Conduent to Deliver Highly Modernized Core Claims Administration Services to Vaya Health

FLORHAM PARK, N.J., Nov. 24, 2020 — Conduent Incorporated, a business process services and solutions company, today announced a new agreement with Vaya Health that will help the managed care organization (MCO) simplify and optimize the administration of behavioral health benefits to Medicaid recipients in North Carolina. Under the terms of the seven-year agreement, Conduent will deliver and host a custom version of its HSP Core Claims Administration software solution allowing Vaya to more efficiently operate and manage benefits in 22 counties.

As one of only seven behavioral health MCOs in the state of North Carolina, Vaya is moving forward with preparations to operate under new program rules that will require MCOs to coordinate payment of benefits with one of four statewide prepaid health plans (PHPs) by July 2021. Vaya chose Conduent for the company’s proven success with embedded automation and artificial intelligence tools to effectively manage medical cost and complex healthcare claims. Prior to the agreement, Conduent developed a systems modernization model using Vaya’s claims data that projected the efficiency gains and cost savings that artificial intelligence, advanced automation and analytics can deliver.

“As an organization with nearly 50 years of experience in behavioral health and managed care, we understand the importance of innovation in the changing Medicaid landscape,” said Robert Webb, Executive Vice President and Chief Information Officer at Vaya Health. “Vaya’s partnership with Conduent demonstrates our ongoing pursuit of excellence as we prepare for the evolution of Medicaid managed care in North Carolina.”

The North Carolina Department of Health and Human Services (NC DHHS) recently announced plans resuming efforts to shift the state’s Medicaid program from a fee-for-service to a pay-for-performance model to improve members’ health outcomes while reducing overall costs. Currently, more than one in five North Carolinians, or 2.36 million people, depend on and are in enrolled in Medicaid.

“We are proud to partner with Vaya to enable their successful transition into a pay-for-performance model that lowers operational costs while enhancing positive digital experiences for beneficiaries,” said Lisa Hopper, General Manager, Healthcare Payer Solutions at Conduent. “Our award-winning core claims administration solution enables Vaya to streamline processes and apply advanced data analytics to control costs while enhancing services.”

Conduent’s Healthcare Payer Solutions span all touchpoints for insured members, helping them navigate through healthcare choices and connect to care teams through automated business processes. Its Payer Solutions portfolio includes its ‘ Best in KLAS’ HSP Core Administration Services , Payment Integrity Services and Care Integration Services.

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