Case Study

From Culture Investment to #1 Best Place to Work: Nebraska Cancer Specialists’ Journey to the Top

Overview

Nebraska Cancer Specialists (NCS) is a multi-site oncology practice serving communities across Nebraska with a mission centered on accessible, whole-person cancer care. Over the last decade, the organization has grown significantly, expanding from a small regional practice to more than 350 employees across 16+ locations.

Since 2020, NCS has worked closely with BetterCulture to intentionally design, strengthen, and sustain a healthy workplace culture that could scale alongside the organization. Rather than relying on a single program or short-term initiative, NCS engaged BetterCulture as a long-term partner to support culture development across employees, leaders, physicians, and executive leadership.

This sustained focus on behavior, leadership, and accountability has helped NCS earn recognition as one of Omaha’s Best Places to Work in 2025 and to be named the #1 Best Place to Work in Omaha for companies with more than 200 employees in 2026. What once felt like a long-term aspiration for the organization became a measurable reality through consistent investment in culture over time.

Challenge

Like many healthcare organizations, Nebraska Cancer Specialists faced increasing pressure from workforce shortages, burnout, and rising turnover across the industry. National healthcare turnover rates regularly exceed 20 percent, creating instability for both employees and patients.

At the same time, NCS was growing rapidly. Expanding locations, increasing headcount, and a growing physician group introduced the risk of cultural inconsistency, leadership misalignment, and uneven employee and patient experience.

Leadership recognized that growth alone would not sustain the organization. Without a clear, shared approach to culture and leadership behavior, scaling the business could undermine employee engagement, retention, and the patient experience NCS was committed to protecting.

At the outset, becoming a top workplace in Omaha, especially within a high-demand healthcare environment, felt more like a long-term aspiration than an immediate outcome.

Solution

Nebraska Cancer Specialists partnered with BetterCulture to build a behavior-based culture system designed to support long-term growth, leadership effectiveness, and employee ownership. Over multiple years, this partnership expanded to reinforce culture across employees, leaders, physicians, and executive leadership.

Early in the partnership, NCS used the BetterCulture Survey to understand the current state of its culture. Leadership wanted a clear, honest view of how employees were experiencing the organization and where alignment, trust, and consistency needed to improve. The survey created a shared baseline and helped leadership focus on what mattered most.

From there, NCS approached culture improvement from both the top down and the bottom up.

Top-down: Leadership alignment and development

Quarterly senior leadership workshops
Executive and physician strategy sessions
Ongoing leadership training across management teams
Participation in BetterCulture Live: The MindSet Leadership Program for current and high-potential leaders

Bottom-up: Employee ownership and shared expectations

Organization-wide rollout of the 20 Tenets of Culture
Clear, behavior-based expectations for communication, accountability, and teamwork
Reinforcement of the Tenets across meetings, onboarding, and daily interactions

This layered approach ensured that insights from the survey, expectations from the Tenets, and leadership development efforts all worked together to create a culture that could scale consistently as the organization grew.

Process

NCS approached culture as a long-term partnership with BetterCulture, rolling out initiatives in intentional phases and reinforcing them over time.

Establish the foundation: Beginning in 2020, NCS aligned senior leaders and managers around the belief that culture is a strategic priority and a shared responsibility.
Listen and measure: Employee feedback through surveys and conversations helped identify strengths, gaps, and opportunities for improvement.
Develop leaders first: Leaders and managers participated in multi-year standard and custom-built BetterCulture leadership training programs, including BetterCulture Live: The MindSet Leadership Program, to build leadership clarity, improve skills, and strengthen leadership consistency.
Engage physician leaders: Physicians were brought into the culture conversation, with evening offsites focused on how their daily interactions significantly influence staff experience and engagement.
Empower all employees: The 20 Tenets of Culture were introduced organization-wide and embedded into meetings, one-on-ones, onboarding, and team discussions—giving employees a practical framework for shaping culture together.
Reinforce continuously: Culture work became a standing priority rather than a one-time initiative, with regular check-ins, shared language, and visible leadership support.

This long-term, multi-layered approach allowed NCS to build momentum over time rather than relying on one-time initiatives.

Outcomes

Nebraska Cancer Specialists’ sustained, multi-year investment in culture has led to measurable improvements in employee retention, leadership effectiveness, and overall employee experience. Most notably, this work culminated in NCS being named the #1 Best Place to Work in Omaha for companies with more than 200 employees in 2026, a significant achievement in a demanding healthcare environment.

Between 2019 and 2025, NCS increased its average headcount from approximately 200 employees to more than 350. During that same period, total turnover declined from over 20 percent to just over 8 percent. Voluntary turnover was reduced by more than 50 percent, signaling stronger engagement and a workforce that is choosing to stay.

These results were not driven by a single initiative. They reflect a long-term, systems-based approach to culture built over years of partnership with BetterCulture, including:

Strong commitment and consistency from NCS leadership
Clear behavioral expectations through the 20 Tenets of Culture
Insight and alignment created through the BetterCulture Survey
Ongoing leadership development through BetterCulture training and BetterCulture Live: The MindSet Leadership Program
Consistent reinforcement of culture across leaders, physicians, and frontline employees

As a result, NCS has experienced:

Sustained turnover reduction in a healthcare environment where national averages remain between 20–25 percent
Strong employee retention during periods of significant organizational growth
Lower recruiting, onboarding, and training costs
Greater leadership consistency and employee ownership of culture
A more stable, engaged workforce supporting a consistent patient experience across locations

What began as a long-term aspiration to become a top workplace has become a defining achievement. Nebraska Cancer Specialists has built a culture where employees feel supported, leaders are aligned, and patients benefit from a consistent, high-quality experience, even as the organization continues to grow.

To learn more about how NCS built such a high-performing company and culture, listen to their practice administrator Danielle Geiger on BetterCulture Podcast #15 – Why Great Culture is Nebraska Cancer Specialists’ Secret Sauce

“If we take great care of our employees and give them a place where they can show up and do meaningful work every day, they’re going to provide excellent patient care, which is the ultimate goal.”

Danielle Geiger, Oncology Practice Administrator, Nebraska Cancer Specialists