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Quality Program Manager

External
evergreennephrology logoEvergreennephrology · Worldwide
Full-timeRemote3w ago
ComplianceDocumentationLeadership
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About the role

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.

Responsibilities

  • Team Leadership & Management
  • Directly manager Quality Improvement Specialists and other quality team members
  • Establish clear expectations, workflows, and performance targets aligned to quality goals
  • Monitor individual and team productivity, quality outcomes, and execution metrics
  • Provide coaching, feedback, and development to improve performance and capability
  • Ensure consistency in how teams execute outreach, gap closure, and documentation workflows
  • Execution Oversight & Operational Management
  • Oversee day-to-day quality operations, ensuring workflows are executed consistently across teams and markets
  • Monitor adherence to care gap closure processes, outreach protocols, and documentation standards
  • Identify breakdowns in execution and implement corrective actions in real time
  • Coordinate resources and support teams to meet program deadlines and deliverables
  • Quality Improvement Education
  • Support implementation of enterprise quality initiatives at the team level
  • Drive targeted interventions to improve care gap closure rates and measure performance
  • Identify workflow inefficiencies and recommend improvements to increase effectiveness
  • Reinforce best practices in documentation, coding, and care coordination
  • Care Gap & Workflow Management
  • Oversee execution of care gap identification and closure processes across teams
  • Ensure accurate documentation and proper capture of quality-related data
  • Partner with CDI and coding teams to reinforce documentation and coding standards
  • Monitor hybrid measure workflows and medical record submission processes as needed
  • Cross-Functional Coordination
  • Serve as the operational bridge between quality leadership and frontline execution
  • Partner with Clinical Operations teams (Navigation, TOC, CCPM, PAC) to integrate quality workflows
  • Coordinate with Analytics on reporting accuracy and data needs
  • Work with Market Operations to align execution and address local barriers
  • Provider & Market Support
  • Support delivery of quality performance insights to providers and market leaders
  • Reinforce expectations for care gap closure and documentation workflows
  • Partner with markets to identify and address execution challenges
  • Ensure alignment between enterprise quality priorities and frontline workflows
  • NCQA
  • Partner with Accreditation and NCQA specialists to ensure operational compliance with NCQA standards
  • Ensure workflows, documentation, and team practices align with accreditation requirements
  • Support NCQA readiness activities, including documentation review and workflow

Requirements

  • Your Role
  • As a Quality Program Manager with Evergreen Nephrology, you are responsible for leading the day-to-day execution of Evergreen's clinical quality programs and managing the performance of Quality Improvement Specialists (QIS) and related quality roles.
  • This role ensures consistent execution of quality workflows, drives accountability for care gap closure, and supports performance improvement across HEDIS, Medicare Stars, CKCC, and other value-based care programs.
  • The Quality Program Manager is also responsible for ensuring that frontline operations align with NCQA accreditation standards, including oversight of documentation practices, workflow adherence, and compliance with required processes to support audit and survey readiness.
  • This role partners closely with Clinical Operations, Analytics, CDI/Coding, and Market Operations to operationalize quality initiatives, monitor performance, and remove barriers to achieving quality targets.

Benefits

Health insurance

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