Mgr Risk Management Business Team
Cambia Health Solutions · Fargo, ND · 3 wk ago
$111k–$151k/yrFull-time
We need to output HTML fragment with sections for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections where posting has real specific content. Must not repeat job title as heading. Must not include Job ID etc. Remove boilerplate. Must preserve all substantive info. Must not invent or summarize away detail. Must not include filler like "commensurate with experience". Must not create Pay/Schedule/Benefits unless posting actually states them. The posting includes Pay info: salary ranges for Oregon, Washington, Utah, Idaho; North Dakota. Also mentions bonus target. So Pay section is appropriate. Schedule: mentions Hybrid role (3 days/week in office) and Work performed in the office or remote. Travel rarely required. So schedule info exists. Benefits: there is a Benefits section with details. So include Benefits.
We need sections: About the role (maybe "About the role" corresponds to description of role). Responsibilities: list of duties. Requirements: maybe combine Qualifications? The instruction says use headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to decide what goes where. The posting includes "Qualifications" heading with bullet list of education/experience. Also "Skills And Attributes". Also "What You Will Do At Cambia" which is responsibilities. Also "Who We Are Looking For" maybe about the role. Also "Work Environment". Also "About Cambia" and "Why Join the Cambia Team?" maybe not needed? But we need to preserve all substantive information. However we should not create sections with filler. We can include About the role (summary of role and mission). Responsibilities (list of duties). Requirements (maybe education/experience). Qualifications (maybe same as Requirements? But we need both headings; we could split: Requirements = education/experience; Qualifications = skills/attributes? But they said use both headings. We need to decide content for each. The posting has "Qualifications What You Bring to Cambia:" includes Bachelor's degree and 10 years experience. Then "Skills And Attributes" list. So we can map: Requirements = education/experience (Bachelor's degree + 10 years). Qualifications = maybe the same? Actually they are similar. Could treat Requirements as education/experience, Qualifications as skills and attributes. But they also have a separate "Skills" heading. So we need three: Requirements, Qualifications, Skills. The posting has Qualifications (education/experience) and Skills And Attributes (skills). So we can assign: Requirements = maybe nothing? But we need to include only if posting has real content. Could we omit Requirements if no distinct content? The instruction: "Prefer a few substantive sections over many thin ones." So we could combine education/experience and skills into Qualifications and Skills, and omit Requirements if no distinct content. However they said use headings list; but they didn't say we must include all; we include only when posting has real specific content. So we can omit Requirements if no distinct content separate from Qualifications and Skills. But we have education/experience under "Qualifications What You Bring to Cambia:" which could be considered Requirements. But there is also a separate "Skills And Attributes". So we could have Qualifications = education/experience, Skills = skills and attributes. Then we can omit Requirements. That seems reasonable.
Now About the role: we can use the paragraph starting "Every day, Cambia’s dedicated Risk Management Business Team Manager is living our mission..." plus maybe "Who We Are Looking For" paragraph. That's about role.
Responsibilities: the bullet list under "What You Will Do At Cambia". Also some responsibilities in earlier paragraph: "Leads a team dedicated to extracting required information..." etc. Also "Corroborates closely with the IT, compliance, legal, revenue management, claims, enrollment, product teams..." etc. We'll combine all duty sentences into a list.
Pay: include salary ranges and bonus target.
Schedule: hybrid role (3 days/week in office), work performed in office or remote, travel rarely required.
Benefits: list of benefits.
We must not include boilerplate like EEO, equal opportunity, scam warning, etc. Also remove duplicated lines, navigation, cookie, legal. Also remove "Learn More About Our Benefits." etc. Also remove "We are happy to offer work from home options..." maybe that's part of benefits? It's about remote work policy; could be considered part of Benefits or Schedule? It's about remote work eligibility; maybe include in Schedule? But it's about work from home options; could be part of Benefits? It's not a benefit per se but a policy. Might be considered part of Work Environment. But we already have schedule. Could include a sentence in Schedule about remote work requirements. However the instruction: include section only when posting has real specific content. The remote work policy is specific; we could include it under Schedule or maybe under Benefits? But Benefits section already has list; we could add a bullet about remote work eligibility? Might be better to add a sentence in Schedule about remote work options and requirements. However the instruction says not to invent or summarize away detail. We'll keep it as a sentence under Schedule.
Now we need to output only HTML fragment, no /, no markdown fences.
We'll structure:
About the role
...
Responsibilities
- ... ...
Qualifications
... (Bachelor’s degree ... 10 years’ experience)
Skills
- ... ...
Benefits
- ... ...
Pay
... salary ranges and bonus target.
Schedule
... hybrid role 3 days/week in office, work performed in office or remote, travel rarely required, remote work eligibility details.
We must ensure we preserve all substantive information. Let's extract details. About the role text: "Every day, Cambia’s dedicated Risk Management Business Team Manager is living our mission to make health care easier and lives better. As a member of the Risk Adjustment team, our Risk Management Business Team Manager is responsible for complying with CMS mandates to submit Enrollment, Medical Claim and Pharmacy Claim data for Reinsurance and Risk Adjustment programs. Leads a team dedicated to extracting required information from the source systems into a staging area, performing validation checks based on CMS Edge Server Business Rules, and submitting correct data to the Edge Server via a translation process. – all in service of creating a person-focused health care experience. Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit." Also "Who We Are Looking For Every day, Cambia’s dedicated Risk Management Business Team Manager is living our mission to make health care easier and lives better." Actually that repeats. The "Who We Are Looking For" paragraph seems same as earlier? Let's check: The posting: "Who We Are Looking For Every day, Cambia’s dedicated Risk Management Business Team Manager is living our mission to make health care easier and lives better. As a member of the Risk Adjustment team, our Risk Management Business Team Manager is responsible for complying with CMS mandates to submit Enrollment, Medical Claim and Pharmacy Claim data for Reinsurance and Risk Adjustment programs. Leads a team dedicated to extracting required information from the source systems into a staging area, performing validation checks based on CMS Edge Server Business Rules, and submitting correct data to the Edge Server via a translation process. – all in service of creating a person-focused health care experience. Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit." So it's duplicate. We'll include once. Responsibilities list from "What You Will Do At Cambia": - Corroborates closely with the IT, compliance, legal, revenue management, claims, enrollment, product teams and other departments to maximize and maintain submission measurements - Helps oversee RADV audits, submits data in a timely manner and prepares executive reports. - Develops medical underwriting rules for the Risk Management business system which accurately reflect the rating strategy and drive achievement of company revenue targets. - Directs business projects and is responsible for the development and delivery of project performance criteria and objectives. - Ensures day-to-day operations are appropriately supported by the Risk Management business team, identifying issues and recommending solutions. - Develops and reviews business policies, processes and practices to ensure seamless coordination with the Risk Management business team. - Develops, implements and monitors audit processes to ensure accurate utilization of the Edge Server system by assigned users. - Responsible for training materials and delivery. - Regularly interacts with the IT team, identifying issues and partnering on resolutions to ensure the data submission system is functioning accurately. - Responsible for staff development, performance conversations, performance coaching and retention activities. - Regularly communicates departmental and organizational goals and objectives to staff. - Develops and maintains departmental policies and procedures and assures adherence to departmental standards and practices. - Oversees the data submission system and ensures it is functioning accurately. Also earlier responsibilities: "Leads a team dedicated to extracting required information from the source systems into a staging area, performing validation checks based on CMS Edge Server Business Rules, and submitting correct data to the Edge Server via a translation process." This is also a responsibility; we can include. Also maybe "Leads a team dedicated to extracting required information..." is part of role description but we can add to responsibilities. Qualifications: "The Manager, Risk Management Business Team would have a Bachelor’s degree in Business, Data Analysis or other related field and 10 years’ experience with data analysis, process modeling or equivalent combination of education and experience." Skills And Attributes list: - Strong analytical skills including the ability to analyze complex data and situations, learn quickly and synthesize corresponding solutions, options and action plans. - Ability to understand, translate and communicate complex ideas and situations to a wide variety of audiences. - Excellent research and problem solving skills including the ability to determine action steps and remediation actions to resolve issues. - Strong knowledge of risk adjustment systems and processes. - Demonstrated experience in business areas, working with business requirements, documentation and data systems. - Strong knowledge of project management processes and practices including experience leading large, complex initiatives. - Knowledge of medical terminology and procedure coding. - Ability to communicate effectively verbally and in writing with all levels of staff. - Ability to develop and lead a team including: hiring, goal setting, motivating, coaching and staff development. - Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired Benefits list: - Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits. - Annual employer contribution to a health savings account. - Generous paid time off varying by role and tenure in addition to 10 company-paid holidays. - Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period). - Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave). - Award-winning wellness programs that reward you for participation. - Employee Assistance Fund for those in need. - Commute and parking benefits. Also maybe "Learn More About Our Benefits." is a link; we drop. Pay: - Oregon, Washington, Utah, and Idaho: The expected hiring range is $111,400.00 – $150,700.00, the full salary range is $104,000.00 – $171,000.00 and the bonus target is 17% - North Dakota: The full salary range is 101,444 – 167,383 and the bonus target is 15%. We need to preserve numbers exactly. Also note formatting: "101,444 – 167,38