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About Us

OUR STORY

Optum has been serving the needs of workers’ compensation
and auto no-fault payers for over 44 years. Our programs and services are coordinated, holistic solutions that go beyond
simple transactional savings
to address an injured person’s complete treatment. 

Pharmacy Care Services
Ancillary Services
Medical Services
Settlement Solutions

By managing it all, we help you manage utilization, control costs and minimize risks for injured people. We call this Total Care Management…it is the Optum way.

Our solution focuses on your needs and is based on three foundational pillars:

Network Management

Maximizing network penetration, increase savings and capture data for accurate reporting.

Clinical Care Management

Delivering appropriate care to improve the recovery process, control costs and facilitate claim closure.

Client Support and Tools

Utilizing client tools to streamline training, identify emerging risk and provide real-time insights.

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Additional Information

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For more info email
ExpectMore@optum.com

Speakers Bureau

Some of the brightest people in the workers’ compensation and auto no-fault industries choose to work at ​Optum. The group below are much sought-after thought leaders who have presented at the industry’s leading conferences. To inquire about availability for speaking engagements and media interviews, please contact us.

Lavonya Chapman

Esq, RN, CMSP Settlement Solutions

Speaker Info

Tron Emptage

Chief Clinical Officer

Speaker Info

Matthew Foster, Pharm.D.

Clinical Pharmacy Manager

Speaker Info

Adam Fowler

Manager - Public Policy and Regulatory Affairs

Speaker Info

Robert Hall, M.D.

Corporate Medical Director

Speaker Info

Adrienne Harris, Pharm.D.

C​linical Pharmacist Liaison

Speaker Info

Brooke Mueller, Pharm.D.

Senior Clinical Pharmacist

Speaker Info

Eileen Fuentes-Ramallo

General Manager of Ancillary Product Development

Speaker Info

Kelli Shonk

Manager of Provider Relations

Speaker Info

Tania Smiley, R.Ph.

Clinical Pharmacist

Speaker Info

Kevin Tribout

Executive Director of Public Policy and Regulatory Affairs

Speaker Info

ACCREDITATIONS

URAC

We are an SSAE 16-accredited organization, which is renewed on an annual basis. We are also certified by URAC (Utilization Review Accreditation Commission) a non-profit, independent agency for pharmacy benefit management and case management. 

URAC Accredited

URAC promotes quality healthcare and provides standards that healthcare organizations must meet in order to receive and maintain accreditation. URAC has a specific set of standards for workers’ compensation PBMs, which serves as an indicator of quality and compliance. ​We are proud to have received URAC accreditation across the entire enterprise; our next scheduled corporate accreditation review is set to occur in September 2022 for pharmacy benefit management, and will be valid for an additional three years after.

NCQA

The Optum Case Management program received certification from the National Committee for Quality Assurance (NCQA). 

NCQA Case Management Accredited

Recognized for quality, the NCQA reviewed our policies, procedures and data reporting and awarded us the highest level of accreditation—a 3 year accreditation—for our comprehensive case management program.

The NCQA Review Oversight Committee (ROC) found that the program offered by Optum demonstrates strong performance of NCQA’s rigorous requirements for comprehensive case management. This status is awarded only to organizations that demonstrate strong performance of the functions outlined in the NCQA standards for Case Management accreditation. Our accreditation is effective October 30, 2017 – October 30, 2020.

Careers

Optum is a part of the UnitedHealth Group (UHG) family of companies.