Insights

Clinical Business Transformation Expansion

WNS-HealthHelp, clinical technology platform, is expanding its existing Utilization Management (UM) solution to include additional Business Transformation solutions designed to support health plans where they need resources in their UM as well as their care management (CM) and Disease Management (DM) programs.

With over two decades of clinical program and business transformation expertise, the ideal place for product expansion was additional integration of digital-led business transformation models within health plans’ existing clinical workflow processes. Adding flexible models enables plans to enhance and scale operations without replacing existing tech and people.

Our expanded services are uniquely designed to meet health plans where they are in their growth journey. We also continue to offer our fully delegated and shared UM programs. WNS-HealthHelp’s clinical solutions can now be categorized as follows:

Our Clinical Experts, Our Platform – Our intelligent UM platform and clinical team offer fully delegated UM programs to payers like genetic testing, cardiology, musculoskeletal, oncology and radiology.
Shared Platform for Payers & WNS-HealthHelp’s Clinical Experts– Our intelligent UM platform can be integrated into payer workflows. Our clinical team, as well as, payers’ clinical teams share the same process environment and collaborate on UM programs.
Our Clinical Experts, Your Platform – Payers who prefer to keep their current clinical platforms and processes, can access our skilled clinical and non-clinical experts to supplement their existing teams or processes around UM, CM and DM. This includes resources to support intake, clinical review, provider and member services, care management and disease management.

About WNS

As a Business Transformation and Services partner, WNS works with marquee brands across industries, solving operational challenges and driving strategic growth journeys. Our collaborative patient care solutions – led by industry, analytics and digital – enable healthcare companies to navigate a changing, regulated and cost-intensive landscape. Our Healthcare BPM services in the payer, provider and life science segments encompass claims, revenue cycle management, healthcare analytics and more. Our evidence-based clinical decision support system lets us evaluate the latest advancements to drive quality care at low costs.

About Availity

Availity empowers payers and providers to deliver transformative patient experiences by enabling the seamless exchange of clinical, administrative, and financial information. As the nation’s largest real-time health information network, Availity develops intelligent, automated, and interoperable solutions that foster collaboration and shared value across the healthcare ecosystem. With connections to over 95% of payers, more than 3 million providers, and over 2,000 trading partners, Availity provides mission-critical connectivity to drive the future of healthcare innovation. For more information visit www.availity.com.

About WNS-HealthHelp

HealthHelp, a unit within WNS, is a trusted healthcare technology platform for health plans’ clinical programs for over 25 years. Our unified suite of Advanced AI powered technology platform-based solutions simplifies medical complexity and workforce challenges, and enhances provider relations and member journeys (i.e., customer experiences). Our uniquely designed UM and clinical solutions were developed to fit into health plans’ existing clinical programs to advance outcomes and success. We work in partnership to understand health plan commercial and Medicare clinical programs, and determine where our solutions can advance outcomes and lower cost. There is no one size fits all, and we know how to expediently deliver the best tailored solution for a specific health plan’s needs.

About WNS

WNS (Holdings) Limited (NYSE: WNS) is a digital-led business transformation and services company. WNS combines deep domain expertise with talent, technology, and AI to co-create innovative solutions for over 600 clients across various industries. WNS delivers an entire spectrum of solutions including industry-specific offerings, customer experience services, finance and accounting, human resources, procurement, and research and analytics to re-imagine the digital future of businesses. As of December 31, 2024, WNS had 63,390 professionals across 66 delivery centers worldwide including facilities in Canada, China, Costa Rica, India, Malaysia, the Philippines, Poland, Romania, South Africa, Sri Lanka, Turkey, the United Kingdom, and the United States.
For more information, visit www.wns.com.