpful in setting a baseline, moving forward, Liz wanted a solution that was easier on both their employees’ and their People Teams’ schedules that also had the same impact and reinforced their values. “The majority of solutions out there are only about prevention: ‘don’t do this, don’t do that because we don’t want to run afoul of the law,’” Liz said. Especially in the current cultural context, with the entire country grappling with how our biases and inequities come into play in the workplace, Liz saw an opportunity for positive change. Cedar began to transition from a solution that focused on “what not to do because it’s illegal” to one that focused on “what to do and be aware of such that we can create and maintain the inclusive and equitable environment we’re proud to be a part of.”


What does a solution that really empowers our team, reflects the times we’re living in, and gives employees the tools they need to be better and create the type of environment we all want to work in actually look like?



The Solution: Onboarding harassment prevention training that is aligned with Cedar’s values

Liz’s team brought Ethena on to replace their once-a-year sexual harassment prevention training. Here’s what the evaluation process looked like:


Training Content and Personalization: Employees must engage with and enjoy the training

As her first priority, Liz wanted a flexible solution that put control in the hands of Cedar’s employees, allowing them to choose how they want to experience the content. “Ethena’s approach honors the individual in terms of learning style, format, and timing,” said Liz. The training is automatically tailored not only by industry, with industry-specific language and examples, but also by individual preferences around tone—every employee can customize their training to be witty or to the point. This evidence-based, effective approach of making training engaging and relevant was a key deciding factor, and Ethena’s thoughtful handling of grey areas and sensitive topics only added to the appeal.


Flexibility: Training that fits into the workflows of employees

Liz immediately understood the advantage of training for a few minutes every month to cumulatively meet the training requirements instead of just once per year. Liz was (and is) a strong believer that Cedar “needed to interact with this content frequently, so we can do this real work. Not to prevent a lawsuit, but to prevent a very real, negative impact on someone we care about.”


Looking forward to more growth, Cedar’s team opts for solutions and systems that can change without a lot of friction as their team scales. Ethena’s modern delivery approach that delivers training directly to an employee’s email or Slack allows employees to choose to engage with Ethena’s training when they’re most-available. “A Slack nudge fits in really well with their workflow and individuals can pick the exact right moment in their day, week, or month to complete it and no pre-scheduling is needed,” Liz said.


Signaling: Frequent training shows the team the importance and prioritization of lesson topics

The ideal harassment prevention training option for Liz’s team was one that emphasized the shared goal Cedar has to support an inclusive environment. Specifically, one that frequently put relevant information in the hands of Cedar’s employees and gave them the power to engage with it and apply the learnings specifically at Cedar.


Bringing on Ethena “sent a signal to folks who have not only been at Cedar for a long time, but new hires as well that ‘this is the way we deliver this training. It should align with your needs and really signal to you that we’ve been incredibly thoughtful about this and we really care about you.’”



The result: Getting compliant and loving the training

From Day One, Cedar has always placed an emphasis on culture. There’s a high bar internally for everything they do, including selecting tools (which should serve to emphasize and reinforce their values). Ethena’s training tools more than met Cedar’s high standards. After Cedar’s People team rolled Ethena out, Liz noted a marked improvement from their training-once-a-year experience: “the feedback has been overwhelmingly positive.. “There’s been no negative feedback at all.”


Training Content and Personalization: Do employees like and engage with training?

“There are skeptics on my team who are skeptical of any kind of company training who have come to me and said ‘I just want to say thank you to whoever made this decision, I really value how quick and easy to interact with this was. I just came and learned and laughed and I really appreciate that,’” said Liz, when asked about how employees felt about their new training platform.


The goal was always to make sure everyone would be comfortable and positively impacted by training, but Liz was initially unsure if giving team members the option to pick a “witty” version of training would be perceived as diminishing the seriousness of the topics. Knowing that Ethena works with experts and advisors to create their curriculum and training methodology was what made Liz more comfortable with rolling it out and testing the waters, and the team’s enjoyment and enthusiasm for the training spoke for itself. “If people are having a delightful moment, the content will stick with them.”


Flexibility: Does Ethena fit into the workflows of employees and the People Team without being disruptive?

Cedar’s People team appreciated that employees could choose when to engage with the content, and setting aside a block of time for an hour or two for the entire company wasn’t needed - especially with a growing remote workforce. “Even a Zoom webinar wouldn’t have helped with this. This might be the hour someone needs to pick up their kid from daycare because they’re in a timezone two hours ahead. We didn’t want to send the message that Cedar thinks their people are robots and always available,” said Liz. “Flexibility and meeting our team where they’re at is incredibly important.”


Initially, Liz was concerned that Ethena’s solution was so lightweight that it would seem extra or optional and employees wouldn’t do it. “In reality, this is not my experience at all,” Liz said. “Ethena has proven itself to fit into everyone’s workflow as a lightweight way to learn and get compliant. It doesn’t create distractions, absorb much-needed time in the workday, or add to anyone’s stress.”


Although the admin experience wasn’t on the top of Liz’s priorities for picking a training provider, administering the training has been a breeze. “Even without an HRIS integration, overall management of user creation and disabling users as the team scales is very easy. As the team scales, I think about which tools will scale with us, and Ethena is probably the lowest effort of all the tools I use.” Bonus points for Ethena using magic links, so employees never have to create accounts and remember login information every month.


Signaling: Does Ethena highlight the importance of these topics and prioritization by the company?

When Liz rolled out in-person training the previous year, there was a lot of upfront justification and work to get people to open up even a little bit: “We really had to do a lot of priming to even get people onboard with the fact that this might be a reasonable way to spend several hours. There was a lot of, ‘Yes we’re asking a lot, but this will be valuable if you engage with it.’”


Rolling out Ethena was an entirely different story: “We really did not have to justify this because Ethena is so low friction,” said Liz. “We could really package this as a gift to the team and say ‘Hey, I know we’re all committed to having an environment that is rooted in inclusion and equity where we don’t have negative impacts on our teammates. This is a gift to you with the information about how to do that really really well.


“It felt like something we could celebrate and say ‘we see you, we hear you, let’s do this together and enjoy it because it’ll make us better.’ Extremely different from the opposite approach of ‘hey we’re going to set aside a lot of time that you don’t have a choice about on a single day of the year so that we don’t run afoul of the law.’ They’re two very different value propositions to the team, and one clearly resonated better.”


Bonus: Training that responds to and works well during the COVID-19 era

Cedar’s success in rolling out Ethena during the pandemic was “a leading indicator of where we needed to take things and shed any of the reliance we’ve had on in-person activities,” Liz recalled. “When we launched, we said ‘Hey, we’re going through a really tough time right now. Everyone at Cedar is going through a unique circumstance for the first time and we are selecting tools for you that reflect that and honor that. We think this is the best one for those reasons.’ Ethena has been the best example of tooling from our People team that has done all of this.”


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