Quality Improvement Specialist - Evergreen Nephrology

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 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 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.

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.
• Educate provider practices on documentation accuracy, coding completeness, and best practice workflows that impact HEDIS and Stars measure performance.
• Facilitate recurring meetings with providers and practice staff to review quality trends, resolve workflow barriers, and co-develop action plans.
• Support provider adoption of Pay-for-Performance (P4P) components related to HEDIS and Stars.
• Identify risks or gaps affecting measure outcomes 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 care coordination.
• Conduct proactive patient outreach through phone, electronic, and other approved channels to motivate and support patients to complete recommended care.
• Address patient-level barriers such as transportation, scheduling, care plan confusion, or health literacy.
• Reinforce provider-directed care plans and ensure clear, timely communication between patients, practices, and care teams.
• Track outreach effectiveness and maintain accurate, 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.
• Participate in cross-functional quality initiatives designed to improve performance at scale.
• Maintain accurate, timely documentation in EMRs and quality systems in adherence with HIPAA guidelines and regulatory requirements.

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 including Outlook and Teams
• Ability to work effectively in a remote environment with high-speed internet (minimum 25 Mbps download / 10 Mbps upload) and a dedicated workspace protecting PHI/HIPAA information

Preferred Qualifications

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