Gold Coast Health Plan Selects Conduent for Medicaid Managed Care Administration

FLORHAM PARK, N.J., Jan. 31, 2019 /PRNewswire/ — Conduent Incorporated (NYSE: CNDT), a digital interactions company, was awarded a $100 million, seven-year contract extension to provide third-party administration services for Gold Coast Health Plan (GCHP), a Ventura County, Calif.-based Medi-Cal plan.

Conduent will deploy an end-to-end plan administration platform, including member experience and automation tools, for GCHP, which manages the Medi-Cal benefit for nearly 200,000 members. The technology will include analytics for fraud, member and provider behavior, and will automate tasks, including enrollment, claims processing and financial management, to reduce transaction time and lower administration costs.

Using an integrated data exchange model, the solution will help GCHP in its quest to exceed member and provider service goals while also maintaining compliance with the California Department of Health Care Services (DHCS) and Centers for Medicare & Medicaid Services (CMS) regulations. The model fully supports the value-based care model of incentive-based provider payments.

“With the acquisition of Health Solutions Plus, Conduent has the technology we need to automate our back-end processing, which will help us ensure both members and providers continue to receive the exceptional service they expect from GCHP,” said Dale Villani, CEO, GCHP. “The new digital solution will make our workflow more efficient, allowing us to save valuable dollars and invest them back into the plan.”

Conduent’s acquisition of Health Solutions Plus, the number one vendor for payer claims and administration platforms in both the 2018 and 2019 Best in KLAS: Software and Services reports, closed earlier this month. The 2019 Best in KLAS report was released earlier today.

“Successfully administering and growing health plans is much easier when the right technology is in place,” said Pratap Sarker, Group Chief Executive, Conduent, Financial Services and Healthcare. “By automating and leveraging analytics for GCHP, we’ll partner every step of the way, from enhancing the member experience to ensuring each claim is properly analyzed and efficiently paid.”

Implementation of the new solution is underway and expected to be complete in 2020.

Conduent Health has more than 30 years of experience in healthcare, with an extensive presence in the payer, provider and pharmaceutical markets, including servicing 20 of the top 20 managed healthcare plans, working with 40 percent of U.S. hospitals and 14 out of 15 of the top global pharmaceutical companies.

Source: Gold Coast Health Plan Selects Conduent for Medicaid Managed Care Administration / PR Newswire

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