AI Co-Pilot Services

The Vendor is required to provide to deploy an AI-enabled workflow-integrated co-pilot to support the end-to-end prior authorization processes and support various components of the utilization management (UM) function, including prior authorizations and appeals processes.
- Solution would ideally integrate into agency existing UM environment (including but not limited to QNXT, excel, SharePoint, etc.) and support the following core capabilities:
•    Automated document ingestion and data extraction
•    Policy and clinical guidance surfacing
•    Auto-approval and streamlined review support
•    Intelligent routing and triage
•    Determination support and letter automation
•    Reviewer analytics and operational transparency
•    AI governance, security, and compliance
•    Implementation approach.