Bmc wellsense

Author: i | 2025-04-24

BMC WellSense Plan: MassHealth: BMC WellSense Plan: Commercial: BMC WellSense Plan: Senior Care Options: Cigna: Commercial (HMO, POS, Gatekeeper, PPO) Commonwealth

WellSense/BMC for ACO and SCO Plans - Mass.gov

WellSense Health Plan to become the largest Medicaid health plan in the state, covering more than 500,000 MassHealth members in eight ACO partnerships across MassachusettsBOSTON – WellSense Health Plan, part of Boston Medical Center Health System, has been selected by the Baker-Polito Administration to expand its participation in the Accountable Care Organization program, doubling the number of its MassHealth ACO partnerships from four to eight, while improving care and coordination for members in its network.After enrollment begins in April, WellSense Health Plan will cover more than 500,000 lives in Massachusetts, supporting the care of nearly 40% of MassHealth ACO adult and child members across the state.The selection by the Baker-Polito Administration makes WellSense the largest partner in the state in caring for a Medicaid ACO population, as well as the largest Medicaid plan overall.The Baker-Polito Administration selected a total of 17 health care organizations across the state, including eight partnerships with WellSense Health Plan, for the re-procurement, which goes into effect April 1, 2023. MassHealth ACOs are integrated networks of physicians, hospitals and other community-based health care providers that are accountable for the quality, cost and member experience of care for 1.2 million MassHealth members.Photo credit: Frank Conte, EastBoston.com“This is a transformational milestone for WellSense and our entire health system,” said Alastair Bell, MD, the Chief Operating Officer of BMC Health System. “This significantly expands our mission, and places WellSense, BMC Health System and our eight partner ACOs at the heart of payment and delivery of high-quality care to low-income populations in Massachusetts.”With state approval, WellSense has renewed ACO agreements with four partners that were initially approved for five-year contracts beginning in March 2018:Boston Accountable Care Organization, which includes Boston Medical Center, its physician network and many of its affiliated health centers; Signature Healthcare Corporation in Brockton; SouthCoast Health in New Bedford, Fall River and Wareham; and Mercy Hospital (Sisters of Providence Health System) in Springfield.The four new ACO partnerships include:Beth Israel Lahey Health Performance Network Boston Children’s Health ACO East Boston Neighborhood Health Center Tufts Medicine and Lowell Community Health Center with WellSense “Working with MassHealth and our eight ACO partners, we will improve health outcomes by continuing to provide access to high-quality care and helping adults and children live their healthiest lives,” said Heather Thiltgen, President of WellSense Health Plan. “Together, we will tackle the most difficult challenges for our members and continually push for innovation in the Medicaid program.”“Serving the Medicaid population is central to our commitment to health equity and improving the health of the people and communities we serve,” said Beth Roberts, president of Beth Israel Lahey Health Performance Network. “We are pleased to partner with WellSense, given their deep experience with Medicaid population health management and our shared commitment for collaborating on behalf of and advocating for our patients.”“Partnering with WellSense Health Plan to introduce this ACO brings tremendous value to our patients and supports our mission of providing high-quality, integrated care to those we serve,” said Greg Wilmot, President and CEO of East

WellSense Medicare Advantage (HMO) - 2025 BMC HealthNet

It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.* Please note: THIS IS A CODE EVERYTHING ROLE - You must have strong proficiency using a coding book, this is not an HCC coding role. Hours are 7:00 AM – 3:30 PM EST OR 8:00 AM – 4:30 PM ESTAn assessment is part of the interview process using an ICD-10 coding bookJob Summary:The Coder manages the day-to-day responsibilities of chart abstraction, vendor auditing and reporting in accordance with state and federal regulations. The coder will abstract from in-patient and out-patient medical records and record findings via electronic database and or excel spread sheets. The coder ensures that all claims accurately reflect the appropriate diagnosis information as outlined in the member’s medial record. Our Investment in You:· Full-time remote work· Competitive salaries· Excellent benefitsResponsibilities · Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation. · Ability to code government and state models. This includes code everything projects. · Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations. · Ability to maintain a 95% accuracy rate on all coding projects. · Coders assist with code abstraction and coding quality audits using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures. Requirements · Current core coding credentials through AHIMA or AAPC (RHIT, CCS, CCS-P, CPC, CIC, etc.) The AAPC CRC (Certified Risk Adjustment Coder) coding certification is highly recommended. · Strong organizational skills · Technical savvy with high level of competence in basic computer skills, Microsoft Outlook, Word, Excel and Outlook. · Strong written and verbal communication skills · Ability to work independently in a remote environment · Private lockable office space to ensure security of Member PHI · Minimum of 5 years coding experience with at least 3 of those years in Risk Adjustment coding. · Completion of an accredited medical coding program with current unencumbered credentials. Required education: · CPC Certification Required experience: · Risk Adjustment coding: 3 years · Coding: 5 years Supervision Received · General supervision is received weekly About WellSenseWellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

WellSense Signature Access (PPO) - 2025 BMC Health System

Illustrates the most commonly used permission groups needed by users to perform their duties. For a detailed description of all of the permission groups that are available for a particular application, click the link in the Application column.Application permissionsKey permission groupsAsset-Management-user-roles-and-permissionsAsset Admin or Asset UserContract Admin or ViewerPurchasing UserReceiving UserChange-Management-user-roles-and-permissionsInfrastructure Change Master, User or ViewerRelease-Management-user-roles-and-permissionsRelease Master, User or ViewerIncident-management-user-roles-and-permissionsIncident Master, User, or ViewerProblem-management-user-roles-and-permissionsProblem Master, User or ViewerService-Request-Management-user-roles-and-permissionsBusiness ManagerService Request UserWork Order MasterKnowledge-Management-user-roles-and-permissionsKnowledge Admin, User or ViewerTask-Management-permissionsTask User (This is only required in certain permission combinations.Subcomponent permission groupsSubcomponents contain features or functionality that are shared among some, or all of the applications. For example, the Task Management subcomponent provides task management functions for BMC Helix ITSM: Change Management and for BMC Helix ITSM: Service Desk:SubcomponentPermissionsFinancial-permissionsCost ManagerCost UserCost ViewerReturn-on-Investment-permissionsROI AdminROI ViewerWork-info-permissionsApplication> MasterApplication>UserApplication> SubmitterApplication> ViewerBMC Helix ITSM user and group synchronization to BMC Helix PortalFor the users to use their existing credentials to authenticate into BMC Helix Portal, the BMC SaaS Operations team needs to perform some configurations to sync the BMC Helix ITSM users into BMC Helix Portal. For more information, see User identities in BMC Helix Portal and contact BMC Support.. BMC WellSense Plan: MassHealth: BMC WellSense Plan: Commercial: BMC WellSense Plan: Senior Care Options: Cigna: Commercial (HMO, POS, Gatekeeper, PPO) Commonwealth This is a transformational milestone for WellSense and our entire health system, said Alastair Bell, MD, the Chief Operating Officer of BMC Health System. This significantly expands our mission, and places WellSense, BMC

WellSense Signature (HMO) - 2025 BMC Health System, Inc

Boston Neighborhood Health Center. “As part of our longstanding commitment to advancing health equity, I am excited by this opportunity for East Boston Neighborhood Health Center to provideeven greater care and improve clinical outcomes for our patients.”About WellSense Health PlanWellSense Health Plan is a nonprofit health insurance company serving more than 440,000 members across Massachusetts and New Hampshire through Medicare, Individualand Family, and Medicaid plans. Founded 25 years ago, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances.About East Boston Neighborhood Health CenterFrom@EBNHC twitter feedEast Boston Neighborhood Health Center (EBNHC) is one of the nation’s largest Federally Qualified Health Centers (FQHCs) and the largest community health center in Massachusetts, serving over 100,000 patients, and recognized by the Health Resources and Services Administration (HRSA) as a Health Center Quality Leader. For more than 50 years, EBNHC has offered access to comprehensive care for the underserved populations of Chelsea, Revere, East Boston, Winthrop, Everett and Boston’s South End. East Boston Neighborhood Health Center is dedicated to promoting and sustaining healthy communities, families, and individuals by providing accessible, person-centered, compassionate, and high-quality health care services to all who live and work in our service area, regardless of ability to pay, while upholding diversity, equity, and inclusion at the core of all we do. www.ebnhc.orgSource: Greenough Agency 11/16/2022

WellSense Medicare Advantage (HMO) - 2025 BMC HealthNet Plan

Register Log in Recently viewed Search result Service Management…Remedy Deployment 19.08PlanningBest practices for BMC Remedy ITSM Deployment We recommend that you review best practices for Remedy Deployment prior to implementing Remedy.CategoryReference topicsPlanningAdditional BMC CMDB requirementsConfiguring private queue threadsEnterprise Centralized Configuration Server as a shared serviceExample configurationsGuidelines for deploying a load balancer in a shared services architectureGuidelines for tenants in shared servicePlanning an upgradePlanning where software is installed in server groupsServer groups overviewSetting the Max-Entries-Per-Query optionTuningAllocating AR System server resourcesBenchmarking for a single userBenchmarking for mixed workloadsBrowser hardware requirements and settingsConfiguring limits and timeoutsConfiguring private queue threadsEvaluating volume with production or synthetic dataPerformance tuning checklistsPerformance tuning for RemedySetting the Max-Entries-Per-Query optionTuning the Oracle database serverTuning the SQL Server databasePreparingAdditional BMC CMDB requirementsBMC Atrium Core checksBMC Remedy AR System checksBMC Remedy ITSM checksBMC Remedy ITSM Process Designer checksBMC Remedy Migrator memory usage and disk space requirementsBMC Service Level Management checksBMC Service Request Management checksDownloading the installation filesHardware requirementsInstalling upgrade utilitiesPerforming configuration checksPreparing an application for installationPreparing to install BMC Remedy Smart ReportingPreparing to run the installersSystem requirementsUnderstanding the BMC Remedy Mid TierUnified Data Management (UDM) checksInstallingApplying a deployment packageBMC Atrium Core postinstallation proceduresBMC Atrium Core preinstallation proceduresBMC Configuration Drift Management pre-installation proceduresCreating a Private Queue for ARID plug-inCreating a silent.txt file for BMC Service Level Management installationDeploying Remedy Mid Tier on Tomcat by using a WAR fileInstallingInstalling BMC Configuration Drift ManagementInstalling BMC Remedy AR SystemInstalling BMC Remedy Mid TierInstalling BMC Remedy Smart ReportingInstalling Drift Management with the CLI installerInstalling Remedy Mid Tier on an external TomcatInstalling the BMC Remedy AR System ServerOptions for the silent .txt file for BMC Service Request Management installationOptions for the silent.txt file for BMC Remedy ITSM installationPerforming BMC Remedy ITSM Process Designer installationPerforming the BMC Atrium Core installationPerforming the BMC Remedy ITSM installationPerforming the BMC Service Request Management installationPreinstallation procedures for BMC Remedy AR SystemPreparing to install BMC Remedy Smart ReportingPrerequisites for Installing Drift Management and help as non-root - Linux onlyUpgradingConfiguring the Delta Data Migration toolMigrating configurationsMigrating data from backend and custom formsPerforming AR reconciliationPerforming BMC Service Request Management upgradePerforming the BMC Atrium CMDB upgradePerforming the BMC Atrium Core Web Services upgradePerforming the BMC Remedy ITSM Process Designer upgradePerforming the BMC Remedy ITSM upgradePerforming upgrade testingPreparing for the BMC Atrium Core upgradePreparing the AR System server before you upgrade BMC Atrium Core and other BMC applicationsRestrictions after restoring the database on a staging systemUpdating the configuration after upgrading and changing from IPv4 to IPv6Upgrading BMC Atrium CoreUpgrading BMC Remedy AR SystemTroubleshootingAR System server file locationsBMC Atrium Core checksBMC Remedy AR System checksBMC Remedy ITSM checksBMC Service Level Management checksBMC Service Request Management checksTroubleshooting installer failure during upgradeTroubleshooting package deployment issuesTroubleshooting Remedy Smart Reporting Installation and Upgrade

WellSense Added Value (HMO) - 2025 BMC Health System, Inc.

I’m thrilled to announce that, starting with the 24.4 release of BMC Helix Service Management, BMC HelixGPT now supports Google Cloud’s generative AI (GenAI) models, Gemini. This release marks a significant milestone in our collaboration, building on our previous integration with Google Cloud and Llama 3.1. Our shared vision for IT management is clear: transform enterprise IT with the power of GenAI and agentic AI, as we highlighted at BMC Connect. With BMC Helix now integrated with Gemini models, we’re empowering IT teams with enhanced flexibility, faster resolutions, and deeper insights, all while delivering cost savings. Top benefits of Google Cloud’s Gemini in HelixGPT to BMC Helix customers include: Faster resolutions: Gemini’s industry-leading long-context window processes long documents quickly, speeding answers and root cause identification. IT practitioners can access relevant knowledge from past resolutions, significantly shortening mean time to resolution (MTTR). Deeper insights: By analyzing large datasets in one go, Gemini models reduce latencies and enhance performance, delivering high-quality critical insights to improve decision-making and customer experiences. Smarter recommendations: The advancing reasoning power of Gemini models, applied to vast amounts of information and relevant problem-solving with longer blocks of code helps IT, DevOps, and developers provide better code recommendations and more accurate next steps, improving DevOps workflows. What sets BMC HelixGPT apart Key differentiators for BMC HelixGPT include: Open platform: Enterprises can use their existing strategies and investments in GenAI and Google Cloud, avoiding costly data migrations while accelerating innovation and time to value. Hands-free setup: With native BMC Helix connectivity and pre-built connectors (e.g., Confluence, Teams), setup is easy, eliminating the need for lengthy configurations. Unified ServiceOps: Combining AIOps and service management data, BMC Helix delivers faster, more accurate issue resolutions, higher-quality answers, and higher operational efficiency. As long-standing collaborators, BMC and Google Cloud share a history that enhances our mutual ecosystems. This latest development cements our joint commitment to provide organizations with innovation that allows quick adoption of generative AI to help eliminate repetitive troubleshooting work and supercharge IT productivity. The release of BMC HelixGPT with Google Cloud’s Gemini models support is not just a step forward for enterprise software—it also paves the way for smarter, faster, and more effective IT operations. Learn how BMC Helix and Google Cloud’s Gemini models together can transform your IT processes—contact BMC today! These postings are my own and do not necessarily represent BMC's position, strategies, or opinion. See an error or have a suggestion? Please let us know by emailing [email protected]. Business, Faster than Humanly Possible BMC empowers 86% of the Forbes Global 50 to accelerate business value faster than humanly possible. Our industry-leading portfolio unlocks human and machine potential to drive business growth, innovation, and sustainable success. BMC does. BMC WellSense Plan: MassHealth: BMC WellSense Plan: Commercial: BMC WellSense Plan: Senior Care Options: Cigna: Commercial (HMO, POS, Gatekeeper, PPO) Commonwealth This is a transformational milestone for WellSense and our entire health system, said Alastair Bell, MD, the Chief Operating Officer of BMC Health System. This significantly expands our mission, and places WellSense, BMC