Optum
Optum is a UnitedHealth Group subsidiary providing integrated health services across care delivery (250+ locations in 20+ U.S. states), pharmacy benefit management (Optum Rx), and AI-powered technology (Optum Real claims platform), serving providers, payers, pharma, and consumers.
- Company typePrivate
- Founded1985
- HeadquartersAlbuquerque, United States
- Headcount5,001–10,000
- GTM typeB2B and B2C
- OfferingServices
What Optum does
Optum is a health services and technology platform operating as a wholly-owned subsidiary of UnitedHealth Group (NYSE: UNH). The company provides an integrated stack of healthcare delivery, pharmacy benefit management, and AI-powered technology services across 20+ U.S. states and internationally in Brazil, India, Ireland, and the UK. Optum operates 250+ care delivery locations in New Mexico (including primary care, mobile clinics, specialty care, virtual care, and Medicare services), runs pharmacy benefit management through Optum Rx, and offers specialized pharmacy services (Home Delivery, Specialty, Infusion, Frontier Therapies for rare diseases), as well as divvyDOSE (pre-sorted medication delivery) and Genoa Healthcare (behavioral health pharmacy).
The company's technology platform centers on Optum Real, an AI-powered real-time claims processing platform developed in partnership with Microsoft, integrating Microsoft Azure cloud infrastructure, Dragon Copilot (with 100,000+ active users), and Microsoft Foundry. Optum applies AI/ML across claims processing and prior authorization automation, population health predictive analytics, Computer-Assisted Coding (CAC) for ICD-10/CPT, clinical documentation via Suki collaboration, and healthcare ETL pipelines standardizing data from 20+ U.S. states. The company is identified as a major market leader in healthcare revenue cycle management alongside Cerner and McKesson.
Optum's business model operates across multiple revenue streams: enterprise B2B technology licensing (claims processing, RCM, prior authorization for healthcare providers and payers), pharmacy benefit management fees and drug margin, direct-to-consumer care delivery fees, consumer financial products (Health Savings Accounts), and parent-internal services to UnitedHealthcare. The company has expanded through significant M&A, including the 2023 acquisitions of Amedisys ($3.3 billion all-cash) for home health and hospice capabilities and Change Healthcare assets ($8.3 billion) for data analytics and technology infrastructure. Customer segments span healthcare providers, payers, pharmaceutical/life sciences companies, technology vendors, and individual consumers. The company is led by CEO Patrick Conway.
Optum firmographics
Firmographics- Name
- Optum
- Legal name
- Optum, Inc.
- Website
- https://nm.optum.com
- Company type
- Private
- Founded year
- 1985
- Operating status
- Operating
- Headcount range
- 5,001–10,000 employees
- Short description
- Optum is a UnitedHealth Group subsidiary providing integrated health services across care delivery (250+ locations in 20+ U.S. states), pharmacy benefit management (Optum Rx), and AI-powered technology (Optum Real claims platform), serving providers, payers, pharma, and consumers.
- Ownership category
- akta.pro rank
Optum industry classification
Industry- Product category
- Healthcare Services and Technology
- NAICS
- Offices of Physicians (except Mental Health Specialists) (621111), Pharmacies and Drug Retailers (456110)
- SIC
- Services-Offices & Clinics Of Doctors Of Medicine (8011)
- akta.pro primary industry
- Primary Care & General Medicine Virtual Care (HLALAAAA)
- akta.pro secondary industries
- Group Pharmacy Benefit (Rx) Coverage & PBM-Integrated Plans (FSAIAFAN), Pharmacy Information Systems (PIS) & Dispensing Workflow (HLACAKAC)
Keywords
Where Optum is headquartered
LocationHeadquarters
- HQ city
- Albuquerque
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
Optum business model
Business model- GTM type
- B2B and B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Infrastructure, Supply Chain, Marketing or Sales
Distribution channels4 records
Marketing channels8 records
Optum product offering
Product offeringCore offering
Optum is a health services and technology company that operates pharmacy benefit management (Optum Rx), primary and specialty care delivery across 250+ U.S. locations, and AI-powered revenue cycle and claims processing platforms (Optum Real). It also provides population health analytics, prior authorization automation, infusion and specialty pharmacy services, and consumer health savings accounts.
Product overview
Optum is a health services and technology company operating as part of UnitedHealth Group, offering a broad platform of products spanning healthcare delivery, pharmacy services, financial accounts, and AI-powered analytics. The core portfolio includes Optum Real (an AI-powered real-time claims processing platform developed with Microsoft), a full pharmacy services suite (Optum Rx, Home Delivery Pharmacy, Specialty Pharmacy, Infusion Pharmacy, Frontier Therapies, divvyDOSE, and Genoa Healthcare), patient-facing care delivery (Optum New Mexico with 250+ locations, OptumMD concierge medicine, virtual care, mobile clinics), patient engagement tools (MyChart patient portal), and financial products (Health Savings Accounts). Optum also provides population health management analytics, AI-powered prior authorization, and revenue cycle management solutions. The product architecture combines a technology platform (AI/ML-driven claims processing and analytics) with a network of care delivery sites and pharmacy benefit management services.
Differentiator
Problem solved
Functional benefit
Brands
- Optum Rx: Pharmacy benefits management and home delivery pharmacy services
- Optum Real
- Optum Infusion Pharmacy
- OptumMD
- Genoa Healthcare
- divvyDOSE
- Frontier Therapies
- OptumMD
Products and services
- Optum Real AI-powered real-time claims processing platform developed with Microsoft (Azure, Dragon Copilot, Microsoft Foundry) that streamlines claims validation, clinical documentation, and prior authorization for healthcare providers and payers.
- Optum Rx Pharmacy benefit management and home delivery pharmacy service for members with pharmacy insurance benefits through Optum, offering prescription management, refills, and delivery through web and mobile applications.
- Home Delivery Pharmacy Mail-order home delivery pharmacy allowing patients to register or sign in, fill prescriptions, and have medications delivered directly to their home, part of Optum's pharmacy services portfolio.
- Specialty Pharmacy Specialty prescription fulfillment for complex therapies, integrated within the broader Optum pharmacy services ecosystem for patients with complex or chronic conditions.
- Infusion Pharmacy Infusion therapy management service that allows patients to manage infusion therapies, including Optum Infusion Pharmacy services used in value-based care arrangements such as Kelsey-Seybold Clinic.
- Frontier Therapies Dedicated offering for patients requiring orphan and specialty drug therapies, managing medications for rare diseases within Optum's pharmacy portfolio.
- divvyDOSE Medication management service that pre-sorts medications by day and time and delivers them to patients' homes, offering adherence support for complex medication regimens.
- Genoa Healthcare Pharmacy and telepsychiatry services managing medications for mental health and complex conditions, serving behavioral health patients within Optum's pharmacy portfolio.
- Optum New Mexico Care Locations Primary care, specialty care referrals, imaging, virtual care, mobile clinic, and Medicare-focused services for adults and children across 250+ locations in New Mexico.
- OptumMD Membership-based primary care and concierge medicine practice offering longer visits, same-day/next-day sick appointments, telemedicine, and after-hours physician access.
- MyChart Patient Portal Patient portal powered by Epic MyChart that enables patients across Optum's care locations to schedule appointments, access medical records, message care teams, pay bills, request medication refills, and manage their health from home.
- Health Savings Account (HSA) Optum Financial Services Health Savings Account that helps members save and pay for healthcare expenses, including account management, balance checking, balance transfers, and HSA tax center resources.
- Optum Claims Processing Automated claims processing software covering the full claims lifecycle from eligibility verification to payment reconciliation, ranked among the top 10 platforms in healthcare alongside Waystar, Availity, and TriZetto.
Quantifiable outcome
- Improved billing cycles and fewer claim denials through AI-powered claims management
- +2 more outcomes
Companies that use Optum
Customer profileNamed customers3 records
Segments5 records
Ideal customer profiles4 records
Optum technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration4 records
AI capability14 records
Feature5 records
Optum partnerships and signals
Strategic signalPartnerships
Seven partnerships are on record, tiered core and minor.
- MicrosoftcoreOptum partnered with Microsoft to introduce AI-powered capabilities within Optum Real, a real-time claims processing platform. The platform integrates Optum's healthcare and AI expertise with Microsoft's cloud and AI technologies including Microsoft Azure, Dragon Copilot, and Microsoft Foundry to improve claims validation, documentation, and prior authorization processes for healthcare providers.
- ANSRminorANSR announced launch of Healthcare GCC Accelerator Platform in Bengaluru, India, combining ANSR's GCC model with healthcare AI capabilities from Optum. The platform aims to modernize operations and embed AI into workflows for healthcare enterprises building AI-enabled global capability centers.
- SukicoreOptum Real and Suki are collaborating to improve real-time claims management and clinical documentation workflows, unveiled during HIMSS 2026 conference. The collaboration aims to reduce administrative errors and costs by leveraging AI to enhance claims accuracy and speed, with early results indicating improved billing cycles and fewer denials.
- Microsoft Dragon Copilot EcosystemcoreOptum is integrated as a third-party health tech partner in Microsoft's Dragon Copilot product at HIMSS26, providing real-time insights and guidance within clinical workflows. The unified AI features aim to reduce administrative burden for clinicians and revenue cycle teams with over 100,000 Dragon Copilot users currently active.
- CHC ConsultingminorCHC Consulting launched Options RCM, a revenue cycle management service for rural and community hospitals providing analytics, processes, and personnel support. Optum is listed as one of the contracted vendors alongside Currance for the service.
- CHC Consulting Options RCMminorOptum is ranked among top 10 automated claims processing software platforms in healthcare, listed alongside Waystar, Availity, TriZetto Provider Solutions, Experian Health, FinThrive, R1 RCM, eClinicalWorks, and SSI Group.
- Origins Texas RecoveryminorOrigins Texas Recovery, a provider of gender-specific addiction treatment in South Padre Island, Texas, partnered with Optum/United Behavioral Health to expand insurance coverage, making addiction care including detox, residential, and outpatient programs more accessible.
Scale indicators9 records
Recent moves6 records
Expansion highlights6 records
Optum competitors and assessment
Company assessmentDirect peers
- CVS Health: CVS Health operates the largest U.S. retail pharmacy chain (CVS Pharmacy), pharmacy benefit management (Caremark), and Aetna insurance - directly overlapping Optum's PBM, retail/home pharmacy, and care delivery verticals. Both are integrated payer-provider-pharmacy platforms.
- McKesson Corporation: McKesson is a major pharmaceutical distributor and healthcare IT/services provider, named alongside Optum as a key Healthcare RCM market player. Both serve payers, providers, and pharma with technology and distribution infrastructure.
- Epic Systems: Epic Systems is the dominant U.S. electronic health record vendor and was highlighted alongside Optum as a market mover in Population Health Management. Optum's MyChart patient portal runs on Epic, illustrating both partnership and competitive overlap in health IT.
- Humana: Humana operates a major Medicare Advantage insurer alongside CenterWell primary care and home health delivery, directly competing with Optum's senior-focused primary care and home-based services (Optum New Mexico, Amedisys). Both pursue value-based care for Medicare populations.
- Cerner Corporation (Oracle Health): Cerner, now part of Oracle Health, is a leading electronic health records and revenue cycle management vendor - explicitly named alongside Optum as a key Healthcare RCM player. Both serve large provider customers with claims and clinical workflow technology.
- Elevance Health: Elevance Health (formerly Anthem) operates Blue Cross Blue Shield plans alongside Carelon health services, mirroring Optum's positioning as a payer-aligned health services and analytics arm. Both compete for payer-provider analytics, care delivery, and pharmacy services contracts.
- Waystar: Waystar is a healthcare revenue cycle and claims management platform explicitly listed alongside Optum among the top 10 automated claims processing software platforms for healthcare organizations in 2026. Both compete for hospital and health system RCM contracts.
- R1 RCM: R1 RCM provides technology-driven revenue cycle management services to hospitals and health systems, also listed among the top 10 automated claims processing platforms for 2026. Directly competes with Optum's claims processing and RCM offerings.
- Availity: Availity operates one of the largest healthcare information networks, connecting payers, providers, and technology vendors for eligibility, claims, and clinical data exchange - overlapping with Optum's data interoperability and claims management capabilities.
- Cognizant (TriZetto): TriZetto Provider Solutions, part of Cognizant, is listed among the top automated claims processing platforms for healthcare in 2026 and provides payer-provider IT and BPO services directly comparable to Optum's RCM and claims management portfolio.
Market position
Competitive moat6 records
Key risks5 records
Key highlights6 records
Customer concentration
Optum social profiles
Digital presenceOptum financial estimates
Financial estimateRevenue estimate
Valuation estimate
Optum leadership team
Management profileNumber of profiles
Profiles3 records
Optum subsidiaries and ownership
Company hierarchySubsidiaries8 records
Optum funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Optum M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Optum
What does Optum do?
Optum is a health services and technology company that operates pharmacy benefit management (Optum Rx), primary and specialty care delivery across 250+ U.S. locations, and AI-powered revenue cycle and claims processing platforms (Optum Real). It also provides population health analytics, prior authorization automation, infusion and specialty pharmacy services, and consumer health savings accounts.
Is Optum a public or private company?
Optum is a private company. It is classified as corporate owned and is currently operating.
When was Optum founded?
Optum was founded in 1985. It employs 5,001 to 10,000 people.
Where is Optum based?
Optum is headquartered in Albuquerque, United States, in the North America region.
Who are Optum's main competitors?
Direct peers on record are CVS Health, McKesson Corporation, Epic Systems, Humana, Cerner Corporation (Oracle Health), Elevance Health, Waystar, R1 RCM, Availity and Cognizant (TriZetto).
Does Optum have an API?
No public API is recorded for Optum.
What industry is Optum in?
Optum's product category is Healthcare Services and Technology. Its primary akta.pro industry code is HLALAAAA, Primary Care & General Medicine Virtual Care, with a secondary code of FSAIAFAN, Group Pharmacy Benefit (Rx) Coverage & PBM-Integrated Plans. Its NAICS code is 621111 and its SIC code is 8011.