Risk Adjustment Specialist (Clinical)

We need to output HTML fragment with sections: Use

for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. Must not repeat job title. Must not include Job ID etc. Remove boilerplate: EEO, equal-opportunity, scam warning, etc. Also remove duplicated lines, navigation, cookie, legal. Must preserve all substantive info. Let's parse the posting: Position Purpose: Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with Risk Adjustment vendors for programs within all lines of business. Key Details: RN License, Clinical and/or Quality Improvement and HEDIS experience is required. Candidates are not required to live in PA but will be required to work EST. Aid in the development and support of company-wide Risk Adjustment initiatives within all product lines and assist in vendor management related to those initiatives Help train providers and Health Plan staff in Risk Adjustment methodologies and activities to continue to improve Centene’s Risk Adjustment score – some travel maybe required Research and assist in development of best practices into operations for Risk Adjustment Prepare operational workflows specific to each product business requirements and the local market dynamics Prepare and participate in meetings with various committees and providers Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor’s degree or equivalent experience. 2 years of quality improvement or clinical experience required. Bachelor’s degree in nursing and experience in managed care industry preferred. Pay Range: $56,200.00 - $101,000.00 per year At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday. Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act We need to remove EEO boilerplate (the last paragraph about equal opportunity). Also remove any duplicated lines. We need to decide sections. We have "Position Purpose" which could be "About the role". Could also be a brief description. We have responsibilities: many bullet-like sentences: Support development and maintenance of Risk Adjustment related programs and reporting; Aid in working with Risk Adjustment vendors for programs within all lines of business; Aid in development and support of company-wide Risk Adjustment initiatives within all product lines and assist in vendor management; Help train providers and Health Plan staff in Risk Adjustment methodologies and activities; Research and assist in development of best practices into operations; Prepare operational workflows specific to each product business requirements and local market dynamics; Prepare and participate in meetings with various committees and providers; Performs other duties as assigned; Complies with all policies and standards. We have Key Details: RN License, Clinical and/or Quality Improvement and HEDIS experience required; Candidates not required to live in PA but will be required to work EST; some travel maybe required. We have Education/Experience: Bachelor’s degree or equivalent experience; 2 years of quality improvement or clinical experience required; Bachelor’s degree in nursing and experience in managed care industry preferred. We have Pay Range: $56,200.00 - $101,000.00 per year. We have Benefits: comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, flexible approach to work with remote, hybrid, field or office work schedules. We have Schedule: not explicitly given besides "will be required to work EST" and "some travel maybe required". Also flexible approach to work with remote, hybrid, field or office work schedules. That could be schedule info. But we need to only include Schedule section if posting actually states them. It does mention flexible approach to work with remote, hybrid, field or office work schedules. That's schedule info. Also "will be required to work EST" is a schedule requirement (timezone). So we can include Schedule. We must not include sections with filler like "commensurate with experience". We have actual pay range, so Pay section is valid. We must not repeat job title as heading. We must not include Job ID etc. We must not include boilerplate EEO etc. Thus sections: About the role (Position Purpose), Responsibilities, Requirements (maybe combine Key Details and Education/Experience?), Qualifications (maybe Education/Experience), Skills (maybe RN License, Clinical/Quality Improvement, HEDIS), Benefits, Pay, Schedule. But we need to avoid thin sections. Let's see if we can combine some. We have "Key Details" which includes RN License, Clinical/Quality Improvement/HEDIS experience, location/EST, travel. That could be Requirements or Qualifications. Education/Experience: Bachelor's degree or equivalent experience, 2 years quality improvement or clinical experience required, Bachelor's in nursing and managed care industry preferred. We could have a "Requirements" section that includes both mandatory and preferred qualifications. We could have a "Skills" section for specific skills like RN License, HEDIS, etc. But maybe better to put those under Requirements. Given instruction: Prefer a few substantive sections over many thin ones. So maybe we have About the role, Responsibilities, Requirements (including education, experience, licensure, location/travel), Benefits, Pay, Schedule. We should not have Qualifications separate if we combine. We need to use

for each section heading. We need to use

• for any list of duties/requirements/benefits. We need to use

  for prose. We must preserve all substantive information. Let's extract substantive info: About the role (Position Purpose): "Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with Risk Adjustment vendors for programs within all lines of business." That's two sentences. Responsibilities: list: - Aid in the development and support of company-wide Risk Adjustment initiatives within all product lines and assist in vendor management related to those initiatives - Help train providers and Health Plan staff in Risk Adjustment methodologies and activities to continue to improve Centene’s Risk Adjustment score – some travel maybe required - Research and assist in development of best practices into operations for Risk Adjustment - Prepare operational workflows specific to each product business requirements and the local market dynamics - Prepare and participate in meetings with various committees and providers - Performs other duties as assigned - Complies with all policies and standards Also earlier: "Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with Risk Adjustment vendors for programs within all lines of business." Those could also be responsibilities but we already used them in About the role. Might duplicate. We could keep them in About the role and not repeat. Requirements: Must include: - RN License - Clinical and/or Quality Improvement and HEDIS experience required - Candidates are not required to live in PA but will be required to work EST - Some travel maybe required (already in responsibilities but we can note) - Bachelor’s degree or equivalent experience - 2 years of quality improvement or clinical experience required - Bachelor’s degree in nursing and experience in managed care industry preferred We could separate mandatory vs preferred but not required. Benefits: list: - competitive pay - health insurance - 401K and stock purchase plans - tuition reimbursement - paid time off plus holidays - flexible approach to work with remote, hybrid, field or office work schedules Pay: Pay Range: $56,200.00 - $101,000.00 per year Also note: Actual pay will be adjusted based on individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. We could include that in Pay section as prose. Schedule: we have "will be required to work EST" and "flexible approach to work with remote, hybrid, field or office work schedules". Also "some travel maybe required". So schedule section could include: Must work EST; flexible work arrangements (remote, hybrid, field, office); some travel may be required. We must not include boilerplate EEO etc. Now produce HTML. Structure:

  About the role

  Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with Risk Adjustment vendors for programs within all lines of business.

  Responsibilities

  • Aid in the development and support of company-wide Risk Adjustment initiatives within all product lines and assist in vendor management related to those initiatives
  • Help train providers and Health Plan staff in Risk Adjustment methodologies and activities to continue to improve Centene’s Risk Adjustment score – some travel may be required
  • Research and assist in development of best practices into operations for Risk Adjustment
  • Prepare operational workflows specific to each product business requirements and the local market dynamics
  • Prepare and participate in meetings with various committees and providers
  • Performs other duties as assigned
  • Complies with all policies and standards

  Requirements

  • RN License
  • Clinical and/or Quality Improvement and HEDIS experience
  • Must work EST (candidates not required to live in PA)
  • Some travel may be required
  • Bachelor’s degree or equivalent experience
  • 2 years of quality improvement or clinical experience required
  • Bachelor’s degree in nursing and experience in managed care industry preferred

  Benefits

  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • Flexible work arrangements: remote, hybrid, field, or office schedules

  Pay

  Pay range: $56,200.00 – $101,000.00 per year. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

  Schedule

  Must work EST; flexible work arrangements (remote, hybrid, field, or office); some travel may be required.

  Check for any duplicated content: We included "some travel may be required" both in Responsibilities and Requirements and Schedule. Might be duplication but it's okay as it's substantive. However we might want to avoid duplication but not required. The instruction: "Preserve ALL substantive information; do NOT invent or summarize away detail." Duplication is okay as it's preserving. Could remove duplicate from Requirements to avoid redundancy but it's still substantive. I'd keep it only in Responsibilities and Schedule maybe. But we have it in Requirements as "Some travel may be required". Might be okay. We need to ensure