What is Optum Utilization Management?

Optum Utilization Management refers to the process managed by Optum, a health services and innovation company, that reviews and evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients. The goal is to ensure that patients receive the right care at the right time while controlling costs and maintaining quality. Utilization management teams at Optum work with healthcare providers, payers, and patients to assess treatment plans, authorize services, and recommend alternatives if necessary. This process often involves pre-authorization, concurrent review, and post-service review of medical services.