Quality Program Manager at Evergreen Nephrology

RemoteFull-timeRemoteQuality & EffectivenessPosted 8 days ago

About the Role

Who We Are  Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants.  We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today.  Who You Are  You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change.   Your Role  As a Quality Program Manager with Evergreen Nephrology, you are responsible for leading the day-to-day execution of Evergreen’s clinical quality programs and managing the performance of Quality Improvement Specialists (QIS) and related quality roles.  This role ensures consistent execution of quality workflows, drives accountability for care gap closure, and supports performance improvement across HEDIS, Medicare Stars, CKCC, and other value-based care programs.  The Quality Program Manager is also responsible for ensuring that frontline operations align with NCQA accreditation standards, including oversight of documentation practices, workflow adherence, and compliance with required processes to support audit and survey readiness.  This role partners closely with Clinical Operations, Analytics, CDI/Coding, and Market Operations to operationalize quality initiatives, monitor performance, and remove barriers to achieving quality targets.  Role Responsibilities  <ul> <li>Team Leadership & Management  <ul> <li>Directly manager Quality Improvement Specialists and other quality team members </li> <li>Establish clear expectations, workflows, and performance targets aligned to quality goals </li> <li>Monitor individual and team productivity, quality outcomes, and execution metrics </li> <li>Provide coaching, feedback, and development to improve performance and capability </li> <li>Ensure consistency in how teams execute outreach, gap closure, and documentation workflows </li> </ul> </li> <li>Execution Oversight & Operational Management  <ul> <li>Oversee day-to-day quality operations, ensuring workflows are executed consistently across teams and markets<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Monitor adherence to care gap closure processes, outreach protocols, and documentation standards<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Identify breakdowns in execution and implement corrective actions in real time<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Coordinate resources and support teams to meet program deadlines and deliverables<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> </ul> </li> <li>Quality Improvement Education  <ul> <li>Support implementation of enterprise quality initiatives at the team level<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Drive targeted interventions to improve care gap closure rates and measure performance<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Identify workflow inefficiencies and recommend improvements to increase effectiveness<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Reinforce best practices in documentation, coding, and care coordination<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> </ul> </li> <li>Care Gap & Workflow Management  <ul> <li>Oversee execution of care gap identification and closure processes across teams<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Ensure accurate documentation and proper capture of quality-related data<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Partner with CDI and coding teams to reinforce documentation and coding standards<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Monitor hybrid measure workflows and medical record submission processes as needed<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> </ul> </li> <li>Cross-Functional Coordination  <ul> <li>Serve as the operational bridge between quality leadership and frontline execution<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Partner with Clinical Operations teams (Navigation, TOC, CCPM, PAC) to integrate quality workflows<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Coordinate with Analytics on reporting accuracy and data needs<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Work with Market Operations to align execution and address local barriers<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> </ul> </li> <li>Provider & Market Support  <ul> <li>Support delivery of quality performance insights to providers and market leaders<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Reinforce expectations for care gap closure and documentation workflows<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Partner with markets to identify and address execution challenges<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Ensure alignment between enterprise quality priorities and frontline workflows<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> </ul> </li> <li>NCQA  <ul> <li>Partner with Accreditation and NCQA specialists to ensure operational compliance with NCQA standards<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Ensure workflows, documentation, and team practices align with accreditation requirements<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Support NCQA readiness activities, including documentation review and workflow validation<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Identify compliance gaps and partner cross-functionally to implement corrective actions<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Reinforce NCQA-aligned practices across frontline teams<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> <li>Support training and education related to accreditation standards and documentation requirements<span data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335557856":16777215,"335559685":1440,"335559737":0,"335559738":0,"335559739":0,"335559740":279,"335559991":360}"> </li> </ul> </li> <li>Other duties consistent with this role, as assigned. </li> </ul> Required Qualifications  <ul> <li>3–5+ years of experience in healthcare operations, quality, or population health </li> <li>Experience with HEDIS, Medicare Stars, or similar quality programs </li> <li>Prior experience leading teams or supervising frontline staff </li> <li>Strong understanding of care gap closure workflows and clinical operations </li> <li>Ability to use data to drive execution and performance improvement </li> <li>NCQA accreditation or regulatory compliance </li> <li>Experience supporting audits, surveys or readiness efforts </li> <li>Intermediate skills with MS Office Suite of products including Outlook and Teams </li> <li>Able to work effectively in a primarily remote environment:  <ul> <li>Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended </li> <li>Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role </li> <li>Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information </li> </ul> </li> </ul> Preferred Qualifications  <ul> <li>Experience in value-based care models </li> <li>Exposure to CKD/ESKD or chronic care management programs </li> <li>Familiarity with documentation and coding practices impacting quality performance </li> </ul> Benefits   Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:  <ul> <li>Paid time off starting at 4 weeks for full-time employees </li> <li>12 paid holidays per year </li> <li>Medical, dental, vision and life insurance, including an HSA with employer match </li> <li>Reimbursement for continuing medical education for eligible roles </li> <li>A 401(k) program where Evergreen matches up to 4% of contributions after six months of tenure </li> <li>Paid parental leave </li> <li>A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology </li> </ul>   Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.    If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at <a href="mailto:%[email protected]">talent@egneph.com</a>.

About the Role

About the Role

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About the Role

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