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 Director of Medical Cost Management is a strategic leader responsible for the identification, development, implementation, and oversight of medical cost containment programs across the book of business. We are seeking a high-level individual contributor who is a team player, driven, highly analytical, and has a history of implementation success. You will work cross-functionally to achieve Zing Health’s economic and affordability goals by identifying cost drivers, managing medical expenses, and optimizing clinical and operational performance in collaboration with internal and external stakeholders.

ESSENTIAL FUNCTIONS:

• Medical Cost Oversight: Lead and manage enterprise-wide initiatives to control and reduce medical expenses, including inpatient, outpatient, professional, and pharmacy services.
• Trend Analysis: Partner with Medical Economics to monitor and analyze medical cost trends, utilization patterns, and healthcare spend to identify key drivers of cost and actionable opportunities for improvement.
• Strategy Development: Design and implement cost reduction strategies, including provider performance management, utilization management optimization, care management alignment, benefit design analysis, and high-cost member interventions.
• Vendor & Partner Management: Evaluate, implement, and performance management of third-party vendors (e.g., UM vendors, analytics partners) to ensure alignment with medical cost goals. Contract and negotiation experience preferred.
• Cross-Functional Collaboration: Partner with clinical, actuarial, finance, network, pharmacy, and population health teams to drive aligned medical cost performance initiatives.
• Reporting & Accountability: Partner with Medical Economics to deliver timely and actionable reporting on medical cost performance to executive leadership, including ROI tracking of cost containment initiatives.
• Regulatory Compliance: Ensure all programs and initiatives comply with CMS requirements and align with Medicare Advantage policies and quality standards.

Qualifications Requirements and Preferences:

Education & Experience:

• Bachelor’s degree
• Minimum of 7–10 years of progressive experience in healthcare consulting, healthcare cost management, finance, or medical economics.
• Experience working with Medicare Advantage populations preferred.
• Strong knowledge of healthcare reimbursement methodologies (e.g., FFS, capitation).

Skills & Competencies:

• Proven ability to lead cross-functional teams and drive complex, data-informed initiatives to measurable results.
• Expertise in claims data analysis, cost containment strategies, and healthcare performance metrics.
• Direct experience measuring the full cost of care life cycle of medical expense initiatives (opportunity assessment, program development, implementation, tracking/ongoing evaluation)
• Excellent communication and executive reporting skills.
• Strong project management and change management skills.
• Strategic mindset with a bias toward execution and continuous improvement.
• Self-driven with ability to identify/assess problems with proposed solutions
• Comfortable with dynamic, fast-paced environment

Zing Health offers the following benefits:

• A competitive salary based on the market
• Medical, Dental, and Vision
• Employer-Paid Life Insurance
• 401(K) match up to 4%
• Paid-Time-Off
• Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc.