Provider Data Manager

About the position

Zing Health is seeking a Provider Data Manager responsible for maintaining accurate and up-to-date provider data within our Medicare Advantage network. This role ensures compliance with CMS regulations, optimizes data quality processes, and collaborates with internal and external stakeholders to enhance provider network operations. This position requires a high-energy individual with a proven ability to manage large workloads, prioritize effectively, communicate clearly, and deliver results.

Responsibilities

• Oversee the maintenance, validation, and accuracy of provider data, including demographic details, contract affiliations, and credentialing information.
• Ensure provider data meets all CMS and state regulatory requirements, including accurate provider directory updates and network adequacy reporting.
• Develop and implement strategies to enhance provider data workflows, reduce errors, and improve automation.
• Partner with provider relations, credentialing, IT, claims, and compliance teams to ensure alignment and data accuracy.
• Work with IT to optimize provider data systems, integration with claims and directory platforms, and troubleshoot system issues.
• Monitor key performance indicators (KPIs), track data accuracy trends, and provide insights for leadership decision-making.
• Manage relationships with external data vendors, clearinghouses, and third-party administrators to ensure data consistency.

Requirements

• Bachelor’s degree in healthcare administration, business, IT, or a related field (Master’s preferred).
• 5+ years of experience in provider data management, network operations, or healthcare data governance, preferably in a Medicare Advantage setting.
• Strong knowledge of CMS Medicare Advantage regulations, including provider directory accuracy requirements.
• Experience with provider data management systems, claims processing, and credentialing platforms.
• Proven track record of process development and optimization.
• Excellent problem-solving, project management, and analytical skills.
• Strong communication and stakeholder management abilities.
• Independent thinker and worker with strong multi-tasking skills.

Benefits

• Medical
• Dental
• Vision
• 401(K) with Employer match up to 4%
• 9 Company Holidays