WEBVTT

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[NARRATOR] Welcome.

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Today we're
going to walk you through

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the Optum Community Engagement
Verification Solution,

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a streamlined, data-first approach

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that helps states meet
H.R. 1 requirements

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without rebuilding
eligibility systems.

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We'll show you how
the components work together,

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what the experience looks like
for staff and members,

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and how states can implement this
quickly and safely.

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Before we jump into the demo,

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here's the foundation it's built on.

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Optum works in all 50 states,

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across eligibility, data analytics,

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call centers,
and program operations.

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This broad footprint
allows us to design solutions

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that fit easily
into existing environments.

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And that's exactly
what we've done here.

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Everything you'll see
in this walkthrough

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reflects real challenges
states have shared

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and real constraints they're facing.

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Let's briefly frame
\what you're about to see.

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H.R. 1 adds new community engagement
verification requirements

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and very tight timelines.

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So our goal is simple.

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Create a solution
that performs verification

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around the eligibility system,
not inside it,

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making it fast to implement
and low risk to maintain.

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States told us they need automation,

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clarity, and minimal disruption.

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They want to avoid coverage loss
caused by missing paperwork.

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They need verification
that spans multiple systems-

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eligibility, MMIS, data exchanges –

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without forcing major redesign.

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And they want tools that
reduce burden on members and staff.

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Everything in this demo
is built to address

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exactly those pain points.

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H.R. 1 goes live on a fast clock,

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with guidance still evolving
and staff already stretched.

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That's why a separate
verification service

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is so important.

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It lets you meet deadlines
without rewriting rules engines,

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retraining staff,
or overhauling workflows.

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Before we show you
the components in action,

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here are the guardrails
that shaped the design.

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One, the eligibility system
stays the system of record.

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Two, staff workflows stay the same.

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Three, every verification result
must be traceable for audits.

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And four, we always use
data before paperwork.

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These principles guide
the workflow you're about to see.

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In most states, the fastest
and lowest risk option

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is to keep eligibility where it is

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and add a verification hub
alongside it.

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That's the model
we're going to demonstrate.

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Eligibility sends a request,

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the hub runs automated checks,

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and the results
return back instantly,

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without staff leaving the system
they already use.

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Here's the full picture.

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The eligibility system
triggers verification.

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Our verification services
run data checks in real time.

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If the data confirms compliance,

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we send results and reason codes

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straight back into existing screens.

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If more information is needed,

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only then do we prompt the member
through the optional portal.

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AI supports the process by reading
and classifying documents,

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but never making
eligibility decisions.

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It simply gives staff stronger,

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clearer information
without changing their workflow.

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Let's walk through the first step,
automated verification.

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When eligibility sends a request,

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our services check wage data,

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SNAP, TANF participation,

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and education data,

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whatever sources your state chooses.

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If the data confirms that
the member meets the requirement

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or qualifies for an exemption,

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we return that result immediately
with a clear explanation.

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No staff review,
no paperwork, no delays.

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States decide
which data sources to use

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and the order
in which they're checked.

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Think of this as
a configurable rule set.

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Prioritize state wage data,

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layer in SNAP, TANF information,

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then education enrollment,
then third-party sources.

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Every result is fully traceable.

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You always know what data
produced the verification.

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Now let's look at what happens

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when the data
can't confirm compliance.

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That's when
the member portal comes in.

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It's mobile first, simple,

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and only used
when absolutely necessary.

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Members can upload documents,

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report work or education activities,
or submit exemptions.

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Behind the scenes,
documents are automatically sorted,

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read with OCR,
and checked for completeness.

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States see fewer paper forms,

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fewer phone calls
asking for status updates,

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and faster turnaround because
the portal guides members

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through what's needed.

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All of this flows through
the integration layer,

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the plumbing that keeps
everything connected

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without changing your systems.

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It aligns identifiers,
uses secure APIs,

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and sends updates in real-time.

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It also logs everything
for audit and appeals,

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and it becomes a reusable foundation

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for future modernization
across programs.

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The big advantage here is speed.

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States can typically go from
kickoff to production

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in just a matter of weeks

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because we're configuring,
not rebuilding.

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Integration is predictable.

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Testing is straightforward,

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and you can phase in
components over time.

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From the staff perspective,
nothing changes.

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They stay in
the same eligibility system.

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They simply see
new verification results show up,

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just like other
electronic verifications today.

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No new screens, no new dashboards,

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no new workflows.

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States choose this approach
because it minimizes risk.

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Verification is automated,

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but eligibility decisions
remain where they belong,

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in the state's system.

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AI assists rather than decides.

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And because everything flows
through the state system of record,

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audits and appeals
stay clean and defensible.

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It's modernized verification
without imposing new workflows

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or new vendor run decisioning.

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To wrap up,
this model can help provide

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a lower risk path
to H.R. 1 compliance.

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It's fast to deploy,
fully fundable with 90-10 match,

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and ready to extend to SNAP, TANF,

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and future modernization.

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Most importantly,
it enhances verification

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without disrupting eligibility.

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We're here to help you explore

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what this could look like
in your state.