PBM Transition Opportunity CommunityCare will partner with Navitus Health Solutions as its new PBM starting January 1, 2026. This transition creates opportunities to position additional cost management services, formulary optimization, utilization analytics, and seamless system integration with the existing tech stack including Dynamics and Dayforce. Offer support for project management, data migration, and vendor alignment to minimize disruption for members and employers.

Hospital Owned Advantage As Oklahoma's largest locally owned health plan, CommunityCare is owned by Ascension St. John and Saint Francis Health System. This strong provider network foundation enables cross selling of value based care programs, care management platforms, and employer health solutions. Highlight integration opportunities with hospital IT ecosystems and patient data sharing to improve outcomes and efficiency.

Product Portfolio Fit CommunityCare offers group and individual plans, Medicare Advantage plans, an employee assistance program and a workers compensation plan. This portfolio positions opportunities to upsell to employers with group coverage and to expand Medicare Advantage member services. Propose bundled solutions combining mental health support, occupational health programs, and enhanced member engagement with data insights.

Tech Modernization The tech stack includes Microsoft Dynamics, Dayforce HCM and other tools such as Worknet and Adobe XD. This suggests readiness for enhanced CRM, HR, and benefits administration modernization. Propose cloud based CRM and benefits platform optimization, data warehousing, analytics, and security improvements to support underwriting, claims processing and member experiences.

Growth and Compliance With revenue in the one to ten billion range and 201 to 500 employees, CommunityCare operates at scale and faces evolving regulatory demands. Leadership changes such as the interim CEO appointment signal ongoing transformation and potential for governance related services. Opportunities include governance, risk and compliance programs, cybersecurity, HIPAA readiness, and regulatory reporting support aligned with hospital system partnerships.