PayerIQ
Production
Back to universe
Tier 2WYMedicaid

Centene Medicaid Wyoming

Active pursuit — access summits + value dossier

Composite
63.8
Rank
#85
Members
11.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
79
+19.8
Lives
20%
73
+14.6
Geography
20%
91
+18.2
Restrictions
15%
39
+5.8
Relationship
10%
43
+4.3
Financials
10%
11
+1.1
Composite Score63.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 19.8 + 14.6 + 18.2 + 5.8 + 4.3 + 1.1 = 63.8
Intelligence

Qualitative intelligence

Members
11.4M
Drug spend
$1.4B
Formulary
4-tier
PA / RA level
Moderate
Biosimilar policy
Case-by-case review
Avg reimbursement
34 days
Strategic notes

Active Medicaid contract renewal cycle; incumbent advantage can be leveraged

Peer set

Closest peers in Medicaid

Washington Medicaid Health Plan
WA · Tier 2
64.7
+0.9
WellCare of Alabama
AL · Tier 2
66.1
+2.3
Idaho Department of Medicaid
ID · Tier 2
60.9
-2.9
Medicaid Managed Care New Jersey
NJ · Tier 2
60.8
-3.0
WellCare of Alaska
AK · Tier 2
59.0
-4.8
Playbook · Tier 2

Engagement timeline

Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review