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Healthcare operations

Clinical Decision Support

We bring together the clinical and financial to drive appropriate, high-value care.

Transformative UM solutions

Payers and providers are united in their goal to deliver the highest-quality and most appropriate care while also striving to eliminate unnecessary costs. While utilization management (UM) is vital to appropriate care, it’s often challenged with clinical resource shortages, inefficient workflows, fragmentation and rising costs.

Optum provides comprehensive solutions to address your UM needs.  We can help you:

  • Transform your current UM processes with advanced technology solutions
  • Outsource the entirety of your program
  • Partake in a hybrid approach

Optum solutions are flexible and meet your UM needs to help strengthen your organization’s clinical operations and revenue integrity.

Clinical Decision Support Solutions

CareSelect

Point-of-order clinical decision support solutions to increase appropriate ordering and drive high-value care across the enterprise.

Case Advisor

Artificial intelligence (AI) and evidence-based content are combined in this comprehensive utilization management (UM) workflow solution.

InterQual

Our evidence-based clinical decision support solution for payers, providers and government agencies.

InterQual Coordinated Care

An integrated, cloud-based care coordination solution for complex care management.

Integrated Utilization Management

A comprehensive outsourced solution that combines expert operations with powerful AI-enabled technology to conduct timely, accurate nurse and physician reviews.

Technology Consulting

Our solutions improve efficiency, lower costs and deliver value across the healthcare ecosystem.

Related healthcare insights

Article

We follow the science and defend against bias

See how Optum follows the science where it leads, validating the research we find to uphold the clinical integrity of InterQual content.

On-demand webinar

Adventist West’s success through redesigning and automating UM

Discover how to leverage automation for centralized, exception-based utilization management.

Article

Promises and pitfalls: AI and clinical decision-making

Learn more about why evidence-based criteria and clinician insight are needed for informed and trustworthy decisions while leveraging AI.

On-demand webinar

The ASAM Criteria® Navigator, 4th edition

Learn how to streamline efficiency and consistency of the utilization review process.

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