AI that makes healthcare better for everyone
Turn AI ambition into measurable results by combining deep healthcare expertise, differentiated data assets, market-ready technology and proven delivery.
Optum has thousands of active use cases — including over 500 generative AI applications — in place today. Our workflow automation and responsible AI-based solutions help healthcare organizations harness the power of AI to improve:
- Efficiency
- Patient experiences
- Health outcomes
Driving real-world outcomes with enterprise healthcare AI
Healthcare operations
Improve claims accuracy and speed with AI-driven validation, adjudication and exception handling. Automate decisions, reduce delays and denials, detect anomalies, strengthen coding and documentation and enhance customer interactions with real-time AI assistance.
Explore our offerings:
- Claims
- Contact Center
- Payment Integrity
- Prior Authorization
- Risk & Quality
Digital operations
Optimize cloud and AI investments to improve performance, control costs and scale solutions. Transform unstructured content into actionable data, strengthen security with AI-driven protection, build reliable data pipelines and capture real-time clinical insights to reduce documentation burden.
Explore our offerings:
- AI Data Engineering
- AI for the CISO
- Ambient Technology
- Cloud Optimization
- Document Intelligence
AI transformation & workforce
Scale AI adoption with governance, workforce enablement and embedded teams that accelerate deployment and outcomes. Enhance productivity with AI agents, build AI fluency across the workforce and improve execution through AI-assisted project management aligned to business priorities.
Explore our offerings:
- Aegis Agentic PMO
- Agentic Workforce Transformation
- AI Learning & Development
- AI Transformation Office
- Zero-Distance AI Engineering
Analytics and insight
Uncover risks and root causes across claims, payments and clinical workflows with AI-driven analytics. Predict disruptions, improve system performance, enrich provider data for better decisions and identify high-impact process improvements through workflow intelligence.
Explore our offerings:
- Forensics AI
- Predictive Maintenance
- Provider Data Intelligence
- Task & Opportunity Mining
Life sciences
Accelerate life sciences innovation with AI-powered clinical trials, biomarker discovery, molecular design and predictive modeling. Improve engagement with real-world data, automate lab workflows to boost efficiency and enhance drug safety through AI-driven monitoring and case management.
Explore our offerings:
- Clinical Trial Operations
- Computational Science
- Intelligent HCP Engagement
- Laboratory Automation
- Pharmacovigilance
Applying our healthcare AI expertise
Proven AI solutions enable real innovation, simplified operations and improved outcomes.
Expert-led AI integration
We deploy expert teams uniquely skilled in both healthcare and AI to lead every part of your AI transformation.
Connected solutions
Our integrated, tested AI solutions deliver results across thousands of use cases in our own care settings and at partner sites — at scale.
Responsible and human-first
We apply AI responsibly, using deep technical expertise and ethical frameworks, while prioritizing human control and decision-making.
Collaborative partnerships
We work together with you — from problem definition through activation — to deliver a custom solution that’s right for your organization.
Explore solutions powered by
Optum AI innovation
Clinical decision support solutions
Case Advisor
Artificial intelligence (AI) and evidence-based content are combined in this comprehensive utilization management (UM) workflow solution.
InterQual Auth Accelerator
Our evidence-based clinical decision support solution for payers, providers and government agencies helps ensure clinically appropriate medical utilization decisions.
InterQual AutoReview
This medical review automation solution increases utilization management (UM) efficiency and review accuracy.
Hospital Case Management Optimization
We offer real-time data and analytics, applied innovation, and expert guidance and investment in case management to optimize performance.
Data and analytics solutions
Life sciences solutions
Drive results across the drug development lifecycle with real-world data, analytics and clinical expertise — helping you move from concept to impact faster.
Crimson AI
Unlock healthcare data and transform it into robust business intelligence using AI-enabled feedback and suggested interventions.
Crimson AI Provider Review
Streamline physician review management and improve provider engagement with a unified AI-enabled workflow tool.
Crimson AI Surgical Capacity
Optimize surgical scheduling and operating room utilization with data-driven analysis and insights.
Crimson AI Surgical Cost Module
Enhance surgical service line profitability by utilizing data-driven insights to streamline costs and improve efficiency.
Financial solutions
Claim Review
Prevent improper payments, reduce medical spend and minimize provider abrasion with our comprehensive suite of pre- and post-pay solutions.
Third-Party Liability
Identify and validate primary policy coverage with accurate eligibility data.
Optum Integrity One
Unlock new levels of efficiency, accuracy and revenue integrity with our revolutionary end-to-end solution for the middle revenue cycle.
Clinical Language Intelligence (CLI)
Learn how Optum AI products use natural language processing (NLP) to make healthcare work smarter.
Operations and technology solutions
Change Healthcare Radiology Solutions
Improve productivity with an AI-enabled enterprise radiology portfolio to streamline workflow.
Optum Real
Improve transparency and administrative efficiency through real-time payer-provider connection.
Comprehensive coding solutions
Explore a robust suite of AI-driven coding solutions with options to fit healthcare organizations of every size and structure.
Retrieval Services
Industry-leading chart retrieval services with a national footprint and continually expanding digital retrieval methods.
Pharmacy benefit management solutions
Smarter Pharmacy Benefits with AI
We’re using responsible artificial intelligence (AI) capabilities to supercharge pharmacy benefit experiences and drive meaningful results.
Related healthcare insights
Case study
See how AI-powered technology and personalized member engagement are helping to identify and enroll more members into Medicaid programs.
White paper
A strategic blueprint to modernize your payment integrity program through intelligent, AI-driven health plan operations.
Article
Learn how Optum takes an innovative approach to smarter, more accurate healthcare coding.
White paper
Transform claims with AI and API integration to reduce denials, strengthen transparency and drive more efficient, intelligent operations.
*First Case On-Time Start (FCOTS) rate measures the percentage of first-scheduled surgical cases in a day that begin exactly at the scheduled time.