Optum Rx has developed AI-driven initiatives to make pharmacy operations faster, safer and more reliable, as well as to give its pharmacists more time to focus on patient care.
“We use both AI and advancing technologies to ensure our pharmacists have the right information at the right time,” Jennifer McGonigle, senior vice president of enterprise capabilities at Optum Rx, told Becker’s. “Our focus is helping patients get on therapy faster, improving patient safety and enhancing operational efficiency.”
One of the initiatives is its AI pill validation model, which uses image recognition to photograph pills in each bottle and confirm they match the prescription before shipment. The system works alongside pharmacists to maintain a 99.998% accuracy rate in Optum’s home-delivery pharmacies, according to Ms. McGonigle.
Another key tool focuses on inventory management. Optum’s AI-powered demand planning model predicts potential drug shortages before they occur by analyzing internal data and assigning a network risk score to each medication. The system enables teams to purchase drugs ahead of demand, cutting out-of-stock incidents by 85% year over year, Ms. McGonigle said.
“Out-of-stock events can be very disruptive for patients,” she said. “By purchasing drugs ahead of need, we can proactively avoid disruptions.”
The company also is using AI to streamline the customer experience. Predictive models identify members likely to encounter an issue or reach out for support, allowing teams to resolve problems in advance or route calls more efficiently. These systems have prevented or streamlined more than 4 million calls in 2025, according to Ms. McGonigle.
Beyond operational improvements, Optum Rx is deploying tools that support pharmacists directly.
“We’ll never replace our pharmacists’ clinical judgment,” Ms. McGonigle said. “We aim to equip them with the right tools so they can work at the top of their license.”
The company’s pharmacist co-pilot aggregates patient data as prescriptions arrive, helping pharmacists make faster, more informed clinical decisions. Its AI drug-SIG normalization tool is designed to standardize prescription directions that arrive in different formats, while a preventive order-issue model in development will flag potential delays before they affect patients.
To encourage adoption, Ms. McGonigle said Optum engaged pharmacists early in the development process.
“They identified the biggest barriers and opportunities to accelerate therapy starts,” she said. “We call them AI champions. Their involvement made rollout and adoption straightforward.”
Optum has also built internal guardrails around how its models are developed and deployed. Every new system goes before an AI review board, which examines ethical frameworks, data integrity and human oversight. “We follow strict, responsible AI protocols,” Ms. McGonigle said.
In 2026, the company plans to introduce Optum Assistant, a digital tool that aims to help members manage prescriptions, locate pharmacies and identify savings opportunities through its mobile app. Optum Rx is also exploring ambient intelligence and conversational AI to streamline documentation and enhance provider-patient interactions.
“Healthcare is inherently complex,” Ms. McGonigle said. “If we can implement tools that optimize safety and remove barriers to care, patients will experience better outcomes.”
