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northstar-payer-ops-determination

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Generate a structured JSON determination for a Northstar Health Plan payer-operations work item — UM nurse authorization determination, pharmacy coverage appeal + manufacturer-assistance intake, payment-integrity claim repricing, peer-to-peer final summary, or UM-finance therapy margin queue. Use when a task provides prompt.txt, task_context.json, and answer_template.json and asks for one JSON object conforming to the template, with facts drawn from the shared payer-operations environment reached over the network via environment_access.md.

experiments/claude_code_glm_5_2_max/reports/skills/task_group_014/fewshot/fewshot_attempt_02/SKILL.md

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Oct 29, 2026
License
Apache-2.0

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# Northstar Payer-Operations Structured Determination

This skill produces one structured JSON determination for a Northstar Health Plan
payer-operations work item. The work item is always some flavor of utilization
management, appeals, payment integrity, peer-to-peer, or finance-margin review.
The deliverable is always a single JSON object whose shape is dictated by the
task's own `answer_template.json`, and whose facts come only from the shared
payer-operations environment reached over the network.

## When to use

Use this skill when a task gives you:

- a `prompt.txt` describing a Northstar payer-ops work request,