ECM Quality Auditor & Clinical Oversight Lead

Vynca Inc.; Northern (KY); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Vynca Inc. is seeking a Clinical Quality Specialist for the Enhanced Care Management (ECM) program.

You will conduct internal chart audits, provide clinical oversight of care management documentation, and translate findings into operational improvements in partnership with ECM Operations and Training and Development. You will collaborate with cross-functional teams, support audit readiness for health plans and regulatory reviews, and help develop training materials to improve documentation

Qualifications

• Bachelor’s degree required; Master’s preferred in Nursing, Social Work, Public Health, or Health Care Administration.
• Active, unrestricted California clinical licensure required or ability to obtain within six months.
• 5+ years in care management, case management, or direct clinical practice.
• 1+ years in quality auditing, chart review, utilization review, or QAPI activities.
• Experience with documentation integrity and clinical documentation review for audit.
• Ability to work Monday–Friday 8:30am–5pm Pacific Time.

Responsibilities

• Conduct internal chart audits of Lead Care Managers across contracted health plans with plan-specific criteria and Vynca standards.
• Maintain audit cadence per ECM procedures, including elevated cadence for new hires.
• Select audit samples based on chart composition and enrollment tenure.
• Document findings with evidence for health plan requests.
• Analyze results to identify trends, opportunities, and risks.
• Support audit readiness for health plan and regulatory audits, including CAP responses.
• Provide secondary clinical review of assessments, care plans, and transitional care documentation.

Skills

Analytical skills

Clinical auditing

Communication skills

Google Suite

EHR proficiency

Cross-functional collaboration

Training delivery

Education

Bachelor’s degree

Master’s degree preferred

Tools

Electronic health records

Zoom

Microsoft Teams

Google Suite

Job description

Vynca Inc. is seeking a Clinical Quality Specialist for the Enhanced Care Management (ECM) program.

You will conduct internal chart audits, provide clinical oversight of care management documentation, and translate findings into operational improvements in partnership with ECM Operations and Training and Development. You will collaborate with cross-functional teams, support audit readiness for health plans and regulatory reviews, and help develop training materials to improve documentation