Third Party Administration Solutions

Effective health plan management means more than dealing with the pressures of competing for membership, implementing complicated mega rules and containing medical and administrative costs. It means doing more to improve the lives of those you serve. Conduent brings a deep understanding of the Medicaid industry to help you accomplish this. Our decades of experience offering member and provider services, coupled with specialized expertise in value-based pricing and payment reform, enables us to offer focused attention to the pressure points you’re experiencing today.

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In a changing healthcare market, your plan must comply with more prescriptive data analysis and performance reporting requirements, respond to member and provider requests, meet basic government requirements for timeliness and accuracy, safeguard against fraud, waste and abuse, and routinely process claims accurately the first time.  Being successful means making the right choices about where to direct resources for the biggest effect on health.  Conduent offers a broad range of end-to-end health plan administration services and solutions with deep subject matter expertise.

Conduent provides outreach programs that streamline enrollment and help members better understand their benefits. We also help you manage provider networks with screening, credentialing and enrollment services that ensure up-to-date information.  Conduent is in partnership, providing a core administration system that is highly configurable and adaptable to meet your plan’s specific needs.   Our pricing methodology team brings subject matter experts in value-based pricing, varied payment options and delivery model reform.  We also offer risk adjustment, subrogation and recovery services to ensure you’re getting the most for every health care dollar.

Conduent can help you optimize administration of your health plan, efficiently and effectively providing quality service.  With Conduent managing claims and payments, improving access to care and ensuring member and provider engagement, members get the most from their benefits and health plans do more with limited resources.