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MedHOK’s Utilization Management, Rx Prior Authorization and Provider Portal Modules Selected by Blue Shield of California

MedHOK’s Utilization Management, Rx Prior Authorization And Provider Portal Modules Selected By Blue Shield Of California

TAMPA, Fla. – April 14, 2015 – MedHOK announced today that Blue Shield of California will implement its integrated cloud-based platform that supports care, quality and compliance to promote adherence to best practices and protocols through the addition of MedHOK’s Utilization Management, Rx Prior Authorization and Provider Portal Modules.

MedHOK offers a unique integrated system that enables real-time, roles-based access to patient information across the care continuum. Blue Shield of California will use the platform to give providers access to best practice guidelines and real-time feedback on their authorization requests to streamline the delivery of care, while ensuring compliance with regulations.

Founded in 2010, MedHOK’s innovative software-as-a-service (SaaS) model delivers to customers the rapid platform implementation and enhancements and lower upfront costs they need to keep pace in a continuously evolving regulatory environment. Its singular focus on technological excellence and superior customer service and support has enabled MedHOK to achieve outstanding growth as evidenced by its ranking as the 25th fastest-growing private company in 2014 by Inc.

MedHOK’s platform creates actionable information that can be leveraged to proactively close care gaps, comply with federal and state regulations, enhance care management and improve Star, HEDIS® and other quality scores.

“We are pleased that Blue Shield of California has chosen MedHOK to support its strategy for further enhancing quality, care and efficiency for its over 3 million members,” said Anil Kottoor, president and CEO, MedHOK. “Our platform provides Blue Shield of California with an integrated, end-to-end solution to manage authorizations and supports transparency for a more customer-centric experience.”

Marc Ryan

Marc S. Ryan serves as MedHOK’s Chief Strategy and Compliance Officer. During his career, Marc has served a number of health plans in executive-level regulatory, compliance, business development, and operations roles. He has launched and operated plans with Medicare, Medicaid, Commercial and Exchange lines of business. Marc was the Secretary of Policy and Management and State Budget Director of Connecticut, where he oversaw all aspects of state budgeting and management. In this role, Marc created the state’s Medicaid and SCHIP managed care programs and oversaw its state employee and retiree health plans. He also created the state’s long-term care continuum program. Marc was nominated by then HHS Secretary Tommy Thompson to serve on a panel of state program experts to advise CMS on aspects of Medicare Part D implementation. He also was nominated by Florida’s Medicaid Secretary to serve on the state’s Medicaid Reform advisory panel.

Marc graduated cum laude from the Edmund A. Walsh School of Foreign Service at Georgetown University with a Bachelor of Science in Foreign Service. He received a Master of Public Administration, specializing in local government management and managed healthcare, from the University of New Haven. He was inducted into Sigma Beta Delta, a national honor society for business, management, and administration.

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