Senior Manager, Risk Adjustment Operations and Performance Improvement

We need to output HTML fragment with sections: About the role? Actually the posting includes "Who Are We?" and "Why Join Us?" and "Job Summary". The instructions: use

for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). Do NOT repeat the job title as a heading. Do NOT put Job ID / requisition numbers as headings — fold minor metadata into a short

or drop it. Preserve ALL substantive information; do NOT invent or summarize away detail. Remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. IMPORTANT: include a section ONLY when the posting has real, specific content for it — never emit a heading followed by filler/placeholder text (e.g. "commensurate with experience", "not specified", "N/A", "varies", "TBD") and never create Pay/Schedule/Benefits sections unless the posting actually states them. Prefer a few substantive sections over many thin ones. We need to decide which sections to include based on content. We have: - Hybrid work schedule: "This position operates on a hybrid work schedule. This position will require 3 days onsite at the Huntington Beach office." That's schedule info. So we can have a Schedule section. - "Are you ready to make a lasting impact and transform the healthcare space?" That's maybe part of intro. - "We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth." That's about the company. - "Who Are We? ✨ Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values." That's about the company. - "Why Join Us? 🏆 We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation." That's benefits/why join. - "Job Summary The Senior Manager, Risk Adjustment Operations and Performance Improvement leads the operational and analytics-informed execution of Medicare Advantage Risk Adjustment (RAF), Stars, HEDIS, and CAHPS initiatives to improve quality outcomes, coding accuracy, member experience, and financial performance. This role oversees day-to-day program operations, provider performance management, vendor oversight, reporting, and cross-functional execution of key initiatives. Working closely with Provider Relations, Care Management, Pharmacy, Network Management, Compliance, Analytics, and other business partners, this position ensures operational plans are executed effectively, performance targets are monitored, and program activities remain aligned with organizational priorities. The role blends program execution, operational analytics, and continuous improvement while serving as a key liaison between strategic direction and frontline implementation." That's job summary. - Then "Function And Job Responsibilities" with subsections: Program Operations & Performance Management, Provider Performance & Engagement, Performance Analytics & Operational Reporting, Quality, Compliance & Audit, Vendor & Program Operations, Operational Excellence & Continuous Improvement, External & Internal Collaboration, Team Leadership & Development. Those are responsibilities. - Then "Leadership Expectations" with bullet points (Model the Way etc). That could be part of responsibilities or maybe separate. - Then "Qualifications" with subheadings: Education And Experience, Licenses/Certifications. - Then "Skills" with bullet list. - Then "Wage Range: $127,000/year to $160,000/year" => Pay section. - Then "Physical & Working Environment" details. - Then EEO boilerplate etc to remove. - Also "A background check is required." That's maybe minor metadata; could be included in a short p. - "Salary ranges posted on the job posting are based on California wages. Salary may be higher or lower depending on the candidate’s state residency." That's also pay detail. We need to decide sections: About the role? Could be "About the role" maybe combine Who Are We and Why Join Us? But instructions: Use headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. They gave examples but we can use those headings if content matches. We need to include a section only when posting has real specific content. We have schedule content => Schedule section. We have pay content => Pay section. We have benefits? "Why Join Us?" is about mission and opportunity; could be Benefits? But Benefits usually refers to compensation/benefits like health insurance, PTO etc. Not present. So maybe we skip Benefits. We have "Who Are We?" and "Why Join Us?" could be under "About the role" or maybe "About the company". But the instruction list includes "About the role" as example. We could put company overview there. We have responsibilities: many bullet points under Function And Job Responsibilities and Leadership Expectations. So we can have Responsibilities section. We have qualifications: Education And Experience, Licenses/Certifications => Qualifications section. We have Skills section => Skills section. We might also have a short paragraph for metadata like background check. We need to output only HTML fragment, no /, no markdown fences. We need to use

for section headings. Use

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

  for prose. We need to preserve ALL substantive information; do not invent or summarize away detail. So we need to keep the details as they appear, but we can format them into lists where appropriate. We must remove boilerplate: EEO, navigation, cookie, legal, scam-warning, duplicated lines, application instructions. The posting didn't have explicit application instructions but we have EEO statement at end; we need to remove that. Also remove "Physical & Working Environment" maybe? It's not in the list of headings but could be part of something else? The instruction says we can create sections only for those headings if content exists. Physical & Working Environment is not in the list; but we could incorporate that info into maybe a short p under Schedule or something? However we should preserve ALL substantive information; we cannot drop it unless it's boilerplate. Physical & Working Environment is substantive (travel, ability to operate keyboard, etc). We need to include it somewhere. Since there's no specific heading for it, we could maybe put it under a generic heading like "Working Conditions" but not in the allowed list? The instruction says use

  for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). It doesn't forbid other headings, but says "use

  for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It seems they expect us to use those headings where appropriate. But we could also add other headings if needed? The instruction: "Use

  for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It doesn't say we cannot use other headings, but they gave examples. Safer to stick to those headings. However we need to include physical working environment info; maybe we can put it under Schedule? Not appropriate. Could be under "About the role"? Not really. Could be under "Responsibilities"? Not really. Could be under "Qualifications"? Not really. Could be under "Skills"? Not really. Could be under "Pay"? No. Maybe we can create a section "Working Conditions" but that's not in the examples; but the instruction didn't forbid other headings, just gave examples. However they said "use

  for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." This could be interpreted as we should use those headings for those types of content, but we could also add other headings if needed. However they also said "Prefer a few substantive sections over many thin ones." So we could combine physical working environment into a short paragraph under maybe "Schedule" or "About the role". But that might be mixing unrelated info. Alternatively, we could create a section "Working Conditions" using

  and it's still a heading; the instruction didn't explicitly forbid it. It just gave examples. I'd lean to include it as its own section, maybe titled "Working Conditions". But to be safe, maybe we can incorporate it into a short paragraph under "Schedule" as it's about work arrangement (hybrid, onsite days) plus physical requirements. However schedule already covers hybrid schedule; physical requirements are separate. Better to create a section "Working Conditions". The instruction didn't say we cannot; it's just an example list. I'll include it. Now we need to decide which sections to include: About the role (company overview), Responsibilities, Qualifications, Skills, Pay, Schedule, Working Conditions. We should not include Benefits unless there is specific benefits info (like health insurance, 401k). Not present. We should not include Requirements separate from Qualifications? The list includes Requirements as an example; but we have Qualifications covering education/experience/licenses. Could treat Requirements as same as Qualifications. But we already have Qualifications; we can omit Requirements to avoid duplication. Now we need to format content. Let's extract substantive content: **About the role / Company overview**: - "Are you ready to make a lasting impact and transform the healthcare space?" (maybe tagline) - "We are one of Southern California’s fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth." - "Who Are We? ✨ Clever Care was created to meet the unique needs of the diverse communities we serve. Our innovative benefit plans combine Western medicine with holistic Eastern practices, offering benefits that align with our members’ culture and values." - "Why Join Us? 🏆 We’re on a mission! Our rapid growth reflects our commitment to making healthcare accessible for underserved communities. At Clever Care, you’ll have the opportunity to make a real difference, shape the future of healthcare, and be part of a fast-moving, game-changing organization that celebrates diversity and innovation." We could combine into a few paragraphs. **Responsibilities**: We have many bullet points under Function And Job Responsibilities subheadings. We need to preserve all detail. We could create a

  with
  • items for each responsibility bullet. However there are subheadings; we could either keep subheadings as

    maybe but instruction only mentions

    for section headings. Could we use

    for subheadings? Not prohibited but maybe better to keep as plain text or . To preserve detail, we could keep subheadings as within

    or as separate

    with . Simpler: create a

    where each
    • contains the responsibility description, possibly with subheadings bolded. Let's list responsibilities from the text: Under "Program Operations & Performance Management": - Lead operational execution of Medicare Stars, HEDIS, CAHPS, and Risk Adjustment programs. - Develop annual operational workplans and performance goals that support organizational quality and RAF objectives. - Coordinate cross-functional implementation of initiatives across Provider Relations, Care Management, Pharmacy, Network Management, Compliance, and Operations. - Use performance data and analytics to drive timely execution of interventions to close quality and coding gaps. - Identify operational barriers and implement corrective action plans to improve outcomes, efficiency, and accountability. - Support operational readiness for CMS, NCQA, HEDIS, RADV, and internal audit activities. Under "Provider Performance & Engagement": - Manage provider performance improvement initiatives across delegated and non-delegated networks. - Support provider engagement strategies, including provider scorecards, incentive programs, education, office outreach, and performance reviews. - Partner with Provider