Project Manager, Provider Quality

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 

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.