MHK
- Company typePrivate
- Founded2010
- HeadquartersTampa, United States
- Headcount251–500
- GTM typeB2B
- OfferingSoftware
MHK firmographics
Firmographics- Name
- MHK
- Legal name
- MedHOK, Inc.
- Website
- https://mhk.com
- Company type
- Private
- Founded year
- 2010
- Operating status
- Operating
- Headcount range
- 251–500 employees
- Ownership category
- akta.pro rank
MHK industry classification
Industry- Product category
- Healthcare SaaS / Care Management Software
- NAICS
- Computer Systems Design Services (541512), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (5182)
- SIC
- Services-Prepackaged Software (7372), Services-Health Services (8000)
- akta.pro primary industry
- Medication Analytics, Outcomes & Cost Optimization (HLACAKAL)
- akta.pro secondary industry
- Patient Relationship Management (PRM) & CRM for Provider Growth (Marketing/Outreach) (HLACAEAO)
Keywords
Where MHK is headquartered
LocationHeadquarters
- HQ city
- Tampa
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
MHK business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Operations, Marketing or Sales, Infrastructure
Revenue model
- SaaS Subscription: MHK operates as a SaaS healthcare technology provider offering subscription-based access to its CareProminence and MarketProminence platforms. Pricing is quote-based and typically structured as per-member-per-month or enterprise licensing depending on client size and needs.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Enterprise SaaS licensing with modular solution packages |
Go-to-market motion1 record
Distribution channels1 record
Marketing channels7 records
MHK product offering
Product offeringCore offering
MHK develops and sells SaaS-based healthcare technology platforms — CareProminence (clinical/operational) and MarketProminence (administrative/enrollment) — for health plans and pharmacy benefit managers. The platforms unify utilization management, care management, population health, pharmacy management, complaints/appeals/grievances, enrollment, premium billing, and financial reconciliation. Solutions are augmented by the SmartProminence AI Orchestrator, FHIR-native interoperability suite, and DataVisor analytics.
Product overview
MHK offers a dual-platform architecture consisting of CareProminence and MarketProminence. CareProminence is a unified medical and pharmacy management platform that combines Utilization Management, Care Management, Population Health & Quality Management, Pharmacy Management, Complaints/Appeals & Grievances, and Interoperability modules, augmented by AI-powered SmartProminence Orchestrator and analytics via DataVisor. MarketProminence focuses on back-office operations including Enrollment & Member Maintenance, Premium Billing, Financial Reconciliation, and Web Portals. The platforms share a unified data layer and can operate independently or together. Additional offerings include the Cares Member Mobile App (iOS/Android) and Provider Portal. The company also offers the SmartProminence AI Solution Suite featuring AI-powered fax intake and workflow automation, as well as the NCQA HEDIS-certified 360Measures module and 360Member consolidated view tool.
Differentiator
Problem solved
Functional benefit
Products and services
- CareProminence Unified medical and pharmacy management platform for health plans that centralizes utilization management, care management, population health, pharmacy management, and compliance workflows in a single cloud-based solution.
- MarketProminence SaaS platform that streamlines enrollment, premium billing, and financial reconciliation for Medicare Advantage and Part D health plans to ensure CMS compliance and maximize revenue.
- SmartProminence Orchestrator Production-ready AI orchestration layer that coordinates intelligent agents across healthcare workflows, enabling health plans to deploy AI securely, compliantly, and at scale within weeks rather than months.
- DataVisor Analytics and insights solution for the CareProminence platform delivering real-time dashboards and operational intelligence, combining productivity metrics, compliance monitoring, and population health analytics in a single view.
- Utilization Management Suite Enables high-quality, timely reviews for prior authorizations, concurrent inpatient cases, and post-service requests with automated workflows and real-time review capabilities.
- Care Management Suite Unifies all medical management activities across the member journey, supporting case management, disease management, care coordination, D-SNP management, and long-term services and support.
- Population Health & Quality Management Suite Leverages advanced analytics and streamlined workflows for risk prediction, care gap remediation, HEDIS measure reporting, and PQA medication adherence monitoring.
- Pharmacy Management Suite Manages the full spectrum of pharmacy operations including prior authorization, external reviews, appeals, grievances, medication therapy management, and overutilization monitoring across medical and pharmacy benefits.
- Complaints, Appeals & Grievances (CAG) Suite Enables efficient management of member and provider complaints, appeals, and grievances with automated workflows, regulatory compliance support, and integrated root cause analysis.
- MHK Interoperability Suite FHIR-native interoperability platform supporting CMS compliance mandates and modernizing prior authorization workflows through standards-based APIs for Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), and Prior Authorization Support (PAS).
- Enrollment & Member Maintenance Solution Purpose-built for CMS compliance, streamlining Medicare enrollment operations with automated workflows, prebuilt correspondence templates, and built-in compliance safeguards.
- Premium Billing Solution Automates complex billing tasks, manages remittance models across member and group accounts, integrates CMS payment files, and provides full visibility into billing statuses.
- Financial Reconciliation Ensures accurate financial processing and reconciliation for health plan operations.
- Web Portals Medicare Advantage Member Enrollment Web Portals include an Enrollment Portal for plan staff and a Beneficiary Portal for members, enabling streamlined application processing with real-time data integration.
- Cares Member Mobile App Mobile application for iOS and Android connecting health plans and members for a centralized care journey, featuring video messaging, medication alerts, health risk assessments, appointment scheduling, and real-time data synchronization with CareProminence.
Quantifiable outcome
- Handle time reduced from 15 minutes to 6 minutes (60% improvement) within 4 months of CareProminence implementation
- +3 more outcomes
Companies that use MHK
Customer profileNamed customers8 records
Segments3 records
Ideal customer profiles2 records
MHK technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration12 records
AI capability10 records
Feature11 records
MHK partnerships and signals
Strategic signalPartnerships
Twelve partnerships are on record, tiered support and core.
- FindhelpsupportThe MHK + Findhelp partnership enables CareProminence users to access Findhelp's extensive social service network, streamlining care coordination and improving outcomes by addressing social determinants of health. From screening and closed-loop referrals to actionable insights.
- Pharmacy Quality Alliance (PQA)corePQA develops and promotes measures for medication safety, adherence and appropriate use. The PQA/MHK partnership aims to advance pharmacy quality and medication adherence, with MHK integrating PQA drug measures into its healthcare platform and supporting value-based care.
- National Committee for Quality Assurance (NCQA)coreNCQA accredits healthcare organizations with emphasis on continuous quality improvement and performance measurement. MHK has achieved Population Health Management (PHM) Prevalidation status, demonstrating that CareProminence meets NCQA's rigorous standards for health plan accreditation and population health program accreditation.
- WebMD IgnitesupportWebMD Ignite delivers evidence-based health education and tools. Through its partnership with MHK, Ignite's resources are integrated into the MHK CareProminence platform to help care teams engage members with meaningful education that drives behavior change and improves outcomes.
- SurescriptssupportSurescripts facilitates e-prescriptions and health intelligence sharing. Partnering with MHK, Surescripts integrates with CareProminence to automate prior authorizations, connect health plans with EHRs and providers, and enable real-time clinical decision-making.
- OraclesupportOracle provides advanced database software, cloud systems and enterprise applications. The MHK/Oracle collaboration enables scalable, secure data exchange, improved automation of prior authorizations, and advanced predictive insights.
- Optum (InterQual)supportOptum's InterQual solution delivers clinical evidence and technology to enhance healthcare quality. The integration strengthens data-driven care and utilization management, enabling payers and providers to streamline prior authorization and optimize care coordination.
- Medi-Span (Wolters Kluwer)supportMedi-Span provides embedded drug data and clinical screening solutions. Integrated into MHK's automated care platform, it enables real-time formulary checks, streamlined prior authorizations, and improved medication safety alerts.
- MCG HealthsupportMCG Health, part of Hearst Health, provides clinical guidelines, AI-driven software and analytics. MCG care guidelines can be integrated with MHK's automation tools to streamline utilization and care management, enabling faster prior authorizations.
- Johns Hopkins ACG SystemsupportThe Johns Hopkins ACG System enables advanced population health analytics by stratifying patient risk and forecasting utilization. Integrating ACGs strengthens predictive modeling within CareProminence for targeting interventions and optimizing care management.
- FDB (First Databank)supportFDB, part of Hearst Health, creates and integrates drug knowledge. FDB's drug databases are embedded within MHK's CareProminence Utilization Management solution, enhancing clinical decision support and streamlining prior authorizations.
- Amazon Web Services (AWS)coreAWS provides MHK with infrastructure hosting. AWS HealthLake is used for managing interoperability with FHIR-based APIs. MHK is building a data lake with AWS QuickSight for advanced analytics to enhance compliance, automate prior authorizations, and deliver scalable, secure solutions.
Scale indicators3 records
Recent moves7 records
Expansion highlights6 records
MHK competitors and assessment
Company assessmentBroad incumbents
- Optum (UnitedHealth Group): Optum offers a comprehensive suite of payer technology, analytics, and care management services at massive scale, competing broadly with MHK's offerings while leveraging the UnitedHealthcare payer ecosystem.
- Change Healthcare (Optum): Now part of Optum, Change Healthcare provides revenue cycle, payment, and interoperability solutions for payers and providers, with overlap on prior authorization and FHIR-based API offerings.
- Oracle Health: Oracle Health (formerly Cerner) provides payer-facing solutions alongside its dominant provider EHR, with growing FHIR-native and analytics capabilities that increasingly overlap with MHK's interoperability and population health modules.
Direct peers
- Inovalon: Inovalon's ONE Platform delivers payer analytics, quality measurement (HEDIS/Star Ratings), and population health insights for health plans, directly competing with MHK's 360Measures, DataVisor, and Population Health suites.
- Cognizant (Trizetto): Cognizant acquired TriZetto to become one of the largest payer technology providers, offering QNXT, CareAdvance, and NetworX platforms that directly compete with MHK's CareProminence and MarketProminence across utilization management, care management, and enrollment.
- Medecision: Medecision offers the Aerial platform for care management, utilization management, and population health for health plans and managed care organizations, competing head-to-head with MHK for similar payer customers.
- ZeOmega: ZeOmega's Jiva platform delivers utilization management, care management, and population health management for health plans and PBMs, closely mirroring MHK's CareProminence suite and competing in the same buyer evaluations.
- HealthEdge: HealthEdge provides next-generation core administrative processing and care management SaaS (HealthRules Payor, GuidingCare) for health plans, directly overlapping with MHK's utilization, care management, and population health offerings.
- Casenet (Centene): Casenet provides care management technology for Medicaid and government-sponsored health plans, overlapping directly with MHK's Care Management Suite for the same payer segment.
Emerging players
- Edifecs: Edifecs specializes in healthcare interoperability, FHIR-based prior authorization, and CMS compliance workflows, competing with MHK's Interoperability Suite and electronic prior authorization capabilities.
Market position
Weaknesses5 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
MHK social profiles
Digital presenceMHK compliance and trust
Trust signalCompliance7 records
MHK financial estimates
Financial estimateRevenue estimate
Valuation estimate
MHK leadership team
Management profileNumber of profiles
Profiles12 records
MHK funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
MHK M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about MHK
What does MHK do?
MHK develops and sells SaaS-based healthcare technology platforms — CareProminence (clinical/operational) and MarketProminence (administrative/enrollment) — for health plans and pharmacy benefit managers. The platforms unify utilization management, care management, population health, pharmacy management, complaints/appeals/grievances, enrollment, premium billing, and financial reconciliation. Solutions are augmented by the SmartProminence AI Orchestrator, FHIR-native interoperability suite, and DataVisor analytics.
Is MHK a public or private company?
MHK is a private company. It is classified as corporate owned and is currently operating.
When was MHK founded?
MHK was founded in 2010. It employs 251 to 500 people.
Where is MHK based?
MHK is headquartered in Tampa, United States, in the North America region.
How does MHK make money?
One revenue line is on record: saaS Subscription.
Who are MHK's main competitors?
Broad incumbents on record are Optum (UnitedHealth Group), Change Healthcare (Optum) and Oracle Health. Direct peers are Inovalon, Cognizant (Trizetto), Medecision, ZeOmega, HealthEdge and Casenet (Centene). Edifecs is listed as an emerging player.
Does MHK have an API?
Yes. MHK offers FHIR-based APIs aligned with CMS interoperability mandates (CMS-0057-F). The platform supports Patient Access API, Provider Access API, Payer-to-Payer API, and electronic prior authorization APIs including Coverage Requirements Discovery (CRD), Documentation Templates and Rules (DTR), and Prior Authorization Support (PAS). The interoperability solution supports Da Vinci burden reduction standards and SMART on FHIR authentication patterns. Additional API categories include: Claims Systems, Clinical Decision Support, CRMs, Document Management Systems, Electronic Prior Auth (ePA), Eligibility and Provider Demographics, Health Education, External Decision Rules, Lab Data, Mail/Fax/Digital/IVR Fulfillment, Member and Provider Portals, Pharmacy Benefit Managers, Pharmacy Content, Pub/Serve Event Notifications, Quality and Risk Adjustment, Social Determinants of Health, and SSO integrations. AWS HealthLake is used for managing FHIR-based API interoperability. Developer documentation is at mhk.com/solutions/mhk-careprominence/mhk-interop-suite.
What industry is MHK in?
MHK's product category is Healthcare SaaS / Care Management Software. Its primary akta.pro industry code is HLACAKAL, Medication Analytics, Outcomes & Cost Optimization, with a secondary code of HLACAEAO, Patient Relationship Management (PRM) & CRM for Provider Growth (Marketing/Outreach). Its NAICS code is 541512 and its SIC code is 7372.