Quality Improvement Specialist

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 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.

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. 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 & Quality Gap Closure
  • Manage a defined patient panel to identify, stratify, and close HEDIS and Stars quality gaps through telephonic and digital outreach, patient education, and care coordination.
  • Collaborate with clinical teams to support patient adherence to evidence-based care plans and preventive health services relevant to kidney disease and comorbid conditions.
  • Track and document outreach and gap closure activities in relevant systems to ensure accurate and timely data capture.
  • Proactively monitor patient attribution changes and adjust outreach strategies accordingly.