Quality Improvement Specialist

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.

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.

Role Responsibilities

• 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.

Required Qualifications

• 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

Preferred Qualifications

• 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

Compensation

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.

This role is also eligible for an annual bonus.

Benefits

Evergreen Nephrology's total rewards program is designed to support you in and outside of work. You can expect:

• Paid time off starting at 4 weeks for full-time employees
• 12 paid holidays per year
• Medical, dental, vision and life insurance, including an HSA with employer match
• Reimbursement for continuing medical education for eligible roles
• A 401(k) program where Evergreen matches up to 4% of contributions after six months of tenure
• Paid parental leave
• A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology

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.