Who We Are

At Koan Risk Solutions, Inc., we are dedicated to delivering innovative solutions that enhance the well-being of the State of Hawaii, its citizens, and its employers. Since our inception in 2015, we have grown from managing the state of Hawaii’s organ transplant program to offering a wide array of services, including enrollment and revalidation for Hawaii Medicaid, ombudsman services for Medicaid providers and beneficiaries, and contact center services for the Department of Commerce and Consumer Affairs.

Our Mission and Vision

Mission: To assist the State of Hawaii and its people by providing excellent services, fostering employee development, and ensuring optimal client satisfaction.

Vision: To be the leading provider of healthcare and support solutions in Hawaii, known for our commitment to quality, innovation, and continuous learning.

Our Values

Our Values
  • Integrity: Upholding the highest standards in all our actions.
  • Innovation: Embracing change and continuously seeking new ways to improve our services.
  • Excellence: Striving for the highest quality in everything we do.
  • Collaboration: Believing in the power of teamwork and partnership.
  • Continuous Learning: Fostering a never-ending learning environment to ensure optimal client satisfaction.

Our Expertise

Our team comprises exceptionally talented professionals who are passionate about serving the needs of Hawaii. Koan employees bring a wealth of experience and expertise in various areas, ensuring comprehensive and high-quality service delivery:

Healthcare System Management
  • Healthcare System Management: Expertise in managing complex healthcare systems, including the State of Hawaii Medicaid (Med-QUEST) Program, catastrophic care management, and community-embedded care management and support services.
  • Provider Enrollment and Revalidation: We excel in the complex process of provider enrollment and revalidation, creating efficient processing systems and customer service engagement that significantly surpasses the service levels set by stakeholders. Utilizing CRM and CTI technologies, we ensure compliance, accuracy, and timely processing, easing the burden on both providers and stakeholders.
  • Claims and Provider Services: Specialized in medical claim processing and adjudication, ensuring compliance and efficient handling of applications, coordinating closely with providers and their staff, and maintaining Medicaid databases.
  • Contact Center Operations: Skilled in call center operations, caller authentication/verification, case/caller de-escalation, and providing status updates and licensing information. We leverage Computer Telephony Integration (CTI) and build knowledge bases customized to fit client needs, with staff trained to meet stakeholder requirements.
  • Ombudsman Services: Providing education on managed care, assisting with navigation through the managed care system, guiding through the grievance and appeal process, supporting beneficiaries with complex healthcare needs, and resolving issues informally through quality improvement health plans.
  • Comprehensive Case Management: Offering thorough case management, care coordination, travel and lodging accommodation coordination, and contract and LOA creation and maintenance.
Contact Center Operations

Our Commitment

The high quality of our work stems from a culture of supportive, effective teamwork. Our diverse consortium of partners drives our strategies and solutions, ensuring that we prioritize goals and deliver a level of service that benefits all stakeholders.

Our Journey

Since 2015, we have continuously expanded our services and capabilities to better serve Hawaii’s healthcare and support needs. Our journey has been marked by a commitment to excellence and a passion for making a positive impact.

Join Us on Our Journey

We invite you to learn more about how Koan Risk Solutions can support your needs. Contact us today and become a part of our mission to transform healthcare and support services in Hawaii.