Quality Technician (Medical)

Join the dynamic journey at Vynca, where we're passionate about transforming care for individuals with complex needs. we're a close-knit community. At Vynca, our mission is to provide comprehensive care for more quality days at home. The Clinical Quality Specialist for the Enhanced Care Management (ECM) program is a newly created role supporting all aspects of ECM quality. This position conducts internal chart audits across Vynca’s contracted health plans, provides clinical oversight of care management documentation, and translates audit findings into operational and educational improvement in partnership with ECM Operations and the Training and Development team. The role requires active clinical licensure and combines independent chart review with cross-functional collaboration, and flexes into training delivery as program needs require. This is a highly visible position that directly supports audit readiness for health plan and regulatory review while advancing internal standards beyond what any single plan measures. Internal Auditing and Monitoring Conduct internal chart audits of Lead Care Managers across contracted health plans, applying each plan’s own audit criteria alongside Vynca internal quality standards. Maintain audit cadence in accordance with the ECM Internal Audit Cadence Stanard Operation Procedure, including elevated cadence for new hires and staff on performance improvement plans. Document findings objectively with supporting evidence locations so internal audit records can be used to respond to health plan documentation requests. Analyze results at the criterion, category, Lead Care Manager, and health plan level to identify trends, areas of opportunity, and emerging risk. Support audit readiness for health plan and regulatory audits, including self-audit submissions and corrective action plan (CAP) responses. Maintain the master audit record and reporting surfaces used for monthly and quarterly quality review. Serve as a clinical resource to Lead Care Managers on complex member scenarios, escalation pathways, and documentation of clinical decision-making. Review clinical content within training materials, assessments, and job aids for accuracy and alignment with scope of practice. Escalate identified clinical risk, member safety concerns, or quality-of-care issues through appropriate channels. Partner with ECM Operations leadership to translate audit findings into workflow change, documentation standards, and targeted remediation. Collaborate with Clinical and Program Managers on performance improvement plans, including audit-based evidence, progress monitoring, and tier and titration decisions. Partner with Training and Development Specialists to convert identified gaps into curriculum updates, education huddle content, and remediation training. Support the Compliance department on ECM audit readiness, regulatory monitoring, and quality assurance and performance improvement (QAPI) activities. Communicate results, trends, and at-risk staff to Clinical and Program Managers and to Directors. Training and Education Support Flex into training delivery as program needs require, including onboarding, ongoing education, and post-remediation reinforcement for Lead Care Managers. Maintain organized, audit-ready documentation of all internal quality activities. Monitor CalAIM policy changes, Department of Health Care Services (DHCS) guidance, and health plan criteria updates, and assess their impact on audit tools and documentation standards. Support the build and maintenance of plan-specific audit tools as health plan contracts are added or criteria change. Support ad-hoc quality initiatives, policy development, and special projects as assigned. Bachelor’s degree required. Master’s in Nursing, Social Work, Public Health, or Health Care Administration preferred.

• 1+ years of experience in quality auditing, chart review, utilization review, or quality assurance and performance improvement (QAPI) activities.
• Willing and able to work Monday through Friday 8:30am to 5pm Pacific Time.
• Strong analytical skills with the ability to identify patterns across data and translate findings into actionable recommendations.
• Exceptional written communication skills, particularly for documenting audit findings objectively and defensibly.
• Proficiency with Google Suite, electronic health records, and virtual collaboration platforms (e.g., Zoom, Microsoft Teams).
• Bilingual proficiency in English and Spanish.

Familiarity with the CalAIM initiative, Enhanced Care Management, and community-based care models. Experience conducting or responding to health plan delegation audits, including corrective action plans. Certification in healthcare quality (CPHQ) or healthcare compliance (CHC). Experience with training delivery, curriculum development, or adult learning principles. The hiring process for this role may consist of applying, followed by a phone screen, online assessment(s), interview(s), an offer, and background/reference checks. A background check, which may include a drug test or other health screenings depending on the role, will be required prior to employment. 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. we embrace diversity and are committed to fostering an inclusive workplace. We value all applicants regardless of race, color, religion, age, national origin, ancestry, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, veteran status, disability, genetic information, citizenship status, or membership in any other protected group under federal, state, or local law. Environmental Conditions and Physical Requirements Works with Vynca patients/clients remotely and/or in-person. Successfully performs the essential duties and responsibilities of the position through the use of physical activities as described below: Regularly requires working at a computer for an entire shift (with appropriate breaks). Regularly requires use of laptop and video-conferencing technology. Occasional travel may be required to perform job duties, attend training, or company events. #J-18808-Ljbffr Vynca Inc.