Compliance Specialist

Vynca•San Mateo, CA

About The Position

Join the dynamic journey at Vynca, where we're passionate about transforming care for individuals with complex needs. We’re more than just a team; we're a close-knit community. Our shared commitment to caring for each other and those we serve is what sets us apart. Guided by our unwavering core values: Excellence, Compassion, Curiosity, and Integrity, we forge paths of success together. Join us in this transformative movement where you can contribute to making a profound difference every day. At Vynca, our mission is to provide comprehensive care for more quality days at home.

Requirements

Bachelor’s degree in Healthcare Administration, Compliance, Legal Studies, Business, or a related field, or equivalent healthcare compliance experience.
2+ years of experience in healthcare compliance, regulatory affairs, audit, or a related role.
Working knowledge of healthcare compliance laws and regulations at the federal and state level.
Familiarity with healthcare enforcement trends and OIG/DOJ Compliance Program Guidance and enforcement priorities.
Experience supporting quality assurance and performance improvement (QAPI) initiatives, audits, or quality monitoring activities.
Strong analytical, organizational, and documentation skills.
Strong understanding of healthcare compliance and regulatory frameworks.
Ability to analyze regulations and translate them into practical guidance.
High ethical standards and sound judgment.
Excellent written and verbal communication skills.
Detail-oriented with strong follow-through.
Ability to assess operational compliance gaps and make risk-based decisions.

Nice To Haves

Certification in Healthcare Compliance (CHC) or similar compliance certification.
Experience supporting compliance audits, investigations, or regulatory examinations.
Knowledge of CMS regulations and reimbursement compliance.
Experience with Enhanced Care Management (ECM), Palliative Care programs, or similar care management models within Medicaid or managed care environments.
Knowledge of federal and state regulations governing telehealth and digital health services, including licensure, scope of practice, reimbursement, and virtual care delivery models.
Experience supporting compliance programs for high-growth, multi-state healthcare organizations, including scalable regulatory frameworks and state-level compliance analysis.
Knowledge of digital health regulatory considerations, including data privacy and remote patient monitoring.

Responsibilities

Compliance Program Support
Support the design, implementation, and ongoing maintenance of the organization’s healthcare compliance program in alignment with OIG and DOJ Compliance Program Guidance.
Assist in operationalizing the seven elements of an effective compliance program, including policies and procedures, training, monitoring, auditing, reporting, and enforcement.
Serve as a key resource to internal stakeholders on compliance-related questions and issues, providing guidance to translate regulatory requirements into actionable organizational practices.
Quality Program Support
Support compliance and quality oversight for Enhanced Care Management (ECM) and Palliative Care programs in alignment with federal, state, and payer requirements.
Monitor regulatory and contractual requirements while tracking evolving guidance impacting program operations, care delivery, and documentation standards.
Conduct audits, monitoring, and QAPI activities, including metric tracking, trend analysis, and support for corrective action plans.
Collaborate cross-functionally to address compliance risks, support audit readiness, and integrate quality and compliance standards into program workflows.
Regulatory Monitoring & Risk Management
Monitor federal and state healthcare laws and regulations, including but not limited to Anti-Kickback Statute, Stark Law, False Claims Act, HIPAA, and applicable state healthcare regulations.
Track DOJ and OIG enforcement actions, advisory opinions, special fraud alerts, and compliance guidance, and assess applicability to organizational operations.
Conduct compliance risk assessments and help identify, document, and address compliance risks, including fraud, waste, and abuse (FWA), enforcement trends, government oversight, and internal audits.
Support regulatory change management by tracking new or updated laws, regulations, and enforcement trends, including monitoring requirements for potential new markets as the organization expands.
Auditing, Monitoring & Investigations
Assist with compliance audits, monitoring activities, and reviews to assess adherence to internal policies and regulatory requirements.
Support internal investigations related to potential compliance concerns, including documentation, issue tracking, and corrective action plans.
Coordinate responses to compliance inquiries, audits, and regulatory requests, as directed by Compliance Leadership.
Maintain investigation and audit documentation in accordance with DOJ and OIG standards and expectations.
Training, Education & Communication
Assist in developing and delivering compliance training and education programs for employees, contractors, and leadership.
Promote awareness of compliance reporting mechanisms and non-retaliation standards.
Draft compliance communications, guidance documents, and policy updates, and support implementation of compliance guidance into day-to-day operations.
General Duties
Maintain organized, audit-ready records.
Collaborate with internal departments to streamline workflows and improve regulatory preparedness.
Stay informed on state and federal regulatory requirements
Support ad-hoc compliance and quality initiatives, including policy updates, audits, and corrective action implementation, as needed.