Pharmacy Benefit Management

Our PBM program provides significant and favorable outcomes ​with customized care


Drive program performance with measurable outcomes

Medication Search

Identify utilization and cost control issues and high- and low-performing providers


Identify and execute resolution management for issues


Follow national standards of care, such as ACOEM, ODG, CDC and APS

Optum pharmacy benefit management (PBM) is laser-focused on doing the right thing. This intensity has sparked innovations that increase cost control by decreasing the personal impact of an injury. Our services:

  • Make filling a prescription easier through a directly-contracted network that includes nearly all of the nation's pharmacies
  • Capture more prescriptions "in-network", achieving up to 98% retail network penetration and reducing your administrative burden in the process
  • Ensure the injured person receives the right medication at the right time
  • Mitigate potential high-risk, high-cost situations
  • Are backed by 24/7/365 service and accessible, hands-on leadership

We built our carefully crafted, deliberately synchronized program on a strong foundation: a fully redundant, secure technology and service platform. On top of this, we overlay injury-specific ​medication ​plans and formularies, drug utilization review criteria, and client-specific business rules. These criteria feed our proprietary electronic adjudication platform, keeping data and communication flowing between pharmacy to payer; lighting the way forward to better outcomes.

Want to know more? Get in touch or click on one of the b​uttons below.

  • Network Access

  • Analytics and Informatics

  • Clinical Services

  • Exceptional Service