How Sana Benefits Scaled Care Navigation with AI-Native Provider Intelligence

Sana Benefits serves small and mid-sized employers with level-funded health plans and an integrated care model, Sana Care, that combines primary care, care navigation, and a curated provider network. Accurate, reliable provider data isn't a nice-to-have — it's the foundation of every member interaction.

As Sana scaled, the cracks in their provider data became impossible to ignore. The team was working across 13 different platforms, manually verifying information for nearly every referral, and still delivering inaccurate results to members. Industry-wide, provider data accuracy hovers around 50–55% due to fragmented ownership and inconsistent standards — and Sana was no exception.

By partnering with Candor Health, Sana replaced all 13 sources with a single AI-native provider intelligence platform that continuously validates and enriches provider data in real time.

Sana's Care Navigation team was working from a patchwork of internal tools, spreadsheets, and third-party platforms — none of which agreed with each other. Provider specialties were wrong, locations were outdated, and network participation data couldn't be trusted.

As care navigation became a more central member benefit, demand rose and the pressure intensified. It wasn't sustainable — and the team knew it.

Sana set out to find a fundamentally different approach. The evaluation was rigorous and cross-functional: Care Navigation, Network Operations, Product, Engineering, and executive leadership all participated. Sana ran a two-week trial, conducted provider accuracy validation against real data, reviewed product mockups, and spoke with an existing Candor customer.

What set Candor apart was the architecture. Rather than ingesting historical claims data or relying on static directories, Candor built a living provider intelligence graph continuously validated across thousands of sources. Claims data was used to understand clinical expertise — not to infer whether a provider's address was correct.

That confidence — backed by evidence — shifted something fundamental at Sana. The team had spent years accepting poor provider data as an intractable industry problem. Candor changed that assumption.

Once Sana selected Candor, implementation moved fast. Weekly syncs between product and engineering teams kept things on track. Within a few months, Care Navigation had fully transitioned to Candor, replacing all 13 previous data sources with a single platform used across daily workflows.

Candor also integrated directly into Sana's member-facing Provider Directory tool, replacing the prior API without disruption. Product and engineering teams described it as seamless, with immediate, measurable improvements in data accuracy.

Network Operations saw gains too. Provider rosters that previously required hours of manual standardization were automatically processed in under five minutes.

Beyond operational gains, Candor has given Sana confidence to move toward more advanced,
automated care navigation models. “AI is only as good as the underlying data,” Dr. Scanlon said. “Solving provider data accuracy was the essential first step.”

Accurate, continuously validated provider data enriched with clinical expertise and plan- specific network intelligence is a prerequisite for any agentic care navigation system, but Sana’s leadership views this as more than just an operational requirement. By solving provider data accuracy at the foundation, Candor has provided a strategic lever for scaling care navigation across plans, networks, and member populations without expanding care coordination teams.

Members consistently rate the Sana Care experience highly, driven by strong relationships with providers and a care navigation team that functions as an extension of the clinical care team itself. Looking ahead, Sana will be offering Sana Care alongside care navigation even for individuals who are not enrolled in a Sana
benefits plan. While delivering navigation across multiple plans and networks introduces significant complexity, Sana believes this is something that could be thoughtfully scaled over time, particularly with Candor’s ability to address provider data accuracy and fragmentation at the foundation

What began as a solution to a workflow bottleneck has become a strategic foundation. Sana’s leadership now points to the Candor evaluation and rollout as a model for how to assess and adopt critical technology partners.