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northstar-payer-operations

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Solve Northstar Health Plan payer-operations determination tasks against the shared read-only environment — UM prior-auth, pharmacy appeal + assistance, claim repricing, peer-to-peer, and therapy margin queue — and return one strict JSON object matching the task's answer template. Read BEFORE working any task whose prompt references Northstar, a TASK_ENV base URL, the /sql/query bearer token, or an input/payloads/answer_template.json.

experiments/claude_code_glm_5_2_max/reports/skills/task_group_014/self/self_attempt_02/SKILL.md

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Oct 29, 2026
License
Apache-2.0

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# Northstar Payer Operations — Structured Determination Skill

This skill produces one strict JSON object for a Northstar Health Plan payer-operations
task. Each task points at a shared read-only environment, names a target business record,
and ships an `answer_template.json` that defines the exact output contract. The work is
always: read the inputs → query only the target record(s) from the environment → apply the
decision rules → emit JSON that matches the template, including a `basis_audit` trail.

## When to use

Use this skill for any task that:
- references Northstar Health Plan, utilization management (UM), appeals, payment
  integrity, peer-to-peer (P2P), or a therapy margin queue; **or**
- gives a `<TASK_ENV_BASE_URL>` / `task-env` environment, a `POST /sql/query` bearer token,
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