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13 days ago
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Requirements and responsibilities
About the jobThe Director, ECM Training & Quality is responsible for building and leading the operational quality infrastructure supporting Enhanced Care Management (ECM) programs across all markets and health plan partnerships. This role will report directly to the Senior ECM Director and be instrumental in designing, building, and operationalizing the organization’s quality, audit readiness, and education functions from the ground up. This is a highly hands-on leadership role requiring a builder mindset. The Director, ECM Training & Quality will not only establish the long-term vision and strategy for operational quality and workforce education, but will also actively develop the foundational processes, workflows, audit programs, onboarding structures, reporting mechanisms, and quality standards that support scalable ECM operations.As an early architect of this function, the Director, ECM Training & Quality will be expected to operate strategically while remaining deeply involved in day-to-day execution, including audit oversight, workflow development, training design, quality trend analysis, corrective action planning, and cross-functional operational problem solving. This leader will play a critical role in creating the infrastructure necessary to support rapid organizational growth, payer expansion, regulatory readiness, and operational consistency across distributed ECM teams.The Director, ECM Training & Quality will directly manage and develop the ECM Education & Training Specialist while building a scalable quality and education department capable of supporting organizational growth and evolving operational complexity. This leader will establish team structure, operational priorities, quality governance processes, and performance expectations for the function. The Director, ECM Training & Quality partners closely with Clinical Operations, People Operations, Compliance, Training, Analytics, and Executive Leadership to improve documentation quality, reduce audit risk, standardize workflows, strengthen staff competency, and drive operational excellence across programs serving high-acuity and vulnerable populations.This role is ideal for a leader who thrives in fast-paced, evolving environments and is energized by building scalable programs, creating structure from ambiguity, and developing high-performing operational quality functions from inception through maturity.What you’ll doOperational Quality Strategy & GovernanceDesign, implement, and lead the ECM operational quality management program across all health plans and ECM lines of businessEstablish enterprise-wide quality standards, documentation expectations, and operational best practicesDevelop standardized workflows and quality governance processes to improve consistency across ECM teamsBuild scalable quality assurance frameworks that support organizational growth and payer expansionPartner with Clinical Operations leadership to align operational quality initiatives with care delivery goals and member outcomesAudit Readiness & Regulatory ComplianceLead organizational readiness for health plan, DHCS, and regulatory auditsOversee internal audit programs focused on ECM documentation quality, workflow compliance, timeliness standards, and regulatory adherenceDevelop and maintain audit readiness scorecards, corrective action plans, and monitoring processesIdentify operational and compliance risks proactively and implement mitigation strategiesPartner closely with Compliance and Clinical leadership regarding evolving CalAIM ECM requirements and payer expectationsSupport responses to external audit findings, remediation plans, and operational follow-up initiativesQuality Improvement & Performance OptimizationAnalyze quality trends, audit findings, operational KPIs, and performance data to identify improvement opportunitiesLead operational quality improvement initiatives aimed at improving documentation accuracy, timeliness, productivity, and member engagement outcomesDevelop and maintain quality dashboards and operational reporting tools for leadership reviewStandardize quality metrics and operational performance expectations across ECM teamsDrive continuous improvement initiatives in partnership with Operations and Clinical leadership teamsEducation, Onboarding & Workforce EnablementDevelop and oversee onboarding, education, remediation, and competency programs for ECM staffEstablish ongoing education strategies aligned with audit trends, operational changes, payer updates, and regulatory requirementsPartner with managers to identify skill gaps and training needs across clinical and non-clinical care management teamsEnsure training programs support operational consistency, quality improvement, and employee readinessOversee development of SOPs, workflow guides, reference materials, and operational education contentLeadership & Cross-Functional PartnershipLead and develop Quality, Audit, and Education team membersPartner cross-functionally with Clinical Operations, Compliance, People Operations, Analytics, and Executive LeadershipServe as a strategic advisor regarding operational quality risks, trends, and process improvement opportunitiesSupport organizational scaling efforts through operational infrastructure development and process standardizationFoster a culture of accountability, operational excellence, continuous learning, and quality improvementWhat Success Looks LikeImproved health plan audit outcomes and reduced corrective action plansIncreased documentation accuracy, timeliness, and workflow complianceStandardized operational workflows across ECM teams and marketsImproved onboarding readiness and staff competency validationReduced quality variance across managers and care management teamsStrong audit readiness infrastructure supporting organizational growth and payer expansionOperational leaders view Quality & Operational Excellence as a strategic business partnerScope & ImpactSupports ECM operations across multiple health plans, markets, and care management teamsInfluences workflows and quality outcomes impacting clinical and non-clinical ECM staffOversees enterprise operational quality, education, and audit readiness initiativesSupports programs serving high-acuity Medi-Cal populations, including individuals experiencing homelessness and complex behavioral health needsYour experience and qualifications7+ years of experience in healthcare operations, care management, population health, managed care, or quality operations3+ years of leadership experience managing operational quality, audit, education, or performance improvement initiativesStrong knowledge of CalAIM ECM requirements, Medi-Cal managed care operations, and health plan expectationsDemonstrated leadership experience in building clinical education, training program development, and quality improvement operational processes in fast-paced or high-growth healthcare environmentsHands-on experience with regulatory compliance and at least one full accreditation cycleDeep knowledge analyzing operational data, quality metrics, and performance trends to drive business decisionsStrong written and verbal communication skills with the ability to translate complex clinical and regulatory concepts for diverse audiencesMust be able to collaborate effectively across geographically distributed, interdisciplinary care teamsPreferred QualificationsClinical leadership background (RN, LVN, LCSW, LMFT, or similar) Experience supporting ECM, care coordination, Medicaid/Medi-Cal, or vulnerable population programs strongly preferredExperience with quality management systems, audit tools, or healthcare reporting platformsLean Six Sigma or operational excellence experience preferredExperience supporting remote and field-based workforce models preferredThis 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.Additional InformationThe 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.Background Screening: A background check, which may include a drug test or other health screenings depending on the role, will be required prior to employment.Job Description Scope: This job description is not exhaustive and may include additional activities, duties, and responsibilities not listed herein.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.Equal Opportunity Employer: At Vynca Inc., 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.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.
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