Expanding UM with Clinical BPM

With over two decades of clinical program and BPM expertise, the ideal place for product expansion was additional integration of BPM 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 BPM solution allows health plans to leverage our expertise in a way that supports what they have already established,” said George Gjermano, Senior VP of Product at WNS/HealthHelp.  “We saw the need to provide this additional flexibility for our clients that desire to grow and adapt their clinical programs within their existing culture.”

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 utilization management programs.  In total, WNS/HealthHelp 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 Payer and HealthHelp / WNS Clinical Experts, Shared Platform – Our intelligent UM platform can be integrated into payer workflows.  Our clinical team as well as payer 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.