Zing Health

Description COMPANY OVERVIEW Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs and a dedicated care team. For more information on Zing Health, visit?www.myzinghealth.com. POSITION OVERVIEW The Provider Data Specialist is responsible for ensuring the accuracy of provider information across multiple internal systems and supporting data integrity for claims payment, provider directories, network participation, and credentialing workflows. This role focuses on maintaining high-quality provider data, performing roster reconciliation, and provider credentialing support. Responsibilities include coordinating credentialing activities such as collecting provider documents, assisting with primary-source verification, and supporting compliance with CMS, NCQA, Medicare, Medicaid, and other regulatory standards. The Provider Data Specialist serves as a key liaison between Provider Network Management, Credentialing, Compliance, and providers/provider organizations, ensuring timely, high-quality service and a positive provider experience. ESSENTIAL POSITION RESPONSIBILITIES Provider Data & Network Operations: - Facilitate provider inquiries promptly and professionally; document issues, actions, and resolutions in designated systems. - Maintain provider rosters and core data elements (demographics, specialties, affiliations, panel status, network participation, etc.) - Perform routine roster reconciliation with delegated entities, provider groups, and facilities to ensure alignment with internal provider data systems. - Configure and update providers (facilities, groups, ancillaries, practitioners) accurately for claims payment, reporting, and directory display. - Conduct data integrity audits and reconciliation activities; identify, correct, and report discrepancies with clear remediation tracking. - Prepare monthly/quarterly provider reports and extracts. - Support CMS-compliant provider directory maintenance by ensuring timely, accurate updates to all required fields. - Collaborate with Claims, Configuration, IT, Compliance, Member Services, and Network Management to resolve data discrepancies and improve workflows. Credentialing & Enrollment Support: - Coordinate collection of credentialing materials (licenses, DEA/CDS, board certifications, malpractice coverage, etc.) from new and existing providers. - Assist with primary-source verification support by gathering documentation and ensuring completeness and current status prior to credentialing review. - Maintain and update credentialing database; ensure provider profiles reflect accurate credentialing and recredentialing statuses and dates. - Conduct and manage credentialing audits with delegated groups. - Review federal/state sanctions (OIG, state boards, Medicare opt-out listings) Requirements POSITION QUALIFICATIONS Required Qualifications - 3+ years of experience in provider data management, credentialing support, provider relations, or managed care operations. - Working knowledge of Medicare Advantage provider requirements relevant to data and directories. - Hands-on experience with provider rosters, demographic maintenance, and data accuracy workflows, including reconciliation across multiple systems. - Ability to analyze large data sets and reconcile provider information across disparate sources. - Familiarity with health insurance operations and terminology (basic claims process; ICD-10, CPT, HCPCS; facility vs. professional billing). - Excellent written and verbal communication, customer service, and stakeholder management skills. - Demonstrated ability to multi-task while remaining well organized and detail oriented. - Proficiency with Microsoft Office; advanced Excel preferred (e.q., VLOOKUP/XLOOKUP, pivot tables, text functions, data validation).? Preferred Qualifications? - Experience with provider data/credentialing platforms (e.g., CAQH, NPPES, NPDB) - Experience working with delegated entities and interpreting roster file layouts. - Exposure to data quality frameworks, data governance, or directory compliance. Member-centric Impact Statement: The Provider Data Specialist plays a critical role in Zing Health’s commitment to member well-being by ensuring members have dependable, accurate information when choosing providers and accessing healthcare services. Zing Health offers the following benefits: - A competitive salary based on the market - Medical, Dental, and Vision - Employer-Paid Life Insurance - Paid Maternal Leave - Paid Paternal Leave - 401(K) match up to 4% - Paid-Time-Off - Employee Assistance Programs - Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc. Zing Health is committed to being an Equal Opportunity Employer. This means the company ensures all employment decisions, including hiring, promotion, compensation, and benefits, are made without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other legally protected characteristic. Zing Health strives to create a diverse, inclusive, and respectful workplace, providing equal access and opportunities for all employees and applicants. The organization actively promotes a culture of fairness and non-discrimination, supporting the personal and professional growth of every team member.

Description COMPANY OVERVIEW Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65 and over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the healthcare equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs, and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com. SUMMARY DESCRIPTION: The Grievance and Appeals Specialist position is responsible for reviewing and resolving members' and/or providers' complaints and communicating resolution to members or authorized representatives and/or providers in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). The Grievance and Appeals Specialist has frequent external contact with members and health care providers and interacts with and plays a key role in collaborating with internal contacts in Member Engagement, Provider Services, Pharmacy, Utilization Management, and other resources to identify factors necessary for the optimal resolution of complaints. ESSENTIAL FUNCTIONS: - Be able to process both appeals and grievances. - Have a strong Medicare Appeals processing background. - Logging, tracking, and ensuring completion of all appeals, direct member reimbursements, and grievance cases in compliance with CMS standards. - Manage tracking database to ensure the integrity of data and that all assigned cases are captured and maintained appropriately. - Prepare documentation and transmit appeals of clinical denials to the appropriate professional for review and tracking review completion to ensure final closure of the associated case. - Participate in all aspects of the direct member reimbursement, grievance & appeal process, specifically intake, triage, coordination, and documentation. - Research, investigate, and resolve administrative aspects of appeals and/or grievances from Zing members and related outside agencies utilizing systems, clinical assessment skills, knowledge, and approved “Decision Support Tools” in the decision-making process regarding health care services and care provided to members. - Assures the accuracy, timeliness, and appropriateness of all grievances and appeals according to state and federal, and Zing guidelines. - Collaborate with internal departments as necessary (Customer Service, Provider Services, Quality, Claims, Utilization Management, and others to ensure the timely resolution of all grievances and appeals. - Document the results of complaints and appeals and dispositions at all levels, including notification to providers and members. - Prepare and determine the appropriate language for letters and prepare responses for all appeals and grievances. - Assists with interdepartmental issues to help coordinate problem-solving in an efficient and timely manner. - Assist the Manager of Grievance and Appeals in establishing and maintaining policies and procedures, compliance reporting, and training material. - Manage workload volume, ensuring accuracy and compliance with scheduled deadlines. - Perform other related duties as assigned. Requirements QUALIFICATIONS AND REQUIREMENTS: Required Qualifications - High school diploma or GED with at least two years of college or equivalent experience - Strong communication skills both oral and written - Strong organizational skills, consistent attention to detail and independent problem-solving skills - Minimum of two (2) years of experience in a Managed Care (Health Plan) environment performing appeals reviews/investigation or data analysis. - Knowledgeable of various operational areas such as customer service, provider service, claims processing, utilization management, pharmacy and dental in a managed care setting. - Ability to perform multiple tasks simultaneously, work under pressure and meet critical deadlines. - Must possess a high degree of professionalism and business ethics. - Knowledge of medical terminology, insurance terminology and benefit plan coverage and exclusions Preferred Qualifications - Familiarity with CMS claims denials and appeals processing, rules, regulations and accreditation standards and requirements. - Advanced knowledge of computer systems, such as Microsoft Word, Excel, and Outlook.

Description Company Overview: Zing Health is a tech-enabled health insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs, and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com. Our technology organization is investing in modern digital and AI capabilities to improve member experience, strengthen provider operations, and increase enterprise efficiency. SUMMARY DESCRIPTION: Zing Health is seeking an AI Engineer to help implement AI-powered solutions across our enterprise technology platform. This is a hands-on engineering role focused on building AI-enabled applications and integrating AI services into existing systems. You will work closely with the AI & Automation team and engineering teams to build and support AI use cases using Azure AI services, APIs, and enterprise data platforms. This role focuses on practical AI implementation rather than research or model development. This is a great opportunity for an engineer interested in working with AI, automation, and modern cloud technologies in a healthcare environment. ESSENTIAL FUNCTIONS: Build AI-enabled applications - Develop applications that leverage Azure OpenAI and Azure AI services - Implement LLM-based workflows such as prompting, document analysis, and conversational experiences - Support AI use cases such as document processing, automation, and intelligent workflow support - Build integrations between AI services and enterprise platforms such as Salesforce, Genesys, and internal applications - Work with APIs and services to enable AI-driven capabilities - Implement workflows using tools such as Azure Functions, Logic Apps, or Power Automate - Support AI-powered automation initiatives across operations and member/provider services - Connect AI services with internal data sources including data warehouses, APIs, and operational platforms - Assist with processing structured and unstructured data for AI use cases - Partner with engineering, security, and data teams to deploy AI solutions - Participate in testing, monitoring, and improvement of AI solutions in production Requirements Required Qualifications - 3–5 years’ experience in software engineering, cloud engineering, or application development - Experience working with cloud platforms such as Microsoft Azure - Experience building or integrating REST APIs - Familiarity with Python, JavaScript, or similar programming languages - Interest in working with AI technologies and automation tools Preferred Qualifications (Nice-to-Haves) - Exposure to Azure OpenAI, Azure AI services, or similar AI platforms - Familiarity with LLM concepts such as prompt engineering or retrieval-based workflows - Experience with automation tools such as Logic Apps or Power Automate - Exposure to enterprise systems such as Salesforce or CRM platforms - Basic understanding of data platforms or SQL - Interest in healthcare technology or regulated environments Zing Health offers the following benefits: - A competitive salary based on the market - Medical, Dental, and Vision - Employer-Paid Life Insurance - Paid Maternal Leave - Paid Paternal Leave - 401(K) match up to 4% - Paid-Time-Off - Employee Assistance Programs - Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc.

Description COMPANY OVERVIEW Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65 and over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the healthcare equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs, and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com. SUMMARY DESCRIPTION: The Project Manager, Provider Quality position is responsible for supporting strategic program and project design, execution, and performance management of initiatives supporting Quality Improvement and the Star Rating measurement system established by the Centers for Medicare and Medicaid Services (CMS). The Project Manager, Provider Quality collaborates across a matrixed organization and is responsible for coordinating efforts across multiple domains and functional workgroups that impact Zing Health’s Medicare Star ratings. This role will leverage project management skills and discipline across a strategic playbook of interventions, campaigns, and initiatives and may involve participating in activities including, but not limited to, market research, competitive analysis, content review and development, partnership with third-party print and engagement solutions, vendor engagement and management, reporting, and presentation development. This role interacts with and plays a key role in collaborating with all departments at Zing Health. ESSENTIAL FUNCTIONS: Project Management & Vendor Implementations - Effectively manage projects from inception to performance management - Demonstrate an understanding of the Medicare Star Rating program - Clear understanding of CMS guidelines and technical specifications - Effective project plan development, maintenance, and management - Risk management and escalation - Star measure data analysis and intervention recommendations - Logging, tracking, and ensuring completion of all key project milestones - Maintain a working knowledge of competitive strategies, marketing techniques, and outsourced solutions to improve Star Rating performance - Effectively communicate across departments and manage expectations and priorities - Participate in or lead cross-departmental workgroups and committees - Closely partner with strategic partners throughout the organization to effectively set and performance manage appropriate project/initiative related goals - Meet with key stakeholders throughout the organization to gather, document, track, and update specific requirements of each project/intervention - Track project / intervention performance, specifically to analyze the successful completion of the project / intervention and continuously improve project / intervention execution for subsequent measurement periods - Communicate, as needed, with appropriate RACI stakeholders to keep projects / initiatives on track and / or aligned with organizational goals and budget - Perform quality control on the projects / interventions throughout the project / intervention lifecycle - Serve as a liaison for the Provider Network department, with a dotted line to the Population Health and Value-Based department, for shared projects, including appropriate routing through compliance and CMS workflows - Perform other related duties as assigned Requirements QUALIFICATIONS AND REQUIREMENTS: JOB REQUIREMENTS: Required Qualifications - Bachelor’s Degree in management, Project Management, or equivalent - Be able to effectively manage a project plan lifecycle - 1-3 years of experience in a Medicare Star Rating related role either at a Medicare Advantage or third party serving Medicare membership as an outsourced solution - Strong communication skills both oral and written - Strong organizational skills, consistent attention to detail, and independent problem-solving skills - Facile with Medicare Advantage and the Medicare Star Rating program, especially areas such as customer service, provider service, pharmacy, marketing, supplemental benefits, flexible spending technology, CAHPS, HOS, and HEDIS - Ability to perform multiple tasks simultaneously, work under pressure, and meet critical deadlines - Must possess a high degree of professionalism and business ethics - Ability to work autonomously with little to no daily supervision while demonstrating continual progress and effective management of projects / interventions Preferred Qualifications - Familiarity with project management tools such as Jira, Trello, Smartsheet, Microsoft Project, Monday, Wrike, etc. - Advanced knowledge of computer systems, such as Microsoft Word, PowerPoint, Excel, and Outlook - PMP or Lean Six Sigma certifications Member-centric Impact Statement Provider Network: Directly impacts member satisfaction and retention by contracting and building strategic relationships with PCPs, Specialists and other Providers, ensuring access to high-quality, culturally competent providers and minimizing care disruptions. Value-based contracts and payment models allow us to tailor our approach, meeting providers where they are on the risk continuum, driving provider quality and efficiency and rewarding performance. Provider Data: Ensures the accuracy, integrity, and timeliness of provider information across directories, claims, contracts, and regulatory systems to enable seamless member access to in-network care. Building rigor in our approach to maintaining clean, compliant data, the team reduces claim denials and rework, improves directory accuracy, supports CMS audit readiness, and enhances operational efficiency—strengthening member satisfaction, provider trust, retention, and overall organizational productivity. Zing Health offers the following benefits: - A competitive salary based on the market - Medical, Dental, and Vision - Employer-Paid Life Insurance - Paid Maternal Leave - Paid Paternal Leave - 401(K) match up to 4% - Paid-Time-Off - Employee Assistance Programs - Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc.

Description COMPANY OVERVIEW Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs, and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com. SUMMARY DESCRIPTION: Reporting to the Director of Enrollment, the Manager, Eligibility & Enrollment is responsible for supporting and optimizing Zing Health’s core eligibility and enrollment functions. This individual will oversee specific operational workflows and vendor relationships to ensure accurate and timely processing of transactions in compliance with CMS regulations. Responsible for overseeing all aspects of enrollment and eligibility including member enrollment, disenrollment, reconciliation, and compliance processes. This role ensures accurate and timely processing of member data in accordance with Centers for Medicare & Medicaid Services (CMS) regulations and internal policies. The Manager, Eligibility & Enrollment leads a team of enrollment specialists and works cross-functionally with compliance, IT, member services, sales, and external vendors to ensure operational excellence and regulatory adherence. A key focus of this role is leveraging data and cross-functional collaboration to drive continuous improvement, resolve discrepancies, and enhance the member onboarding experience. The ideal candidate will bring strong analytical expertise, operational savvy, people leadership skills, and a proactive, solutions-oriented mindset. ESSENTIAL FUNCTIONS: - Oversee assigned operational workflows within eligibility and enrollment, ensuring accuracy, compliance, and alignment with CMS requirements. - Manage and develop a small team responsible for execution of day-to-day enrollment and eligibility tasks, fostering a culture of accountability, growth, and continuous improvement. - Analyze enrollment and eligibility data to identify trends, root causes, and performance gaps; translate insights into actionable solutions. - Design and lead cross-functional projects to enhance operational performance and member experience. - Maintain and enhance internal tracking, reconciliation, and audit-readiness protocols. - Monitor vendor performance against SLAs and ensure timely resolution of escalated issues. - Develop and deliver high-quality reports and dashboards for internal stakeholders and senior leadership. - Stay abreast of CMS guidance and evolving regulatory requirements, ensuring that internal procedures remain compliant. - Manage end to end eligibility, enrollment and disenrollment processes. - Partner with end users and business owners to thoughtfully design and deliver AI/automation solutions, translating workflow needs into clear business requirements (scope, rules, dependencies, SMEs/UAT resources), and leading solutions through build, testing/validation, and production rollout. Requirements MINIMUM QUALIFICATIONS: - Bachelor’s degree or equivalent experience - 3+ years of Medicare Advantage experience - Demonstrated leadership experience, including managing people or operational teams - Strong analytical skills with proficiency in Excel, SQL, or BI tools - Experience collaborating cross-functionally in fast-paced, complex environments - Background in management consulting or healthcare advisory preferred, particularly with exposure to process optimization, operational design, or strategy implementation - Strong understanding of Medicare Advantage regulatory requirements, enrollment/eligibility platforms, and reconciliation tools? PREFERRED QUALIFICATIONS: - Strong project management skills with a track record of leading initiatives across departments - Proven ability to synthesize complex data into clear insights and practical improvements - Experience with vendor management and performance monitoring - Excellent communication, interpersonal, and organizational skills Member-centric Impact Statement: Enrollment: Supports satisfaction by ensuring a seamless, error-free onboarding and eligibility experience. Improves retention by preventing coverage disruptions and billing inaccuracies. Enhances productivity by maintaining accurate CMS transactions and minimizing retroactive corrections and member confusion. C-SNP Verification: Verifies eligibility of members enrolled in C-SNPs. Protects C-SNP members from involuntary disenrollment and helps to ensure continuity of care by ensuring required chronic condition verification is completed within CMS’s 60 day verification window. Zing Health offers the following benefits: - A competitive salary based on the market - Medical, Dental, and Vision - Employer-Paid Life Insurance - Paid Maternal Leave - Paid Paternal Leave - 401(K) match up to 4% - Paid-Time-Off - Employee Assistance Programs - Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc. Zing Health is committed to being an Equal Opportunity Employer. This means the company ensures all employment decisions, including hiring, promotion, compensation, and benefits, are made without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other legally protected characteristic. Zing Health strives to create a diverse, inclusive, and respectful workplace, providing equal access and opportunities for all employees and applicants. The organization actively promotes a culture of fairness and non-discrimination, supporting the personal and professional growth of every team member.

Description COMPANY OVERVIEW Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com. SUMMARY DESCRIPTION: The Manager, Vendor Programs & Implementation is a full-time role responsible for overseeing the operational performance, implementation, and ongoing management of supplemental benefit vendors. This role is split between project management for new and upcoming vendor implementations and day-to-day vendor management oversight, ensuring operational readiness, regulatory compliance, data integrity, and high-quality member experience. This individual serves as a key liaison between internal stakeholders and external vendors, owning timelines, issue resolution, reporting, and escalation management across multiple supplemental programs. This person should be a high achiever and performer. ESSENTIAL FUNCTIONS: Project Management & Vendor Implementations Own and manage end-to-end project execution for supplemental vendor implementations and enhancements, including planning, coordination, testing, go-live, and post implementation stabilization. Primary implementation responsibilities include: Project Management expectations: - Develop and maintain detailed project plans, timelines, and dependencies - Coordinate cross-functional stakeholders (Operations, IT, Compliance, Finance, Marketing) - Track risks, issues, and mitigation strategies - Ensure vendors meet contractual, technical, and regulatory requirements - Lead vendor testing, validation, and sign-off processes - Communicate status updates and executive-level summaries as needed Vendor Management & Operational Oversight (Ongoing) - Provide ongoing vendor oversight to ensure performance, compliance, and service quality across all assigned supplemental vendors. Cross Functional Collaboration - Partner closely with Operations, Compliance, IT, Finance, and Member Experience teams - Act as a single point of accountability for assigned vendors and implementations - Translate operational and regulatory requirements into actionable vendor expectations - Support leadership with insights, risks, and recommendations Requirements Required Qualifications: - Bachelor’s degree or equivalent professional experience - 5+ years of experience in: - Vendor management - Project or program management - Healthcare operations, preferably Medicare Advantage or supplemental benefits - Strong understanding of: - Supplemental benefits and vendor ecosystems - 837 file formats and data exchanges - Regulatory and Part C reporting considerations Preferred Qualifications: - Experience with SSBCI programs, and carded services - Prior implementation experience with OTC, transportation, or carded benefits - Familiarity with healthcare data reporting and dashboards - PMP, Lean, Six Sigma, or similar project management certification (preferred, not required) - Strong understanding of: - Supplemental benefits and vendor ecosystems - 837 file formats and data exchanges Member-centric Impact Statement: This role directly supports Zing Health’s commitment to delivering reliable, compliant, and high-quality supplemental benefits by ensuring vendors are implemented accurately and managed consistently across the member lifecycle. Through strong project management and ongoing vendor oversight, the position helps ensure members receive ID cards, welcome kits, OTC, transportation, and other supplemental services on time, without errors or disruptions. By proactively managing vendor performance, data accuracy, and escalations, this role reduces member confusion, prevents avoidable issues, and supports Zing’s goals of operational excellence, regulatory compliance, and a seamless member experience—particularly as the organization scales into 2027 and beyond. Zing Health offers the following benefits: - A competitive salary based on the market - Medical, Dental, and Vision - Employer-Paid Life Insurance - Paid Maternal Leave - Paid Paternal Leave - 401(K) match up to 4% - Paid-Time-Off - Employee Assistance Programs - Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc Zing Health is committed to being an Equal Opportunity Employer. This means the company ensures all employment decisions, including hiring, promotion, compensation, and benefits, are made without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other legally protected characteristic. Zing Health strives to create a diverse, inclusive, and respectful workplace, providing equal access and opportunities for all employees and applicants. The organization actively promotes a culture of fairness and non-discrimination, supporting the personal and professional growth of every team member

Description COMPANY OVERVIEW Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com. JOB DESCRIPTION: The Integrated Care Manager will be responsible for conducting health risk assessments, coordination of care, and care management for MAPD, C-SNP, and D-SNP members. ESSENTIAL FUNCTIONS: Fundamental Components include but are not limited to: - Performs assessments of members, including Health Risk assessments per CMS regulation - Follows the patient through various transitions of care to ensure that any gaps in treatment plans are identified and remedied, and promote efficient health care delivery. - Participates in assessment activities to develop individualized care plans in coordination with the patient, family, and providers. - Applies case management standards of practice to focus on effective care of high-need members. - Serves as a member advocate and resource, and provides critical information and recommendations to the rest of the care team. - Maintains strong knowledge of Case management, community resources, and plan benefits to promote improved member experience and health outcomes. - Works collaboratively with the member (and caregivers), primary care physicians, specialists, and other care providers to ensure member compliance and adherence to the medical plan of care. - Assists the Health Services Team in implementing best practices for chronic care and disease management. - Follows standard protocols, processes, and policies. - Provides member education to assist with self-management and encourages members to make healthy lifestyle changes. - Interacts with Medical Directors, Pharmacists, Social Workers, Behavioral Health Clinicians, and Other Impact Team Members on cases - Makes referrals to outside sources. - Documents and tracks clinical reviews, member care plans, referrals, and findings. - Performs other duties, projects, and actions as assigned. Requirements QUALIFICATIONS AND REQUIREMENTS: JOB REQUIREMENTS: Required Skills: - Registered Nurse (RN) with 3 years of direct clinical care to the consumer in a clinical setting. - Current, valid, unrestricted license - 3 years of managed care experience or other commensurate experience - Demonstrates strong clinical knowledge, ability to perform clinical assessments, ability to use critical thinking skills and has the capacity for continued learning. - Knowledge of plan benefit designs. - Demonstrated ability to perform case management & disease management activities. - Ability to demonstrate knowledge of and apply those to the job function and responsibilities. - Problem-solving skills: the ability to systematically analyze problems, draw relevant conclusions, and devise appropriate courses of action. - Verbal and written communication skills, including listening, discussing, and documenting medical needs with members, providers, internal staff/management, external vendors, and community resources. - PC proficiency to include Outlook, Word, Excel, database experience, and web-based applications. - Personal management skills — Plan and manage multiple assignments and tasks, set priorities, and adapt to changing conditions and work assignments. Teamwork — ability to work well with one or more groups. - Interpersonal effectiveness — Relate to co-workers and build relationships with others in the organization. Preferred Skills: - CM or DM experience with a Managed Care Organization (MCO) - Patient education experience. - Bilingual – English and Spanish - Certification in Case Management or a nationally recognized health care certification. Member-centric Impact Statement: The Health Services department ensures that members receive high-quality, evidence-based medical care and interventions. By closely monitoring clinical outcomes and implementing best practices, Clinical ME enhances member satisfaction, encourages retention through improved health outcomes, and supports productivity by reducing preventable complications and hospitalizations. Zing Health offers the following benefits: - A competitive salary based on the market - Medical, Dental, and Vision - Employer-Paid Life Insurance - Paid Maternal Leave - Paid Paternal Leave - 401(K) match up to 4% - Paid-Time-Off - Employee Assistance Programs - Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc.

Description Company Overview: Zing Health is a tech-enabled health insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs, and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com. Our technology organization is investing in modern digital and AI capabilities to improve member experience, strengthen provider operations, and increase enterprise efficiency. SUMMARY DESCRIPTION: Zing Health is seeking an AI Engineer to help implement AI-powered solutions across our enterprise technology platform. This is a hands-on engineering role focused on building AI-enabled applications and integrating AI services into existing systems. You will work closely with the AI & Automation team and engineering teams to build and support AI use cases using Azure AI services, APIs, and enterprise data platforms. This role focuses on practical AI implementation rather than research or model development. This is a great opportunity for an engineer interested in working with AI, automation, and modern cloud technologies in a healthcare environment. ESSENTIAL FUNCTIONS: Build AI-enabled applications - Develop applications that leverage Azure OpenAI and Azure AI services - Implement LLM-based workflows such as prompting, document analysis, and conversational experiences - Support AI use cases such as document processing, automation, and intelligent workflow support - Build integrations between AI services and enterprise platforms such as Salesforce, Genesys, and internal applications - Work with APIs and services to enable AI-driven capabilities - Implement workflows using tools such as Azure Functions, Logic Apps, or Power Automate - Support AI-powered automation initiatives across operations and member/provider services - Connect AI services with internal data sources including data warehouses, APIs, and operational platforms - Assist with processing structured and unstructured data for AI use cases - Partner with engineering, security, and data teams to deploy AI solutions - Participate in testing, monitoring, and improvement of AI solutions in production Requirements Required Qualifications - 3–5 years’ experience in software engineering, cloud engineering, or application development - Experience working with cloud platforms such as Microsoft Azure - Experience building or integrating REST APIs - Familiarity with Python, JavaScript, or similar programming languages - Interest in working with AI technologies and automation tools Preferred Qualifications (Nice-to-Haves) - Exposure to Azure OpenAI, Azure AI services, or similar AI platforms - Familiarity with LLM concepts such as prompt engineering or retrieval-based workflows - Experience with automation tools such as Logic Apps or Power Automate - Exposure to enterprise systems such as Salesforce or CRM platforms - Basic understanding of data platforms or SQL - Interest in healthcare technology or regulated environments Zing Health offers the following benefits: - A competitive salary based on the market - Medical, Dental, and Vision - Employer-Paid Life Insurance - Paid Maternal Leave - Paid Paternal Leave - 401(K) match up to 4% - Paid-Time-Off - Employee Assistance Programs - Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc.