Quality Engagement Specialist

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 Summary: 

As a Quality Engagement Specialist at Zing Health, you will be an integral part of ensuring a positive and supportive experience for our members, playing a vital role in ensuring our members receive comprehensive support in navigating the healthcare spectrum. This role has an emphasis on inbound and outbound campaigns and focuses on preventive and chronic care aligned with the Medicare Star Rating and general quality improvement programs. This role requires a deep understanding of health insurance processes, excellent communication skills, and a commitment to enhancing overall member satisfaction.

Key Responsibilities:

Member Interaction:

• Conduct inbound/outbound campaigns in accordance with departmental initiatives.
• Deliver a superior level of service by providing white-glove assistance, engaging in positive and empathetic conversations with members to ensure their needs are not only met but exceeded.
• Provide clear and accurate information regarding health plan coverage, benefits, and claims processes.
• Assist members in navigating the healthcare system and understanding their policy.

Member Education:

• Educate members on preventive care, wellness programs, and available resources within their health plan.
• Collaborate with internal teams to stay updated on policy changes, new benefits, and healthcare regulations.
• Ensure members are aware of and understand the various tools and resources available for managing their health.

Feedback Management:

• Gather and analyze customer feedback to identify trends and areas for improvement.
• Collaborate with cross-functional teams to implement changes based on customer feedback.
• Implement strategies to enhance overall customer satisfaction and loyalty.

Documentation and Compliance:

• Maintain accurate and detailed records of member interactions, ensuring compliance with healthcare privacy regulations.
• Stay informed about industry regulations, ensuring that all interactions comply with health plan policies and guidelines.

Requirements

Required Qualifications:

• High school diploma or equivalent required. 
• Minimum of 2 years of customer service and/or call center experience required. 
• Experience in healthcare, health insurance, Medicare, managed care, or member services preferred. 
• Strong verbal and written communication skills. 
• Strong typing, documentation, and data entry skills. 
• Ability to explain complex health plan information in a clear and member-friendly way. 
• Ability to organize work, manage multiple priorities, and follow campaign-specific workflows. 
• Strong attention to detail and commitment to accurate documentation. 
• Ability to demonstrate empathy, patience, professionalism, and sound judgment in all member interactions. 
• Familiarity with CRM systems, healthcare software, call center platforms, or Salesforce preferred. 

Preferred Qualifications:

• Knowledge of Medicare Advantage, Stars, HEDIS, CAHPS, preventive care, or care gap initiatives. 
• Comfortable conducting both inbound and outbound member outreach in a fast-paced call center or member engagement environment. 
• Ability to identify barriers, document outcomes, and escalate concerns appropriately. 
• Strong customer service mindset with a focus on improving the member experience. 
• Ability to adapt to new campaigns, workflows, systems, and business priorities. 
• Collaborative approach when working with internal departments and leadership. 

Member-Centric Impact Statement

Member Services is the frontline of member interaction, resolving concerns, answering questions, and providing assistance with empathy and efficiency. Exceptional customer service fosters member trust and satisfaction, encourages loyalty and retention, and streamlines processes to boost overall organizational productivity. Measurable impact includes improved retention rates, higher CAHPS and NPS scores, reduced voluntary disenrollment, and increased member engagement with preventive and supplemental benefits.

Member Success drives satisfaction and retention quality engagement by conducting proactive outreach, guiding members through benefits, coordinating issue resolution across departments, and ensuring smooth transitions of care. The team focuses on members with care gaps and issues and medication adherence concerns and addresses their barriers to care.

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