COMPANY OVERVIEW

Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for Medicare Beneficiaries. 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 Member Quality & Concierge Coordinator supports the Customer Success organization by delivering proactive outreach and concierge-level support designed to improve member engagement, close care gaps, enhance member satisfaction, and drive performance on Stars, HEDIS, CAHPS, and retention initiatives. This role serves as a trusted resource for members, assisting them with benefit education, healthcare navigation, appointment scheduling, issue resolution, medication adherence support, and completion of health-related initiatives.

The Coordinator is responsible for delivering personalized service that promotes trust, loyalty, and a positive member experience while executing outbound campaigns tied to quality and member experience goals including Health Risk Assessments (HRAs), medication adherence, preventive screenings, Annual Wellness Visits (AWVs), new member onboarding, annual support campaigns, and other strategic outreach initiatives. 

Essential Functions:

• Execute outbound member outreach campaigns related to quality, Stars, CAHPS, retention, and engagement initiatives such as new-member engagement and annual support.
• Contact members regarding Health Risk Assessments (HRAs), preventive care screenings, medication adherence programs, Annual Wellness Visits (AWVs), and other care gap closure opportunities.
• Educate members on available plan benefits, supplemental benefits, rewards programs, and healthcare resources.
• Schedule appointments and facilitate connections to providers, pharmacies, transportation resources, care management teams, and internal departments.
• Identify barriers to care and work collaboratively with members to facilitate resolution.
• Maintain ongoing follow-up activities to support successful completion of member objectives.
• Resolve member concerns through effective coordination with operational departments and vendor partners.
• Escalate member concerns requiring additional intervention while maintaining ownership through resolution.
• Utilize approved scripts, workflows, and documentation standards to ensure quality and compliance requirements are met.
• Share member feedback, trends, barriers, and opportunities for operational improvement with leadership.
• Participate in quality reviews, calibration sessions, coaching activities, and training programs.
• Accurately document all member interactions, outcomes, member needs and concerns, appointments, and follow-up activities within applicable systems.
• Adhere to CMS regulations, Medicare Advantage requirements, HIPAA guidelines, and company policies and procedures.
• Maintain confidentiality and data security standards.
• Meet established productivity, contact, quality, and campaign performance goals.
• Participate in team meetings, huddles, training sessions, and special projects.
• Perform other duties as assigned

Required Qualifications:

• High School Diploma or equivalent.
• Minimum of 2 years of customer service, healthcare, contact center, member services, or related experience.
• Strong verbal and written communication skills.
• Demonstrated ability to build rapport and establish trust with diverse populations.
• Strong organizational skills with exceptional attention to detail.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency with Microsoft Office applications and customer management platforms.
• Ability to work independently while contributing to team objectives.

Preferred Qualifications:

• Associate's or Bachelor's degree in a related field.
• Medicare Advantage, Medicaid, managed care, or healthcare experience.
• Experience supporting Stars, HEDIS, CAHPS, member engagement, or care gap initiatives.
• Experience scheduling healthcare appointments or conducting healthcare outreach campaigns.
• Bilingual English/Spanish preferred.
• Experience with Salesforce, Genesys, or similar CRM/contact center platforms.

Member-centric Impact Statement: 

Customer Success serves as a proactive extension of the member experience by helping members understand their benefits, navigate the healthcare system, and access needed services. Through personalized outreach and concierge-level support, the Member Quality & Concierge Specialist helps members overcome barriers to care, engage in preventive health activities, and maximize the value of their health plan.

Measurable impact includes increased Health Risk Assessment completion rates, improved medication adherence, higher preventive screening participation, stronger CAHPS and member satisfaction results, improved Star Ratings performance, increased member retention, and enhanced overall health outcomes. The Specialist's efforts directly contribute to Zing Health's mission of delivering a best-in-class member experience through meaningful engagement and support.