Mary Jane Beesor (left) and Missy Lerma have set up shop in Cheyenne as Optum
begins to transition the WYhealth program from Xerox to Optum, starting July 1.
Optum Set to Take over WYhealth Contract
By Tom Lacock
Wyoming Medical Society
CHEYENNE – The WYhealth care management program is nothing new to Wyoming providers, though the folks running the program will be starting July 1. Optum, a health services company under the umbrella of UnitedHealth Group has been awarded state contracts for utilization management and health management for WYhealth. The contract was previously held by Xerox.
WYhealth is a Medicaid program that provides care management to Medicaid clients. Among its more successful and popular efforts are Due Date Plus, a mobile application for expected mothers which reminds them of doctors appointments, as well as look up symptoms and issues, and connect to health plan services like nurse support.
Optum has sent Mary Jane Beesor to Wyoming as the project manager for WYhealth as well as Missy Lerma, a provider relations director. They are in Cheyenne this month helping Optum hire and train provider relations staff. Meanwhile, Marion Brown and Richard Hererra have come from Optum’s corporate offices to meet with Wyoming providers to introduce the organization and changes.
“We are building out a team that will land at four to five people on the provider relations side,” said Lerma. “We have one person who has started as of this week. We have two more coming on before July 1. On July 1 we will be staffed, be able to take calls.
“We will have a grouping of folks here in Cheyenne and Casper primarily, but everyone knows and expects that they will be spending some time on the road to meet with providers in other parts of the state.”
Lerma, who was at Jackson Lake Lodge last week for the WMS Annual Meeting, said the first hire on the provider relations side is Morris McGaugh, who formerly worked in provider relations with Xerox and has also spent time at Blue Cross Blue Shield. As of Wednesday two other offers for provider relations were being extended while a provider relations director is still being sought. Lerma said all of those on the provider relations team have ties to, or already live in Wyoming. She added that provider relations advocates will be reaching out to providers around the July 1 date.
The Optum contract with WYhealth comes in two pieces, utilization management and health management. Beesor said providers won’t see much change in their utilization management efforts. The same phone and fax numbers will be used as prior to July 1, as well as the same website. An email address of email@example.com will be available as well for questions from providers.
Beesor did say as things ramp up, Optum will offer a portal functionality for providers to use in submitting pre-authorizations and supporting documentation. Status updates will also be available on those online for pre-authorization submissions.
“I appreciate Medicaid Providers,” Beesor said. “I have worked in the Medicaid arena for over 30 years. I know how much providers do for the members. We plan to make their lives easier and we welcome the collaboration with them. We want to make life better for their members, so they can provide the best care to their patients.”
Next week Beesor said Optum will be working with the state to present its operations readiness plan before making another push to introduce itself to the state’s providers.
“WYhealth is a name providers recognize and there are a lot of benefits within the program,” Beesor said. “We will be working closely with provider to help them understand the different benefits members have available to them.”