Quality Improvement Specialist

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Evergreen Nephrology

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

💰 $4.3M Venture Round on 2022-06

Healthcare • Healthcare Insurance • Pharmaceuticals

Evergreen Nephrology is a company focused on transforming kidney care by empowering nephrologists to provide high-quality and personalized care to patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). By putting nephrologists at the forefront, the company provides them with financial backing, interdisciplinary clinical resources, analytical insights, and technology-enabled tools to improve patient outcomes and experience. Evergreen Nephrology collaborates with strategic partners to address healthcare challenges, including disparate electronic health records (EHRs), transplantation process visibility, and patient readmission risks. The company's co-founders, Adam Boehler and Abe Sutton, have been recognized for their contributions to kidney care models and organ procurement standards, reflecting a deep commitment to improving kidney care quality nationwide.

📋 Description

• Serve as a trusted partner to nephrology and primary or specialty practices on HEDIS and Stars expectations, documentation standards, and value-based care priorities • Share and interpret quality reports, care gap lists, and dashboards, translating performance data into practical improvement steps • Educate provider practices on documentation accuracy, coding completeness, and best-practice workflows affecting HEDIS and Stars 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 components related to HEDIS and Stars • Identify risks or gaps affecting measure outcomes, escalate appropriately, and partner with internal teams on intervention • Manage an assigned patient panel and prioritize HEDIS and Stars care gaps • Conduct proactive patient outreach by phone, electronic, and other approved channels • Address patient barriers such as transportation, scheduling, care-plan confusion, limited health literacy, and social barriers • Reinforce provider-directed care plans and coordinate communication among patients, practices, and Evergreen care teams • Track outreach effectiveness, gap closure, and patient responsiveness; document patient interactions accurately and timely • Collaborate with Quality, Clinical Operations, Coding & Documentation, Practice Transformation, and Pharmacy • Participate in cross-functional quality initiatives • Maintain documentation in EMRs and quality systems • Adhere to compliance standards, HIPAA guidelines, and regulatory requirements • Perform additional responsibilities aligned with value-based care and quality improvement objectives

🎯 Requirements

• 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 primarily remote environment • Home internet supporting at least 25 Mbps download and 10 Mbps upload; cable, fiber, or DSL hardwired connections recommended • Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information • Preferred: hands-on experience with HEDIS and Medicare Stars measures • Preferred: experience in nephrology, CKD/ESRD, or chronic disease management • Preferred: Medical Assistant or LPN license • Preferred: Bachelor’s degree in a health-related field 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 • Annual bonus eligibility • Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role