Quality Improvement Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as a reliable partner to nephrology and primary or specialty practices regarding HEDIS and Stars expectations, documentation standards, and Evergreen’s value-based care objectives.

• Distribute and explain quality reports, care gap lists, and dashboards, converting performance data into actionable improvement steps that align with Evergreen’s workflows and practice capabilities.

• Provide education to provider practices on the importance of documentation accuracy, coding completeness, and best practice workflows that have a direct impact on HEDIS and Stars measure performance.

• Organize regular meetings with providers and practice staff to analyze quality trends, address workflow challenges, and collaboratively develop action plans for performance enhancement.

• Assist providers in the adoption of Pay-for-Performance (P4P) elements related to HEDIS and Stars by clarifying incentives, expectations, and measure specifications.

• Identify risks or gaps that may affect measure outcomes, escalate issues as necessary, and collaborate with internal teams to ensure timely interventions.

• Oversee an assigned panel of patients, prioritizing and monitoring HEDIS and Stars care gaps across preventive care, chronic disease management, and care coordination.

• Engage in proactive patient outreach using phone, electronic, and other approved communication methods to educate, motivate, and support patients in completing screenings, labs, immunizations, specialty appointments, and other recommended care.

• Monitor outreach effectiveness, track gap closure progress over time, and maintain accurate and timely documentation of all patient interactions.

• Collaborate with Quality, Clinical Operations, Coding & Documentation, Practice Transformation, and Pharmacy to ensure alignment of support for both providers and patients.

• Take part in cross-functional quality initiatives aimed at improving performance on a larger scale.

⛳️ Requirements

• 1-2 years of experience in quality improvement, population health, provider engagement, or care coordination.

• Experience in patient-facing outreach.

• Knowledge of quality workflows, gap closure processes, and documentation standards.

• Excellent communication and relationship-building skills.

• Proficiency in EMR and familiarity with healthcare technology tools.

• Intermediate skills with the MS Office Suite, including Outlook and Teams.

• Ability to work effectively in a primarily remote setting.

🏝️ Benefits

• Paid time off starting at 4 weeks for full-time employees.

• 12 paid holidays each year.

• Comprehensive medical, dental, vision, and life insurance, including an HSA with employer matching.

• Reimbursement for continuing medical education for eligible roles.

• A 401(k) plan with Evergreen matching contributions up to 4%.

• Paid parental leave.

• A comprehensive training and development program that begins with onboarding and extends throughout your career with Evergreen Nephrology.