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Member health and care management

Optum Specialty Management

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

We simplify the care path for patients with complex needs

Every patient deserves the simplest path to care. At Optum, we’re reimagining the healthcare 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.

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

Specialty management solutions

Payment integrity solutions for health plans

Improve payment accuracy and maximize medical expense savings across the claim lifecycle.

Claims Edit System

Achieve clean claims and maximize medical spend savings with our flexible, real-time claim editing software.

Emergency Department Claim Analyzer – Facility

Control rising emergency outpatient facility costs with automated, consistent and defensible E/M (evaluation and management) coding.

Laboratory Affordability Products

Reduce your lab spend and improve patient outcomes with our comprehensive approach.

Managed Transplant Program

Manage the risks of complex medical conditions.

Musculoskeletal (MSK) Solutions

Manage escalating utilization and spend.

Oncology Solutions

Our solutions address complex challenges and help manage cancer costs while improving outcomes and quality of care.

Specialty Pharma Solutions

Manage specialty medical drug expenses.

Specialty Fusion

Experience a specialty drug management solution that does more by bringing medical and pharmacy benefits together at the point of care.

Transplant Resource Services

We offer 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 healthcare 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. 

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Unraveling complexity specialty care

Learn how Optum is streamlining care delivery with insights from patients and providers to improve outcomes and drive down costs.

Find out how Optum simplifies complex care delivery