Support for happier, healthier and more productive employees
Optum Guide™ provides your employees with meaningful, proactive support to improve engagement with their healthcare benefits. Our approach helps employees achieve healthier outcomes at a lower cost by offering:
- Integrated clinical resources and data in a streamlined, simplified benefit experience
- Personalized guidance for each individual’s unique needs and goals
- Optum Guide Advocacy includes convenient access to care guides and nurses plus expert multidisciplinary support from behavioral specialists, research advisors, pharmacists, medical directors and social and lifestyle support experts
Helping employees get needed care and support
A powerful partnership driven by clinical expertise
Our dedicated team of clinicians and specialists provides one-on-one guidance for members and their families with more complex needs.
NurseLine services
NurseLine healthcare experts are available by phone 24/7/365. They provide general health information, verify provider networks and availability, promote healthy living, help reduce ER visits and more.
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HEATHER LOOK: Here we go.
JEREMY SELKO: Optum Guide is a member service model that's really, truly making healthcare human.
HEATHER LOOK: The service we built is helping people navigate healthcare much more simply.
SHAWN MCNATIN: People need help. People need a copilot. People need somebody who looks out for them, who is an industry insider.
STEPHANIE MEYER: Every opportunity we get to connect with a member, we take very seriously. It started with members that had children that had special needs. We noticed that these members were having an incredibly challenging time navigating the system. We also recognized that while we proved out there was a value to helping members in that way, there were certainly broader needs across the healthcare system that were not focused on dependents with special needs.
HEATHER LOOK: Members with complex conditions have even more to navigate. It's our job to help them make sure to get the most out of all the benefits that their employer has provided.
JEREMY SELKO: We want people to live healthier lives, holistically. We want to guide people through to root cause solutions.
HEATHER LOOK: Our guides do whatever it takes to help members navigate healthcare. Healthcare is hard, and we need to be able to make it easy.
STEPHANIE MEYER: And helping bring clinical and administrative needs together, in an on demand model for members, is not only what they need, it’s helping heal the healthcare system kind of one member at a time.
SHAWN MCNATIN: When they don't have that advocate, they're not getting the best care. They're not getting the highest quality. And their health suffers, they spend more on health care, there's bad outcomes, the payers suffer. And so the whole ecosystem is impacted by those poor decisions and lack of knowledge.
JEREMY SELKO: Our people are making incredible differences in the lives of those they serve, and they take it very personally. We've had instances where our agents, our advocates, have been invited to weddings.
PATIENT ADVOCATE: How are you doing?
FEMALE PATIENT: Good.
JEREMY SELKO: They're not just patients. They're not just a number on an ID card. They're part of our family.
SHAWN MCNATIN: They just never expect this out of their insurance company or their plan sponsor or the customers that buy our services. It's a wow factor almost every time.
JEREMY SELKO: My mom recently had cancer. I wish she had someone that stood by her, removed all of the barriers, allowed her to just focus on her illness and overcoming it, enjoying and embracing her family. That's what we do.
STEPHANIE MEYER: That's why this work is important. We're not only trying to change advocacy inside of Optum, we're trying to change the way healthcare is delivered in the US, and this is one step closer to that.
The making of Optum Guide
Hear from the amazing people behind the scenes helping to make health advocacy solutions work for you.
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Jessie, Care Guide
[BACKGROUND MUSIC PLAYING THROUGHOUT THE VIDEO]
[LOGO: OPTUM]
[VIDEO OF JESSIE PREPARING IN A STUDIO, PREPARING FOR HER TALK]
[JESSIE SPEAKING ON SCREEN]
JESSIE: There's not an issue that is too big for us.
[Text On Screen – Your employee’s benefits offer access to Optum Guide, a resource that provides your employees with personalized care.]
[Text On Screen – Jessie is part of your employee’s Care Guide member support team.]
[Text On Screen – Working with your employee’s step by step to explore solutions for them and their families.]
There's not a challenge that's too big for us.
[Text On Screen – Jessie, Care Guide]
I began with this member. I heard immediately the distraught mom. And as a mom myself, I could relate.
[Text On Screen – Jessie helped a mother get the care her son with autism needed.]
She was notified from the provider that the claims were denying, for her son. After the initial fix of the claims, we quickly realized that every week the claims were denying. I remember at one point I reached out to the provider as well, and I shared with them, the last thing we want is to have services interrupted, so here's my number. They never missed a therapy session after that.
[Text On Screen – Jessie also helped secure a specialized bed for the member’s son.]
To be that person's voice and actually get something done that is going to be incredibly impactful for the member, I will tear up because the joy and the hard work that we had put in, it worked. We did what I'm there to do, to go into it and want to make the difference and see this type of outcome. Best job in the world.
[LOGO: OPTUM]
[Text On Screen – Optum, Connect with a Care Guide today at no extra cost.* Download the Optum app or visit guide.optum.com. *Provided at no additional cost as a part of your health plan. This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only, benefits, services and coverage may vary based on an individual’s health plan. Please call the number on the back of your insurance card for more information. The nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor’s care. Please discuss with your doctor how the information provided may be right for you. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. © 2024 Optum, Inc. All rights reserved.]
[END MUSIC]
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Vicki, Registered Nurse, Care Guide
[BACKGROUND MUSIC PLAYING THROUGHOUT THE VIDEO]
[LOGO: OPTUM]
[VIDEO OF VICKI PREPARING IN A STUDIO, PREPARING FOR HER TALK]
[VICKI SPEAKING ON SCREEN]
VICKI: As long as I'm sitting there, I'm making a difference. That's the best part.
[Text On Screen – Your employee’s benefits offer access to Optum Guide, a resource that provides your employees with personalized care.]
[Text On Screen – Vicki is part of your employee’s Care Guide member support team.]
[Text On Screen – Whenever your employees need it, at no additional cost.*, *Provided at no additional cost as part of your employee’s health plan.]
[Text On Screen – Vicki, Registered Nurse, Care Guide]
I got a call from a member who literally was in her hospital bed, and she was afraid to go home. I needed to be her advocate. I called the facility and I asked for the discharge planner. She is elderly, does live alone. She's saying she's unsteady.
[Text On Screen – Vicki helped secure a ride home for her member.]
[Text On Screen – And made sure the driver helped the woman into her home.]
I said, how can we help her? I called her back, told her that, and she was just elated. And then afterwards I said, would it be okay if I called you in the morning and checked on you? And right away she was my first call the very next day. I called her and then we actually enrolled her in case management as well, and we worked on her getting back her balance. That was her goal, was to get her balance back then, and to understand why she had fallen in the first place. And that's exactly what she needed, and I was there for her.
[LOGO: OPTUM]
[Text On Screen – Optum, Care Guides are ready to help, get started today. Download the Optum app or visit guide.optum.com. This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only, benefits, services, and coverage may vary based on an individual’s health plan. Please call the number on the back of your insurance card for more information. The nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor’s care. Please discuss with your doctor how the information provided may be right for you. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. © 2024 Optum, Inc. All rights reserved.]
[END MUSIC]
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Nicky, Care Guide
[BACKGROUND MUSIC PLAYING THROUGHOUT THE VIDEO]
[LOGO: OPTUM]
[VIDEO OF NICKY PREPARING IN A STUDIO, PREPARING FOR HER TALK]
[NICKY SPEAKING ON SCREEN]
NICKY: I love my job because I can connect with the families. It's not like they're just a number. They become almost family.
[Text On Screen – Your employee’s benefits offer access to Optum Guide, a resource that provides your employees with personalized care.]
[Text On Screen – Nicky is part of your employee’s Care Guide member support team.]
[Text On Screen – Offering clear answers and helpful support, just a phone call away.]
[Text On Screen – Nicky, Care Guide]
I got a call and it was from a father who was very distraught.
[Text On Screen – A father and mother called about their son’s cancer journey.]
[Text On Screen – They needed an advocate.]
The member's parents were involved because he was battling throat cancer. He couldn't talk. They were calling because the bills started coming in and they were unsure how his insurance worked, and they needed help. They were so confused and I was so happy to take that burden off of them because I speak medical fluently. I was a support system to them. I was a friend to them. I would sometimes just listen. Sometimes we had hours of conversation. When calling that number on the back of your card and feeling like somebody cares, that I'm not alone, that's why I do it. Because I have felt alone. The thank yous and the gratitude that I get from the members are worth all of it, so…
[LOGO: OPTUM]
[Text On Screen – Optum, Connect with a Care Guide today at no extra cost.* Download the Optum app or visit guide.optum.com. *Provided at no additional cost as a part of your health plan. This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only, benefits, services and coverage may vary based on an individual’s health plan. Please call the number on the back of your insurance card for more information. The nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor’s care. Please discuss with your doctor how the information provided may be right for you. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. © 2024 Optum, Inc. All rights reserved.]
[END MUSIC]
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Vicki, Registered Nurse, Care Guide
[BACKGROUND MUSIC PLAYING THROUGHOUT THE VIDEO]
[LOGO: OPTUM]
[VIDEO OF VICKI PREPARING IN A STUDIO, PREPARING FOR HER TALK]
[VICKI SPEAKING ON SCREEN]
VICKI: It's just that sense of pride and that I'm making a difference.
[Text On Screen – Your employee’s benefits offer access to Optum Guide, a resource that provides your employees with personalized care.]
[Text On Screen – Vicki is part of your employee’s Care Guide member support team.]
[Text On Screen – No question or challenge is too big or small.]
[Text On Screen – Vicki, Registered Nurse, Care Guide]
In my position, it's actually two roles in one. We have the telephone triage part, which means one of our members call in and speak to a nurse immediately, and then the other part is case management.
[Text On Screen – Vicki helped a member navigate his health journey, with gender affirmation surgeries, stress management and so much more.]
[Text On Screen – Listening, acting, every step of the way.]
He was scheduled to have an MRI done. And the person checking him in says they had no record of a prior authorization. It wasn't on file. And so he's like, I know I can call Vicki. Vicki will be there to help me. He put me on speakerphone. We got it figured out for him. They found it, and he was able to have his testing, and the rest of his surgeries went as scheduled. At one spot, he was under a lot of stress, increased anxiety about it all. And so I connected him with our Life Solutions program and that was just another program to help him manage that stress. I've learned so much from him, which then I get to carry through to more members. And now I'm going to get teary eyed. He's no longer technically my member anymore, but just the other day he called me because he’s like, I know I have a nurse, but I don't have her number in my phone yet. He goes, but I knew I could get through to you, and you could help me. It feels so good to have that connection, where you did make a difference.
[LOGO: OPTUM]
[Text On Screen – Optum, Connect with a Care Guide today at no extra cost.* Download the Optum app or visit guide.optum.com. *Provided at no additional cost as a part of your health plan. This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only, benefits, services and coverage may vary based on an individual’s health plan. Please call the number on the back of your insurance card for more information. The nurses cannot diagnose problems or recommend specific treatment and are not a substitute for your doctor’s care. Please discuss with your doctor how the information provided may be right for you. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. © 2024 Optum, Inc. All rights reserved.]
[END MUSIC]
A powerful partnership driven by clinical expertise
Our dedicated team of clinicians and specialists provides one-on-one guidance for members and their families with more complex needs.
Key benefits
Providing personalized support for complex needs, we deliver outcomes that matter.
Recommended by members
With an 81 net promoter score, more and more members recommended Optum Guide.*
High member satisfaction
Members report an average of 89% satisfaction after engaging with Optum Guide.*
Helping more employees resolve issues
Optum Guide has an 89% issue resolution, ranking among the highest in the industry.*
Closing gaps in care
For each clinical enrollment in the Optum Guide Enhanced Family Support model, we create an average $2,154 value of closed gaps.*
Related healthcare insights
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Navigating a complex healthcare environment is challenging. Using hub and advocacy solutions together helps employers and employees alike.
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A great health advocacy program helps employees get the most out of their benefits while fostering strong health outcomes and savings.
An active approach to advocacy can help improve member experiences while driving down costs. Read our e-book to learn how.
Product information and resources
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Case study
Kate’s story
See how we helped a mom in need of pediatric behavioral health resources.
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Case study
Max’s story
Find out how we supported the needs and preferences of a member with diabetes.
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Case study
Cheryl’s story
When a grieving member needed ongoing and holistic support, we stepped in.
Complementary solutions
NurseLine Services
Optum Hub
*2024 Optum book of business data