Evergreen Nephrology · 1 day ago
Quality Improvement Specialist
United States
Full-time
Remote
Entry Level
$20/hr - $24/hr
1+ years expEvergreen Nephrology is dedicated to transforming kidney care through a value-based, person-centered approach. The Quality Improvement Specialist will connect patients, provider practices, and internal teams to manage quality gaps, deliver performance insights, and drive improvement across care measures.
Health CareMedicalWellness
Responsibilities
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
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
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
Qualification
Required
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
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
Benefits
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
Paid parental leave
A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
Company
Evergreen Nephrology
Evergreen helps nephrologists focus on the right patients at the right time across the full care spectrum.
201-500 employees
Funding
Current Stage
Growth StageTotal Funding
$134.34MKey Investors
Oak HC/FT,Rubicon Founders
2025-01-07Series Unknown· $130M
2022-06-06Seed· $4.33M
Leadership Team
John E. Donlan
Board Member and Strategic Advisor
Recent News
2025-07-05
2025-01-10
Company data provided by crunchbase