PayerIQ
Production
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Tier 3GANational

Centene Corporation

Monitor & nurture — quarterly touchpoints + data sharing

Composite
56.8
Rank
#168
Members
27.5M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
51
+12.8
Lives
20%
65
+13.0
Geography
20%
67
+13.4
Restrictions
15%
45
+6.8
Relationship
10%
53
+5.3
Financials
10%
56
+5.6
Composite Score56.8
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 12.8 + 13.0 + 13.4 + 6.8 + 5.3 + 5.6 = 56.8
Intelligence

Qualitative intelligence

Members
27.5M
Drug spend
$8.3B
Formulary
4-tier
PA / RA level
Very High
Biosimilar policy
Step therapy required
Avg reimbursement
40 days
Strategic notes

Outperforms nationals in local market; key state champion opportunity

Peer set

Closest peers in National

Kaiser Permanente Insurance
MT · Tier 3
57.1
+0.3
Regence BlueCross BlueShield
MN · Tier 3
57.5
+0.7
Blue Cross Blue Shield Association
LA · Tier 2
58.2
+1.4
Independence Blue Cross
KS · Tier 3
54.3
-2.5
AmeriHealth
UT · Tier 3
54.1
-2.7
Playbook · Tier 3

Engagement timeline

Week 2
Account manager check-in
Bi-annually
Formulary monitoring report