vynca - Director, ECM Training & Quality
Requirements
• 7+ years of experience in healthcare operations, care management, population health, managed care, or quality operations • 3+ years of leadership experience managing operational quality, audit, education, or performance improvement initiatives • Strong knowledge of CalAIM ECM requirements, Medi-Cal managed care operations, and health plan expectations • Demonstrated leadership experience in building clinical education, training program development, and quality improvement operational processes in fast-paced or high-growth healthcare environments • Hands-on experience with regulatory compliance and at least one full accreditation cycle • Deep knowledge analyzing operational data, quality metrics, and performance trends to drive business decisions • Strong written and verbal communication skills with the ability to translate complex clinical and regulatory concepts for diverse audiences • Must be able to collaborate effectively across geographically distributed, interdisciplinary care teams • Clinical leadership background (RN, LVN, LCSW, LMFT, or similar) • Experience supporting ECM, care coordination, Medicaid/Medi-Cal, or vulnerable population programs strongly preferred • Experience with quality management systems, audit tools, or healthcare reporting platforms • Lean Six Sigma or operational excellence experience preferred • Experience supporting remote and field-based workforce models preferred • This is a remote position with occasional travel required for training, meetings, and other business needs. At this time we are only considering applicants in the following states: Arizona, California, Colorado, Florida, Georgia, Illinois, Nevada, North Carolina, Oregon, Texas, Utah, and Washington, with a preference for applicants based in the Pacific Time Zone.
Responsibilities
• OPERATIONAL QUALITY STRATEGY & GOVERNANCE • Design, implement, and lead the ECM operational quality management program across all health plans and ECM lines of business • Establish enterprise-wide quality standards, documentation expectations, and operational best practices • Develop standardized workflows and quality governance processes to improve consistency across ECM teams • Build scalable quality assurance frameworks that support organizational growth and payer expansion • Partner with Clinical Operations leadership to align operational quality initiatives with care delivery goals and member outcomes • Audit Readiness & Regulatory Compliance • Lead organizational readiness for health plan, DHCS, and regulatory audits • Oversee internal audit programs focused on ECM documentation quality, workflow compliance, timeliness standards, and regulatory adherence • Develop and maintain audit readiness scorecards, corrective action plans, and monitoring processes • Identify operational and compliance risks proactively and implement mitigation strategies • Partner closely with Compliance and Clinical leadership regarding evolving CalAIM ECM requirements and payer expectations • Support responses to external audit findings, remediation plans, and operational follow-up initiatives • QUALITY IMPROVEMENT & PERFORMANCE OPTIMIZATION • Analyze quality trends, audit findings, operational KPIs, and performance data to identify improvement opportunities • Lead operational quality improvement initiatives aimed at improving documentation accuracy, timeliness, productivity, and member engagement outcomes • Develop and maintain quality dashboards and operational reporting tools for leadership review • Standardize quality metrics and operational performance expectations across ECM teams • Drive continuous improvement initiatives in partnership with Operations and Clinical leadership teams • EDUCATION, ONBOARDING & WORKFORCE ENABLEMENT • Develop and oversee onboarding, education, remediation, and competency programs for ECM staff • Establish ongoing education strategies aligned with audit trends, operational changes, payer updates, and regulatory requirements • Partner with managers to identify skill gaps and training needs across clinical and non-clinical care management teams • Ensure training programs support operational consistency, quality improvement, and employee readiness • Oversee development of SOPs, workflow guides, reference materials, and operational education content • LEADERSHIP & CROSS-FUNCTIONAL PARTNERSHIP • Lead and develop Quality, Audit, and Education team members • Partner cross-functionally with Clinical Operations, Compliance, People Operations, Analytics, and Executive Leadership • Serve as a strategic advisor regarding operational quality risks, trends, and process improvement opportunities • Support organizational scaling efforts through operational infrastructure development and process standardization • Foster a culture of accountability, operational excellence, continuous learning, and quality improvement • WHAT SUCCESS LOOKS LIKE • Improved health plan audit outcomes and reduced corrective action plans • Increased documentation accuracy, timeliness, and workflow compliance • Standardized operational workflows across ECM teams and markets • Improved onboarding readiness and staff competency validation • Reduced quality variance across managers and care management teams • Strong audit readiness infrastructure supporting organizational growth and payer expansion • Operational leaders view Quality & Operational Excellence as a strategic business partner • Supports ECM operations across multiple health plans, markets, and care management teams • Influences workflows and quality outcomes impacting clinical and non-clinical ECM staff • Oversees enterprise operational quality, education, and audit readiness initiatives • Supports programs serving high-acuity Medi-Cal populations, including individuals experiencing homelessness and complex behavioral health needs • Vaccination Requirement: Employees in patient, client, or customer-facing roles must be vaccinated against influenza. Requests for religious or medical accommodations will be considered but may not always be approved. • Employment Eligibility: Compliance with federal law requires identity and work eligibility verification using E-Verify upon hire.
Benefits
• We offer competitive compensation based on factors such as experience, skills, location, company needs, and market demands. • Great humans deserve great benefits! At Vynca, full time employees are eligible for benefits such as: medical, dental, and vision insurance, income protection benefits, flexible PTO, company holidays, 401k, and access to other wellness benefits. For field roles, mileage reimbursement will be provided per IRS guidelines. • Upload your resume here to autofill key application fields. • Drop your resume here! • Parsing your resume. Autofilling key fields... • or drag and drop here • Decline to self-identify • Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race. • Hispanic or Latino • White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. • White • Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa. • Black or African American • Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands. • Native Hawaiian or Other Pacific Islander • Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. • Asian • American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment. • American Indian or Alaska Native • Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races. • Two or More Races • Hispanic or Latino • White (Not Hispanic or Latino) • Black or African American (Not Hispanic or Latino) • Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) • Asian (Not Hispanic or Latino) • American Indian or Alaska Native (Not Hispanic or Latino) • Two or More Races (Not Hispanic or Latino) • I identify as one or more of the classifications of protected veteran listed above • I am not a protected veteran
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