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Complex Medical Management

Our specialty network offers focused clinical interventions to improve outcomes, reduce unit costs and deliver enhanced member experiences.

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Manage unit cost and network access

Optum operates high-performance, specialty provider networks addressing complex medical conditions. Our Centers of Excellence (COEs) and other specialized clinical networks connect you to enhanced network access and better contract rates, and prevent non-compliance issues.

Improve outcomes and quality

We help improve utilization trends, reduce spend and incidence variability. We identify members for clinical interventions.

Our clinical expertise includes:

  • Condition-specific MDs
  • Specialty nurse case managers
  • Expert panel oversight of our qualification process

Enhance member experience

We help minimize administrative burden, and our specialized clinical team guides members through the health care system. As members become more engaged with their own health care journey, they receive a positive experience with improved outcomes.

How we help

Bariatric Resource Services

Support your employees before and after weight-loss surgery to improve their potential for success.

Chronic Kidney Disease Stage 4–5

Provide comprehensive, cost-effective disease management.

Discover how to partner with Optum today