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.