Quality Improvement Specialist at Evergreen Nephrology

<p><strong>Who We Are</strong></p> <p>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.</p> <p>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.</p> <p><strong>Who You Are</strong></p> <p>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.</p> <p><strong>Your Role</strong></p> <p>As a Quality Improvement Specialist with Evergreen Nephrology, you are responsible for serving as the connector between patients, provider practices, and internal teams to&nbsp;identify, manage, and close quality gaps through targeted education, consistent outreach, and&nbsp;data driven&nbsp;collaboration. The&nbsp;Quality Improvement&nbsp;Specialist manages&nbsp;a defined patient and provider panel, delivers actionable performance insights, and drives improvement across HEDIS and Medicare Stars measures&nbsp;using payer specific specifications,&nbsp;timelines&nbsp;and attribution logic. The ideal candidate is effective&nbsp;across&nbsp;patient engagement, provider coaching, workflow optimization, and cross&nbsp;functional&nbsp;teamwork, and is comfortable operating in a fast pace, performance-oriented value-based care environment.</p> <p><strong>Role Responsibilities</strong></p> <ul> <li><strong>Provider Engagement, Quality Education &amp; Measure Performance</strong> <ul> <li>Serve as a trusted partner to nephrology and primary&nbsp;or&nbsp;specialty practices on HEDIS and&nbsp;Stars&nbsp;expectations, documentation standards, and&nbsp;Evergreen’s&nbsp;value-based&nbsp;care&nbsp;priorities.&nbsp;&nbsp;</li> <li>Share and interpret quality reports, care&nbsp;gap&nbsp;lists, and dashboards, translating performance data into clear, practical improvement steps&nbsp;that align with Evergreen’s workflows and practice capabilities.&nbsp;</li> <li>Educate&nbsp;provider&nbsp;practices on documentation accuracy, coding completeness, and best&nbsp;practice&nbsp;workflows that directly&nbsp;impact&nbsp;HEDIS and Stars&nbsp;measure&nbsp;performance,&nbsp;including practice&nbsp;workflows&nbsp;timing and acceptable data sources.&nbsp;&nbsp;</li> <li>Facilitate recurring meetings with providers&nbsp;and practice staff&nbsp;to review quality trends, resolve workflow barriers, and&nbsp;co-develop action plans for performance&nbsp;improvement.&nbsp;&nbsp;</li> <li>Support provider adoption of&nbsp;Pay-for-Performance (P4P)&nbsp;components&nbsp;related to HEDIS and Stars by clarifying incentives, expectations, and&nbsp;measure&nbsp;specifications.&nbsp;</li> <li>Identify&nbsp;risks&nbsp;or&nbsp;gaps&nbsp;affecting measure outcomes and escalate as&nbsp;appropriate, and partner with internal teams to drive&nbsp;timely&nbsp;intervention.&nbsp;</li> </ul> </li> <li><strong>Patient Panel Management, Outreach &amp; Gap Closure</strong> <ul> <li>Manage an assigned panel of patients, monitoring and prioritizing HEDIS and Stars care gaps across preventive care, chronic disease management, and&nbsp;coordination of care.&nbsp;&nbsp;</li> <li>Conduct proactive patient outreach&nbsp;through phone, electronic and other approved communication channels to&nbsp;educate,&nbsp;motivate, and support patients to complete screenings, labs, immunizations, specialty appointments, and other recommended care.&nbsp;&nbsp;</li> <li>The Quality Improvement Specialist plays a pivotal role in patient care coordination as the gateway to closing quality gaps and improving overall patient well-being.&nbsp;&nbsp;</li> <li>Identify&nbsp;and address&nbsp;patient level&nbsp;barriers such as transportation, scheduling,&nbsp;care plan&nbsp;confusion, or limited health&nbsp;literacy or other social barriers,&nbsp;leveraging&nbsp;internal resources and escalation&nbsp;pathways&nbsp;when&nbsp;appropriate.&nbsp;&nbsp;</li> <li>Reinforce&nbsp;provider directed&nbsp;care plans and ensure clear,&nbsp;timely&nbsp;communication between patients,&nbsp;practices&nbsp;and Evergreen&nbsp;care teams.&nbsp;&nbsp;</li> <li>Track outreach effectiveness, gap closure progress over time, and patient responsiveness,&nbsp;maintaining&nbsp;accurate&nbsp;and&nbsp;timely&nbsp;documentation of all patient interactions.&nbsp;&nbsp;</li> </ul> </li> <li><strong>Cross&nbsp;Functional&nbsp;Collaboration &amp;&nbsp;Compliance</strong> <ul> <li>Collaborate with Quality, Clinical Operations,&nbsp;Coding &amp; Documentation, Practice Transformation, and Pharmacy to&nbsp;ensure payer aligned support for providers and patients.&nbsp;&nbsp;&nbsp;&nbsp;</li> <li>Participate in quality initiatives that are cross functional and designed to improve performance at scale.&nbsp;&nbsp;</li> <li>Maintain&nbsp;accurate,&nbsp;timely&nbsp;documentation in EMRs and quality systems.&nbsp;</li> <li>Adhere to Evergreen’s compliance standards, HIPAA guidelines, and all regulatory requirements.&nbsp;</li> <li>Perform&nbsp;additional&nbsp;responsibilities aligned with Evergreen’s&nbsp;value-based&nbsp;care and quality improvement&nbsp;objectives.&nbsp;</li> </ul> </li> <li>Other duties consistent with this role, as assigned.</li> </ul> <p><strong>Required Qualifications</strong></p> <ul> <li>1-2 years&nbsp;of experience&nbsp;in&nbsp;quality improvement, population health, provider engagement, or care coordination&nbsp;</li> <li>Patient-facing&nbsp;outreach experience&nbsp;</li> <li>Understanding of&nbsp;quality workflows, gap&nbsp;closure&nbsp;processes, and documentation&nbsp;requirements&nbsp;</li> <li>Strong communication&nbsp;and relationship&nbsp;building&nbsp;skills&nbsp;</li> <li>EMR&nbsp;proficiency&nbsp;and familiarity with healthcare technology tools&nbsp;</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> <p><strong>Preferred Qualifications</strong></p> <ul> <li>Hands-on experience with HEDIS and Medicare Stars measures, including gap identification and closure workflows&nbsp;</li> <li>Experience in nephrology, CKD/ESRD, or chronic disease management</li> <li>Medical Assistant or LPN license</li> <li>Bachelor’s degree in health-related field preferred, or equivalent healthcare experience</li> </ul> <p><strong>Compensation</strong></p> <p>The pay range for this role is $20-$24/hr. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.&nbsp;</p> <p>This role is also eligible for an annual bonus.</p> <p><strong>Benefits </strong></p> <p>Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:</p> <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</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> <p>&nbsp;</p> <p>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.</p> <p>&nbsp;</p> <p>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]">[email protected]</a>.</p>