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Optum Specialty Management

Simplify specialty care with medical and pharmacy solutions that deliver enhanced analytics to inform strategy and lower costs.

Every patient deserves the simplest path to care. At Optum, we’re reimagining the health care experience with leading-edge solutions across medical and pharmacy needs. We're also removing barriers to getting the right care — even for patients with the most complex needs.

Grounded in deep clinical expertise and backed by the latest technology and data, we deliver innovative tools and integrated capabilities to address specialty needs in oncology, rheumatology, cardiovascular and transplant care.

And by layering on rich analytics and reporting, we provide actionable insights to improve specialty strategies and augment savings along the way.

We simplify the care path for patients with complex needs

Our full range of specialty management solutions helps you delivery high-quality care.

Claims and payment accuracy

Optum® Payment Integrity strengthens accuracy at every touch point in the billing lifecycle.

Claims Edit System

Edit claims for all business lines and claim types.

Emergency Department Claim Analyzers

Control rising emergency outpatient facility cost.

Itemized Bill Review

Save on high-dollar inpatient cases.

Kidney Disease Management

Attain comprehensive, cost-effective disease management.

Laboratory Benefit Management

Manage all routine and genetic lab testing spend.

Managed Transplant Program

Manage the risks of complex medical conditions.

Musculoskeletal (MSK) Solutions

Manage escalating spend and utilization.

Oncology Care Management Programs

Manage cancer costs, improve outcomes and quality of care.

Specialty Pharma Solutions

Manage specialty medical drug expenses.

Specialty Pharmacy Management

We take an integrated approach to controlling specialty costs by managing across both benefits and creating a seamless patient experience.

Transform Specialty Medication Management

Eliminate the burden of managing specialty medications separately across the medical and pharmacy benefit.

Transplant Resource Services (TRS)

TRS Network Access delivers a high-quality nationwide provider network of transplant centers and industry-leading discounts.

Transplant Solutions

Get significant savings and statistically superior outcomes.

White paper

Learn how Optum streamlines care for patients with complex needs

Our fragmented health care delivery system needs forward-thinking solutions. With Specialty Fusion, we are unraveling complexity in specialty care by applying cross-benefit drug strategies and real-time analytics at the point of care.

Our North Star is to make the health care system work better for everyone, and reducing complexity is at the core of that.

CEO, Optum Specialty Pharmacy

Erin Satterwhite

Find out how Optum simplifies complex care delivery