The new SmartProminence AI Solution Suite helps health plans and pharmacy benefit managers streamline utilization and pharmacy workflows, strengthen compliance readiness, and improve outcomes for members.
MHK, a leading healthcare technology provider and part of the Hearst Health network, announced the launch of its SmartProminence solution suite. Featuring AI-powered capabilities across MHK’s platform, with initial focus on Utilization Management (UM), Complaints, Appeals & Grievances (CAG), and Pharmacy Management solutions, SmartProminence is designed to help health plans and pharmacy benefit managers more efficiently achieve operational excellence, ensure compliance, and deliver better outcomes for members.
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MHK’s suite of AI agents will transform operations by modernizing current processes to significantly improve staff efficiency, quality, and compliance readiness. By reducing manual burdens and accelerating case resolution, SmartProminence users can focus on performance, accuracy, and efficiency across core operations.
“Healthcare organizations are under immense pressure to balance clinical appropriateness, regulatory compliance, and member experience, all within increasingly constrained resources,” said Maurice Herbelin, MD, MBA, Chief Medical Officer at MHK. “Our SmartProminence AI solutions enhance the organization’s ability to make timely, accurate, and evidence-based decisions. The technology enables care teams to redirect their time and expertise to higher-value interactions with members, while still meeting compliance and cost-containment goals.”
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Key Capabilities of the SmartProminence AI Suite
- The SmartProminence AI Suite is launching with AI-powered fax intake capabilities that automatically capture, classify, and route prior authorization requests, significantly reducing manual entry and processing. It’s built to handle complex requests, multi-request faxes, and intelligent triage with rigor and a focus on compliance. AI-powered fax intake capabilities will be available for MHK clients across the Utilization Management, Pharmacy Management, and Complaints Appeals & Grievances solutions starting in Q1 2026.
- Compliance-Ready: Built-in guardrails aligned with Centers for Medicare & Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), and state-level requirements, ensuring organizations remain audit-ready.
- Actionable Insights: Paired with CareProminence DataVisor, MHK’s AI-powered, real-time analytics tool for health plan performance and compliance, MHK delivers dynamic dashboards and advanced reporting that provide transparency into performance, empowering payers to proactively manage care quality, utilization, and operational outcomes.
“Operational excellence is about more than efficiency—it’s about empowering payers and PBMs to deliver consistent, reliable, high-quality outcomes. By embedding natively built AI into the MHK portfolio, and pairing those insights with CareProminence DataVisor’s advanced dashboards, we’re giving organizations the tools to transform complex processes into streamlined, proactive operations. This marks a pivotal step in MHK’s mission to simplify healthcare through technology,” said Conor Bagnell, President of MHK.
With the release of the SmartProminence suite, MHK reinforces its commitment to helping payers and pharmacy benefit managers achieve operational excellence in a complex and rapidly evolving healthcare environment. Additionally, it aligns with MHK’s vision to reduce human touch to areas where highest value occurs.
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Source- PR Newswire
