Quality Improvement Specialist

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.

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.

As a Quality Improvement Specialist with Evergreen Nephrology, you are responsible for serving as the connector between patients, provider practices, and internal teams to identify, manage, and close quality gaps through targeted education, consistent outreach, and data driven collaboration. The Quality Improvement Specialist manages a defined patient and provider panel, delivers actionable performance insights, and drives improvement across HEDIS and Medicare Stars measures using payer specific specifications, timelines and attribution logic. The ideal candidate is effective across patient engagement, provider coaching, workflow optimization, and cross functional teamwork, and is comfortable operating in a fast pace, performance-oriented value-based care environment.

• →Provider Engagement, Quality Education & Measure Performance
  • →Serve as a trusted partner to nephrology and primary or specialty practices on HEDIS and Stars expectations, documentation standards, and Evergreen’s value-based care priorities.  
  • →Share and interpret quality reports, care gap lists, and dashboards, translating performance data into clear, practical improvement steps that align with Evergreen’s workflows and practice capabilities. 
  • →Educate provider practices on documentation accuracy, coding completeness, and best practice workflows that directly impact HEDIS and Stars measure performance, including practice workflows timing and acceptable data sources.  
  • →Facilitate recurring meetings with providers and practice staff to review quality trends, resolve workflow barriers, and co-develop action plans for performance improvement.  
  • →Support provider adoption of Pay-for-Performance (P4P) components related to HEDIS and Stars by clarifying incentives, expectations, and measure specifications. 
  • →Identify risks or gaps affecting measure outcomes and escalate as appropriate, and partner with internal teams to drive timely intervention. 
• →Patient Panel Management, Outreach & Gap Closure
  • →Manage an assigned panel of patients, monitoring and prioritizing HEDIS and Stars care gaps across preventive care, chronic disease management, and coordination of care.  
  • →Conduct proactive patient outreach through phone, electronic and other approved communication channels to educate, motivate, and support patients to complete screenings, labs, immunizations, specialty appointments, and other recommended care.  
  • →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.  
  • →Identify and address patient level barriers such as transportation, scheduling, care plan confusion, or limited health literacy or other social barriers, leveraging internal resources and escalation pathways when appropriate.  
  • →Reinforce provider directed care plans and ensure clear, timely communication between patients, practices and Evergreen care teams.  
  • →Track outreach effectiveness, gap closure progress over time, and patient responsiveness, maintaining accurate and timely documentation of all patient interactions.  
• →Cross Functional Collaboration & Compliance
  • →Collaborate with Quality, Clinical Operations, Coding & Documentation, Practice Transformation, and Pharmacy to ensure payer aligned support for providers and patients.    
  • →Participate in quality initiatives that are cross functional and designed to improve performance at scale.  
  • →Maintain accurate, timely documentation in EMRs and quality systems. 
  • →Adhere to Evergreen’s compliance standards, HIPAA guidelines, and all regulatory requirements. 
  • →Perform additional responsibilities aligned with Evergreen’s value-based care and quality improvement objectives. 
• →Other duties consistent with this role, as assigned.

• 1-2 years of experience in quality improvement, population health, provider engagement, or care coordination 
• Patient-facing outreach experience 
• Understanding of quality workflows, gap closure processes, and documentation requirements 
• Strong communication and relationship building skills 
• EMR proficiency and familiarity with healthcare technology tools 
• Intermediate skills with MS Office Suite of products including Outlook and Teams
• Able to work effectively in a primarily remote environment:
  • 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
  • Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
  • Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

• Hands-on experience with HEDIS and Medicare Stars measures, including gap identification and closure workflows 
• Experience in nephrology, CKD/ESRD, or chronic disease management
• Medical Assistant or LPN license
• Bachelor’s degree in health-related field preferred, or equivalent healthcare experience