Manager, Special Investigative Unit/ Program Integrity/ CPC - Remote

We need to output HTML fragment with sections: h3 headings for sections for headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections if posting has real specific content. We need to parse the job posting. Key info: - Title: Manager, Special Investigative Unit/ Program Integrity / CPC - Remote (but we don't repeat title as heading). - Location: City/State Norfolk, VA (but remote opportunities available in many states). Work shift: Multiple shifts available. Work hours: 8am to 5pm EST, M-F. Status: Full-time, permanent position (40 hours). Travel to Virginia Beach 1x a year. - Overview: Sentara Health Plan is currently hiring a Manager, Special Investigative Unit/ Program Integrity / CPC - Remote! - Job Responsibilities: list of responsibilities. - Education: Bachelor’s degree REQUIRED - Certifications/Licenses: Certified Professional Coder (CPC) REQUIRED - Experience: 2 years of Supervisory experience REQUIRED; Insurance experience REQUIRED; 5 years of Coding experience REQUIRED; Candidates must have prior leadership experience managing a pre-pay review team, including oversight of pre-payment claim reviews, provider monitoring activities, medical record reviews, and payment integrity operations within a healthcare payer environment. - Additional description about Sentara Health Plans. - Benefits: list: Medical, Dental, Vision plans; Adoption, Fertility and Surrogacy Reimbursement up to $10,000; Paid Time Off and Sick Leave; Paid Parental & Family Caregiver Leave; Emergency Backup Care; Long-Term, Short-Term Disability, and Critical Illness plans; Life Insurance; 401k/403B with Employer Match; Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education; Student Debt Pay Down – $10,000; Pet Insurance; Legal Resources Plan; Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. - Pay: base pay range $109,033.60 - $163,259.20 annually. Additional compensation may be available (shift differentials, standby/on-call pay, overtime, shift premiums, extra-shift incentives, or bonus opportunities). Compensation within the range may vary based on qualifications, experience, location, market conditions, and business needs. Note: If an annual salary is posted, it is based on a full-time colleague working 2,080 hours annually. - Schedule: Work hours: 8am to 5pm EST, M-F. Multiple shifts available? It says Work Shift Multiple shifts available. So schedule info: multiple shifts available; work hours 8am-5pm EST M-F. We need to decide sections: - About the role: could include overview and maybe description of Sentara. - Responsibilities: list. - Requirements: could combine Education, Certifications, Experience. - Qualifications: maybe same as Requirements? But we need to avoid duplication. The instruction: prefer a few substantive sections over many thin ones. So we can have sections: About the role, Responsibilities, Requirements, Benefits, Pay, Schedule. We should not include Skills unless there is specific skills list; not present. We need to use

for each section heading. Inside sections, use

• for any list of duties/requirements/benefits, and

  for prose. We must preserve all substantive information, not invent or summarize away detail. So we need to include all details from posting. We must remove boilerplate: cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. The posting includes EEO statement at end: "Sentara Health is an equal opportunity employer..." and diversity statement, tobacco-free environment. Those are boilerplate; we should remove them. Also the "To apply, please go to..." application instructions should be removed. Also the list of remote states repeated; we can include that info maybe in About the role or Requirements? It's substantive: remote opportunities available in many states. That's not boilerplate; it's location info. Should we include? It's part of job posting. We'll include in About the role maybe. Also the "Work Shift Multiple shifts available" and "Work hours: 8am to 5pm EST, M-F" is schedule. We need to include travel to Virginia Beach 1x a year. We need to include that Sentara Health Plans provides health plan coverage to close to one million members in Virginia, etc. That's substantive about organization; we can include in About the role. We need to include the base pay range and additional compensation details. We need to include benefits list exactly as given. We need to ensure we don't repeat duplicated lines: e.g., list of remote states appears twice; we should include once. We need to avoid placeholders like "commensurate with experience" etc. Not present. Now craft HTML. Structure:

  About the role

  Sentara Health Plan is hiring a Manager, Special Investigative Unit/Program Integrity/CPC – Remote. The position is full‑time, permanent (40 hours/week) with work hours 8 am–5 pm EST, Monday–Friday, and multiple shifts are available. Remote work is permitted in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington (state), West Virginia, Wisconsin, and Wyoming. The role requires travel to Virginia Beach approximately once per year. Sentara Health Plan serves close to one million members in Virginia and offers a full suite of commercial products, including employee‑owned and employer‑sponsored plans, Individual & Family Health Plans, Employee Assistance Programs, and plans serving Medicare and Medicaid enrollees, supported by a robust provider network and wellness programs.

  Responsibilities

  • Manage a team of Special Investigative Unit (SIU) Investigators across multiple states.
  • Report findings to appropriate government and regulatory agencies.
  • Interact extensively with internal departments, providers, and government agencies.
  • Review and propose updates to health plan rules and policies relating to fraud, waste, and abuse.
  • Provide compliance advice and assist with organizational change and compliance interpretation as it relates to fraud, waste, and abuse.
  • Lead the monthly FWA subcommittee meeting.

  Requirements

  • Bachelor’s degree (required).
  • Certified Professional Coder (CPC) (required).
  • Minimum 2 years of supervisory experience (required).
  • Insurance experience (required).
  • Minimum 5 years of coding experience (required).
  • Prior leadership experience managing a pre‑pay review team, including oversight of pre‑payment claim reviews, provider monitoring activities, medical record reviews, and payment integrity operations within a healthcare payer environment.

  Benefits

  • Medical, Dental, Vision plans
  • Adoption, Fertility and Surrogacy Reimbursement up to $10,000
  • Paid Time Off and Sick Leave
  • Paid Parental & Family Caregiver Leave
  • Emergency Backup Care
  • Long‑Term, Short‑Term Disability, and Critical Illness plans
  • Life Insurance
  • 401k/403B with Employer Match
  • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
  • Student Debt Pay Down – $10,000
  • Pet Insurance
  • Legal Resources Plan
  • Opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria are met

  Pay

  Base pay range for full‑time employment: $109,033.60 – $163,259.20 annually. Additional compensation may be available, such as shift differentials, standby/on‑call pay, overtime, shift premiums, extra‑shift incentives, or bonus opportunities. Compensation within the range may vary based on qualifications, experience, location, market conditions, and business needs. (Note: annual salary is based on a full‑time colleague working 2,080 hours per year.)

  Schedule

  Work hours: 8 am to 5 pm EST, Monday–Friday. Multiple shifts are available. The role requires travel to Virginia Beach approximately once per year.

  Check for duplication: travel mentioned both in About the role and Schedule; that's okay but maybe we should avoid duplication. The instruction: preserve ALL substantive information; do NOT invent or summarize away detail. Duplication is not prohibited but we could avoid repeating same sentence. However it's okay to mention in both sections if it's relevant. But we could keep travel only in About the role and schedule only about hours/shifts. Let's adjust: In About the role we already mentioned travel. In Schedule we can just mention work hours and multiple shifts. Remove travel from Schedule. Thus Schedule:

  Work hours: 8 am to 5 pm EST, Monday–Friday. Multiple shifts are available.

  Now ensure we didn't include any boilerplate: removed EEO statement, diversity statement, tobacco-free environment, application instructions. Check for any leftover boilerplate: The line "Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce." removed. Also "Diversity, inclusion, and belonging is a guiding principle..." removed. Also "In support of our mission “to improve health every day,” this is a tobacco-free environment." removed. Also removed "To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-102996 Talroo-Health Plan Keywords: ..." removed. Also removed repeated list of remote states duplication? We have only one list. Check for any other boilerplate: "We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits." That's substantive? It's generic but maybe we can keep as part of Pay section? It's somewhat generic but still part of posting. Could be considered boilerplate but it's about compensation. Might keep but we already have Pay details. Could incorporate that sentence into Pay section as prose. However the instruction: prefer a few substantive sections over many thin ones. It's okay to include that line in Pay section as prose. We have Pay section currently with base pay range and additional compensation. Could add that sentence. Let's adjust Pay section:

  We provide market‑competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay range for full‑time employment is $109,033.60 - $163,259.20 annually. Additional compensation may be available for this role, such as shift differentials, standby/on‑call pay, overtime, shift premiums, extra‑shift incentives, or bonus opportunities. Compensation within the range may vary based on qualifications, experience, location, market conditions, and business needs. Note: If an annual salary is posted, it is based on a full‑time colleague working 2,080 hours annually.

  That preserves the line. Now ensure we didn't miss any substantive info: The overview about Sentara's quality provider network, programs to support members with chronic illnesses, customized wellness programs, integrated clinical and behavioral health services, family-friendly culture, community involvement,