The Beat How Optum Is Using Real-Time Intelligence to Eliminate Avoidable Claim Denials
About Madhu Pawar:
Madhu Pawar is a board director and cross-disciplinary technology leader operating at the intersection of healthcare, data, and product innovation. She serves on the Board of Directors at Talkspace (NASDAQ: TALK) and is the Chief Product Officer for Optum Insight, where she drives product strategy and platform innovation across UnitedHealth Group’s most critical assets. Prior to Optum, she spent over six years at Google leading the global SMB Ads product ecosystem—overseeing AI-driven insights platforms, multi-billion-dollar revenue lines, and large-scale engineering, product, and operations teams across multiple continents. Madhu also teaches consumer analytics in healthcare as an adjunct professor at Carnegie Mellon University. Earlier in her career, she was a partner in McKinsey’s Global Healthcare Practice, where she built and scaled technology and services businesses for payers, providers, and fast-growth health companies. She began her career in software engineering at Hewlett-Packard Labs, earning patents in authentication and location-aware computing, followed by roles at PwC in security and technology. Madhu holds graduate degrees from Stanford School of Medicine and Carnegie Mellon University and a bachelor’s in computer engineering from Nanyang Technological University.
Things You’ll Learn:
- Real-time data exchange between payers and providers can significantly reduce the confusion, delays, and costs associated with today’s claims processes. AI-enabled reasoning over contracts and encounters improves accuracy from the start.
- Optum Real aims to bridge the transparency gap by connecting stakeholders through a multi-party hub, enabling real-time understanding of coverage and reimbursement. Early pilots show tangible reductions in denials and improved patient clarity.
- The majority of first-time denied claims are avoidable, signaling an industry-wide opportunity to remove unnecessary rework. Solving this problem increases efficiency for providers, payers, and patients.
- Real-time intelligence opens the door for more effective value-based care arrangements. When providers can see financial implications instantly, incentives align more naturally.
- The long-term vision includes real-time payment flows, AI-driven clinical decision support, and improved patient engagement. Breaking down paper-based silos will unlock entirely new use cases at scale.
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