Bilingual Care Coordinator (Pacific Time)
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
The Evergreen Chronic Care Management (CCM) Care Coordinator supports proactive care coordination services for patients with complex chronic conditions, including chronic kidney disease (CKD), hypertension, diabetes, cardiovascular disease, and related comorbidities. Working under Evergreen’s clinical supervision, the Care Coordinator conducts patient outreach, creates, maintains, and reinforces established care plans, supports documentation compliance, and coordinates communication between patients, providers, and healthcare partners.
This role is outreach-driven and operationally focused, requiring strong organization, patient communication skills, and the ability to manage a high-volume patient panel. Experience supporting nephrology or CKD patient populations is strongly preferred.
The program uses SMS as the first-line channel for patient engagement, with phone outreach used when appropriate.
While this position is fully remote, you must be able to work 8:00am – 5:00pm in the pacific time zone.
Role Responsibilities
Some responsibilities may vary based on specific patient programs, but this role's primary duties include the following:
- Patient Enrollment & Eligibility
- Support CCM patient enrollment and onboarding activities.
- Verify eligibility based on Evergreen and payer program guidelines.
- Ensure patient consent documentation is completed prior to outreach.
- Proactively maintain patient engagement regularly.
- Identify inactive or non-engaged patients and escalate appropriately.
- Patient Outreach & Engagement
- Conduct text & telephonic outreach to enrolled CCM patients weekly.
- Achieve required engagement time standards aligned with Medicare CCM billing requirements.
- Support achievement of required engagement time for billing compliance.
- Reinforce provider-directed care plans during patient interactions.
- Identify barriers to adherence including medication access, transportation, or social needs.
- Expected activities include:
- High-volume outbound patient calling and texting.
- Follow-up outreach attempts.
- Documentation & Billing Compliance
- Document patient interactions accurately within the CCM patient management platform and EHR systems.
- Track engagement time consistent with Medicare CCM billing requirements.
- Maintain audit-ready documentation standards.
- Ensure HIPAA and PHI compliance.
- Patient Care Coordination & Clinical Workflow
- Facilitate patient access to their referring provider and clinical staff.
- Support care transitions following hospitalizations or ED visits.
- Coordinate referrals and follow-up appointments.
- Escalate symptom concerns or medication issues to licensed clinical staff.
- Preferred experience includes:
- Chronic kidney disease patient populations.
- Dialysis patient coordination.
- Medication adherence monitoring.
- Kidney transplant or specialty referrals.
- Technology & Communication
- Utilize CCM platform and EHR systems daily.
- Manage patient messaging workflows.
- Collaborate with remote clinical and operational teams.
Required Qualifications
- Certified Medical Assistant
- Bilingual (Spanish/English)
- 1–3 years healthcare experience
- Chronic disease or nephrology experience is preferred.
- Strong clinical assessment, communication, and documentation skills.
- Comfortable working in two systems (EHR + CCM platform) simultaneously.
- Ability to manage a structured, metric-driven workflow with reliability.
- Intermediate skills with MS Office Suite of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Preferred Qualifications
- Experience in chronic disease management
- Prior work in virtual care, remote nursing, or telehealth programs.
- Familiarity with CCM regulatory requirements.
- Strong patient education and motivational interviewing skills.
Compensation
The pay range for this role is $45,000 to $52,000 annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.
This role is also eligible for a bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- 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 after six months of tenure
- Paid parental leave
- A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.
Bilingual Care Coordinator, LPN (Pacific Time)
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 Licensed Practical Nurse (LPN) with Evergreen Nephrology, you are responsible for conducting monthly clinical check-ins, identifying and addressing clinical concerns, reinforcing care plans, escalating issues appropriately, and ensuring clinical documentation accuracy across both the EHR and partner technology platform. This position requires clinical judgment, licensed expertise, and the ability to support patients between office visits while collaborating closely with Evergreen’s providers, care teams, and leadership. LPNs are essential to delivering a safe, compliant, clinically credible Connected Care Program.
The program uses SMS as the first-line channel for patient engagement, with phone outreach used when appropriate.
While this position is fully remote, you must be able to work from 8:30am – 5pm in the pacific time zone.
Role Responsibilities
Some responsibilities may vary based on specific patient programs, but this role's primary duties include the following:
- Patient Engagement & Outreach
- Perform monthly CCM touchpoints for assigned patient panels.
- Build strong, ongoing relationships with patients and caregivers through regular outreach.
- Review patient chart data (diagnoses, kidney disease history, medications, labs, imaging, treatment cycles) before calls.
- Explain CCM participation and reinforce program benefits.
- Clinical Assessments & Judgment
- Conduct structured symptom assessments (pain, fatigue, neuropathy, SOB, nausea, etc.).
- Evaluate changes in condition using licensed clinical judgment.
- Assess medication adherence issues, side effects, or confusion about regimen.
- Identify clinical red flags requiring escalation (e.g., worsening symptoms, new SOB, uncontrolled pain, concerning vitals).
- Escalation, Coordination & Provider Communication
- Escalate urgent issues based on defined triage pathways (same-business-day or immediate).
- Collaborate with the provider team on symptom changes, new concerns, or medication-related issues.
- Route EHR messages with clinically relevant documentation.
- Assist in coordinating care: scheduling follow-up, arranging labs, ensuring nephrology appointments are kept, and reducing missed care.
- Care Plan Reinforcement & Patient Education
- Reinforce provider-developed CKD and chronic disease care plans.
- Provide clinical explanation of symptom management instructions (within LPN scope).
- Support adherence to medications, lifestyle changes, and follow-up instructions.
- Identify social, behavioral, or access barriers and determine appropriate interventions or referrals.
- Documentation, EHR Updates & Compliance
- Document all patient interactions clearly in both the EHR and CCM patient management platform.
- Track and log qualifying CCM time accurately for billing compliance.
- Ensure documentation meets regulatory, internal QA, and partner expectations.
- Maintain high call quality and adherence to scripting and workflow pathways.
- Quality, Performance & Continuous Improvement
- Maintain or exceed:
- ≥80% monthly engagement
- ≥90% billable conversion
- High QA/documentation accuracy scores
- Participate in peer reviews, QA audits, coaching sessions, and continuous education.
- Identify recurring patient needs and communicate trends to the Program Manager.
- Maintain or exceed:
- Other duties consistent with this role, as assigned.
Required Qualifications
- Active LPN or Licensed Vocational Nurse (LVN) license
- Bilingual (Spanish/English)
- Minimum 1–2 years of clinical experience in:
- Ambulatory care
- Population health
- Care coordination
- Case management
- Strong clinical assessment, communication, and documentation skills.
- Comfortable working in two systems (EHR + CCM platform) simultaneously.
- Ability to manage a structured, metric-driven workflow with reliability.
- Intermediate skills with MS Office Suite of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Preferred Qualifications
- Experience in chronic disease management
- Prior work in virtual care, remote nursing, or telehealth programs.
- Familiarity with CCM regulatory requirements.
- Strong patient education and motivational interviewing skills.
Compensation
The pay range for this role is $55,000-$65,000 annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.
This role is also eligible for a quarterly bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- 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 after six months of tenure
- Paid parental leave
- A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.
Community Health Worker
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
The Community Health Worker (CHW) at Evergreen Nephrology supports high-quality, patient-centered care by providing exceptional patient service, care coordination, and connection to community-based resources. This role serves as a trusted liaison between diverse, underserved, and vulnerable populations and the health and social service systems that support them, with a strong focus on building trust, engagement, and patient empowerment.
Working within an interdisciplinary care team including Nurse Practitioners, Nurse Care Managers, Care Coordinators, Dietitians, Pharmacists, Licensed Clinical Social Workers, Population Health Social Workers, and Psychiatrists, the CHW leverages Evergreen’s integrated technology platform to help patients access services aligned with their individual needs. The CHW also partners with clinical teams and leadership to support community outreach initiatives designed to promote, maintain, and improve the health and well-being of patients and their families.
You will take the lead on comprehensive care coordination with a focus on identifying and addressing Social Determinants of Health while partnering with the interdisciplinary care team. You will be an essential resource for patients, assisting them in navigating the healthcare system, accessing resources and support, and achieving better health outcomes.
To be successful in this role, you must hold an active Community Health Worker (CHW) certification. Bilingual proficiency in Spanish and English is strongly preferred to support effective engagement with diverse patient populations.
Role Responsibilities
Some responsibilities may vary based on specific patient programs; however, the primary duties of the Community Health Worker include:
- Patient Engagement & Outreach
- Conduct telephonic and virtual outreach to patients identified with high social determinants of health (SDOH) needs.
- Establish trust and serve as a primary point of contact for patients enrolled in the CHW program.
- Build culturally competent relationships that promote engagement, encouragement, and patient empowerment.
- Care Coordination & Navigation
- Serve as a liaison between patients, families, clinical teams, dialysis centers, and community-based service providers.
- Facilitate seamless transitions of care across care settings to support comprehensive, patient-centered care.
- Assist patients with enrollment in health and social services, including completing applications, paperwork, and required documentation.
- Support clinical staff by coordinating care activities, identifying resources, and addressing barriers to care.
- Social Determinants of Health
- Conduct comprehensive assessments to identify social, economic, cultural, and environmental factors impacting patient health.
- Recommend gap closures and contribute SDOH findings to individualized care plans to improve quality and health outcomes.
- Connect patients to appropriate resources, including housing assistance, transportation, food security, utilities, and community support programs.
- Resource Management & Follow-Up
- Guide patients in understanding and accessing available health and social services within Evergreen Nephrology and external organizations.
- Follow up on and track referrals and outcomes related to pharmacy services, durable medical equipment (DME), home care, and other supportive services.
- Assist with identifying, scheduling, and coordinating transportation for medical and community appointments.
- Build and maintain up-to-date resource inventories across service areas and multiple states.
- Member Advocacy & Support
- Advocate for patients by identifying barriers to care, addressing inequities, and ensuring appropriate interventions and support are provided.
- Support patients and families in navigating complex systems and overcoming challenges that impact care access and adherence.
- Administer health screenings as appropriate and support preventive and supportive care initiatives.
- Documentation, Reporting & Compliance\
- Maintain accurate, timely, and compliant documentation of patient interactions, assessments, referrals, and care plan updates in accordance with organizational and regulatory requirements.
- Identify situations requiring mandatory reporting and complete all required reporting in accordance with state and organizational guidelines.
- Education & Empowerment
- Provide education and resources to patients and families to address stressors and barriers to care.
- Empower patients to manage their health conditions by increasing understanding of available supports and promoting self-advocacy.
- Perform other duties consistent with the Community Health Worker role, as assigned.
Required Qualifications
- 3+ years of experience in health care coordination, community health work, or similar healthcare related field
- Credentialed Community Health Worker
- Experience with team-based approach to care
- Excellent working knowledge of community resources
- Exceptional ability to prioritize and task-switch to meet needs of patients and overall care team
- Self-directed and motivated to resolve issues professionally and creatively
- Strong communication and teaching skills
- Intermediate skills with MS Office Suite of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Compensation
The pay range for this role is $22-25 per hour. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.
This role is also eligible for a quarterly bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- 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 after six months of tenure
- Paid parental leave
- A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.
Nurse Care Manager
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 Nurse Care Manager supporting the Evergreen Aligned (EGA) team with Evergreen Nephrology, you are responsible for supporting care delivery within the EGA model by partnering with Advanced Practice Providers (APPs) to ensure effective execution of individualized care plans for patients with chronic kidney disease, hypertension, diabetes, and congestive heart failure.
This role focuses on enhancing clinical outcomes, patient engagement, and care coordination through education, remote monitoring, medication management, and longitudinal patient support in a virtual care environment.
Role Responsibilities
Some responsibilities may vary based on specific patient programs, but this role's primary duties include the following:
- Visit Preparation & Coordination
- Conducts pre-visit planning by reviewing patient records, identifying care gaps, and ensuring necessary clinical information, laboratory results, and assessments are available for scheduled visits.
- Care Plan Execution & Clinical Support
- Reinforces APP-directed care plans through post-visit follow-up and ensures patient understanding and adherence.
- Monitors completion of key care elements including labs, medications, and referrals.
- Chronic Kidney Disease Management & Education
- Provides stage-based CKD education, reinforcing guideline-directed therapies, and key lifestyle strategies.
- Supports early patient understanding of disease progression and renal replacement options.
- Hypertension Management & Education
- Educates accurate home BP monitoring and trends data to identify uncontrolled hypertension or hypotension.
- Reinforces protocol-driven treatment adjustments and lifestyle interventions.
- Diabetes Management & Education
- Reviews SMBG/CGM data to identify glycemic trends and support timely escalation of care.
- Educates on hypo-/hyperglycemia management and reinforces medication adherence and A1c monitoring.
- Congestive Heart Failure Management & Education
- Monitors weight, blood pressure, symptoms, and other clinical indicators to identify early signs of heart failure exacerbation.
- Reinforce guideline-directed medical therapy, sodium and fluid management, medication adherence, and self-management strategies while facilitating timely escalation of care to prevent avoidable hospitalizations.
- Medication Management
- Performs medication reconciliation and identifies adherence barriers, side effects, and safety concerns.
- Educates patients and coordinates with APPs and pharmacy on refills and therapy optimization.
- Quality Measures and Care Gap Closures
- Supports achievement of HEDIS, Medicare Stars, and other value-based care quality measures by partnering with APPs, providers, and quality teams to proactively identify, address, and close care gaps through patient outreach, education, and follow-up.
- Remote Patient Monitoring (RPM)
- Conducts proactive outreach for abnormal or missing data and supports device (DM, HTN, CHF) onboarding and troubleshooting.
- Drives patient engagement and improves data completeness for clinical decision-making.
- Patient Engagement & Relationship Building
- Serves as a consistent, trusted point of contact, building rapport through empathetic and culturally competent communication.
- Addresses concerns and reinforces trust in the care model and longitudinal care.
- Self-Management Education
- Delivers simplified, low health literacy education using teach-back methods to confirm understanding.
- Provides clear, actionable guidance to support self-management and adherence.
- Cross-Functional Program Collaboration
- Partners closely with Program Managers, Care Coordinators, Clinical Educators, Pharmacists, Quality, and other interdisciplinary team members to support patient care objectives and program outcomes.
- Community Provider Collaboration
- Partners with community nephrologists and primary care providers to ensure coordinated care delivery, address care gaps, support transitions of care, and improve clinical outcomes for patients with chronic conditions.
- Other duties consistent with this role, as assigned.
Required Qualifications
- Active, unrestricted Registered Nurse (RN) license
- 2+ years of clinical experience in chronic disease management (CKD, diabetes, or hypertension)
- Strong patient education and communication skills
- Experience with electronic health records (EHR)
- Clinical judgment and data interpretation
- Patient-centered communication and motivational interviewing
- Collaboration in multidisciplinary teams
- Ability to manage multiple patients in a fast-paced virtual environment
- Strong organizational and follow-through skills
- Intermediate skills with MS Office Suite of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Preferred Qualifications
- Experience in virtual care, care management, or remote patient monitoring
- Familiarity with value-based care models and quality metrics
- Bilingual (Spanish/English) (as applicable to patient population)
Compensation
The base salary pay range for this role is $90,000 to $103,000 annually. Exact pay is determined based on experience, education, and other role-specific factors.
This role is also eligible for a quarterly bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- 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 after six months of tenure
- Paid parental leave
- A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at talent@egneph.com.
Care Management Pharmacist
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 Pharmacist with Evergreen Nephrology, you are responsible for ensuring the best clinical care for your patients. You will work with patients collaboratively with an assigned panel of physicians and care managers to manage the medication regimen for patients living with kidney disease and other chronic, complex diseases. This includes the opportunity to work with many different members of the interdisciplinary team including registered nurses, nurse care managers, health coaches, dieticians, pharmacists, psychiatrists, social workers, and even cardiologists and podiatrists – all within the Evergreen Nephrology family.
While this position is fully remote, you must be able to work from 8:30am – 5pm in the central time zone.
Role Responsibilities
- Consult directly with patients, their caregivers, and other members of their care team to implement Evergreen’s comprehensive pharmacy care management programs, including medication reconciliation, patient education, and collaboration with the patient’s care team to resolve medication concerns.
- Utilize principles of Comprehensive Medication Management (CMM) to optimize all clinical aspects of medication therapy regimens, considering effectiveness of medications, identify unnecessary drug therapies, incomplete immunization records, medication safety, adverse effects, renal dose adjustments, and other contraindications.
- Engage in patient outreach and consultation to support real-world adherence with the medication plan of care, integrating best practice techniques for behavior modification, to optimize patient health outcomes
- Drive medication-related clinical quality initiatives, including GDMT optimization and adherence improvement, by identifying gaps, designing targeted interventions, and partnering with care teams to improve patient outcomes and performance against value-based quality measures
- Participate in medication safety initiatives to minimize use of nephrotoxic medications among our CKD patient population and address other high-risk medication use with a holistic, patient-centered approach
- Support appropriate medication use across the continuum of care, focusing on the post-hospital discharge period, to ensure patients accurately implement the medication plan
- Seek alternatives as necessary to ensure the best care is provided that will maximize clinical outcomes, ensure equitable access to medications, and support appropriate levels of financial spend
- Analyze and recommend cost-savings strategies based on plan formularies, insurance phases, and evidence-based chronic disease management guidelines
- Act as an internal subject matter expert, developing and delivering education to patients, caregivers, and internal Evergreen teams regarding medications and chronic disease states
- Other duties consistent with this role, as assigned.
Success in this role is measured by improvements in medication adherence, GDMT utilization where clinically appropriate, closure of medication-related quality gaps, and meaningful contributions to improved outcomes and performance across Evergreen’s value-based care programs.
Required Qualifications
- Doctorate or bachelor’s degree in pharmacy
- You hold an unrestricted Pharmacy state license or will acquire one within 60 days from the time of hire
- You have a strong comprehension of pharmaceutical therapies and are focused on quality of life for your patients
- You are comfortable delivering educational seminars/instruction on pharmaceutical-related topics to clinicians and patients
- Intermediate skills with MS Office Suite of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Preferred Qualifications
The following are not required, but we believe will set pharmacists up for success in this role:
- Residency training in ambulatory care, health system, or community pharmacy-based programs
- BPS board certification in pharmacotherapy, ambulatory care, geriatrics, or other relevant specialty
- Multistate licensure including the following states: TN, MN, CO
- Experience in care management, value-based care, or population health programs
Compensation
The pay range for this role is $140,000-$160,000 annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.
This role is also eligible for a quarterly bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- 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 after six months of tenure
- Paid parental leave
- A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.
Senior Director, Operations
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 a results-driven operational leader who thrives at the intersection of patient engagement, clinical operations, and performance management. You're passionate about building and scaling teams that connect patients to the care they need — and you understand that exceptional outreach and patient engagement is the foundation of a successful value-based care model. 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 thrive in innovative and evolving environments with high rates of change.
Your Role
As Senior Director, Operations - Evergreen Provider Group & Patient Engagement with Evergreen Nephrology, you are responsible for the overall P&L performance of patients attributed to Evergreen Nephrology and the operational performance of the Patient Engagement Services (PES) team. This is a highly collaborative leadership role with dual accountability: driving EPG performance outcomes while ensuring the PES team is effectively reaching, engaging, and scheduling patients into care. You will provide strategic and operational oversight across both functions to ensure alignment, efficiency, and measurable results.
This role requires an experienced operator with demonstrated expertise in owning P&L performance, scaling virtual care delivery models, and driving end‑to‑end performance across the patient funnel (outreach, scheduling, and visit completion). The role also requires strong data and performance management capabilities and the ability to lead cross-functional partnerships to drive outcomes in a value-based care environment.
Role Responsibilities
This role's primary duties include the following:
Evergreen Provider Group (EPG) Operations & Strategy
- Oversee the overall performance of Evergreen-aligned (EGA) patients across all markets and payers
- In close dyad partnership with the Chief Clinical Officer, lead the buildout and growth of EPG as a scalable virtual care delivery model, ensuring the infrastructure, workflows, and team are positioned to expand across markets
- Develop and deploy strategy to implement standardized quality programs that drive maximum performance and quality outcomes across all markets and payers
- Own and manage the EGA P&L
- Develop and maintain dashboards and reports to track KPIs; monitor performance and drive action plans to address gaps
- Collaborate with key internal and external stakeholders to drive performance in overall engagement, documentation, quality, and total medical expense
- Lead the ongoing management of value-based partnerships, including addressing payer issues and ensuring adherence to contractual obligations
Patient Engagement Services (PES) Operations & Strategy
- Provide strategic and operational oversight of the PES function, ensuring the team is effectively reaching, engaging, and scheduling patients into care
- Set clear productivity and performance expectations with KPI targets; drive accountability for team capacity utilization and outreach effectiveness, identifying and removing barriers to patient access
- Own and manage the PES program budget
- Partner with clinical leadership to align outreach efforts with provider availability and evolving capacity needs
- Partner with Marketing and Tech teams to develop and execute patient engagement campaigns that drive awareness, outreach effectiveness, and scheduling conversion
- Continuously improve outreach models, workflows, and tools to scale PES operations as EPG grows
Leadership & Cross-Functional Collaboration
- Manage, coach, and develop the EPG and PES teams, fostering a high-performance culture with clear expectations, regular feedback, and professional growth opportunities
- Drive cross-functional collaboration across clinical, operations, quality, and technology teams to ensure alignment with organizational priorities and patient care goals
- Other duties consistent with this role, as assigned
Required Qualifications
- 8+ years of experience in healthcare operations, with demonstrated experience in P&L oversight, financial performance management, and team leadership
- Strong understanding of and experience in value-based care
- Experience managing a medical group, physician practice, or clinical operations team - virtual care delivery environment strongly preferred
- Experience building or overseeing patient outreach, engagement, or access operations (e.g., call center, scheduling, care coordination) is a plus
- Proven ability to build, scale, and hold teams accountable to productivity and performance metrics
- A bachelor's degree or higher related to education, quality, public health, business administration, health services research, or a related field is preferred
- Intermediate skills with MS Office Suite of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Compensation
The pay range for this role is $175-195k annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.
This role is also eligible for an annual bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- Flexible time off policy 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 after six months of tenure
- Paid parental leave
- A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at Talent@egneph.com.
Principal, Medical Economics
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 Principal, Medical Economics at Evergreen Nephrology, you will play a key role, as an individual contributor, in shaping and advancing the organization’s medical economics capabilities. You will partner closely with leaders across Analytics, Actuarial, Clinical, Operations, Finance, and Technology to strengthen our analytical capabilities. This role will help ensure the integrity of claims data flowing into enterprise datasets, enable more sophisticated economic and impact modeling, and connect cost insights with clinical and risk stratification efforts to support value-based care performance.
Role Responsibilities
- Lead and define statistical analyses to identify cost, utilization, and performance drivers across populations, markets, and payer arrangements.
- Partner with data, actuarial, and analytics teams to validate healthcare claims data structures, ensure data is accurately represented in enterprise datasets, and resolve discrepancies affecting downstream reporting and analysis.
- Apply economic insights to strengthen impact modeling and quantify the financial and operational implications of clinical and business initiatives.
- Develop experimental designs for new program initiatives to ensure programs are set up for impact analysis in advance
- Translate complex claims, reimbursement, and utilization data into clear, actionable recommendations for cross-functional stakeholders and senior leadership.
- Identify trends, anomalies, and emerging opportunities within claims and performance data, and communicate their implications for value-based care strategy.
Required Qualifications
- Bachelor’s degree in economics, statistics, mathematics, public health, healthcare administration, data science, or a related field; an advanced degree is preferred.
- 8+ years of experience in healthcare analytics, medical economics, actuarial analytics, or a related analytical function within the healthcare industry, with a focus on medical cost, utilization, or financial performance metrics. Experience with causal inference is preferred.
- Deep understanding of healthcare claims data structures, medical coding systems, and reimbursement concepts, including ICD-10-CM, CPT, HCPCS, DRGs, capitation, fee-for-service, and value-based payment models.
- Demonstrated ability to assess data quality, investigate discrepancies, and partner with technical teams to improve data integrity and usability.
- Strong SQL skills are required; experience with Python, R, or other analytical tools is preferred.
- Strong problem-solving, critical thinking, project management, and cross-functional collaboration skills, with the ability to influence stakeholders at multiple levels of the organization.
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Compensation
The pay range for this role is $135,000 to $150,000 annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.
This role is also eligible for an annual bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- 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 after six months of tenure
- Paid parental leave
- A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.
Senior Analyst, Reporting & Analytics
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 Sr. Analyst, Reporting & Analytics with Evergreen Nephrology, you will report to the Manager of Reporting & Analytics and collaborate with the broader analytics, technology, and operations teams to develop data-based solutions and tools that drive company performance and patient outcomes. Your reporting (e.g., Power BI) and analytical skills (SQL) will help develop new reports and tools, and your communication skills and business acumen will drive collaborative efforts in gathering requirements and feedback, providing analytic insight to our stakeholders, and drive improvements to our operating and clinical models. This role is an individual contributor role.
Role Responsibilities
- Collaborate with business partners to gather business reporting and analytics requirements to drive operational and clinical efficiency
- Understand and validate the accuracy and quality of the data represented within analytics and reporting outputs
- Collaborate with Data Engineering and Advanced Analytics to transform raw data into desired metrics and insights
- Utilize visualization tools (e.g., PowerBI) to design and create analytics dashboards and operational reports
- Train end users on newly deployed dashboards/deliverables
- Support ongoing enhancements and maintenance of deployed dashboards/deliverables
- Manage internal and external timelines for data reporting
- Identify and track issues with reports, including defects in logic, data quality problems, and process errors
- Maintain documentation of existing reports and dashboards (KPI definitions, data sources, etc.)
- Other duties consistent with this role, as assigned.
Required Qualifications
- A bachelor’s degree in engineering, data science, statistics, public health, economics, or a related field. Master’s degree preferred.
- 3+ years of experience in a reporting or health economics environment in the health care industry
- 1+ years developing dashboards and reports utilizing BI tools (e.g., Power BI, or Tableau)
- Strong SQL skills required; expertise in SQL and Python programming preferred
- Experience developing data models, or partnering with data engineering teams to translate business needs into scalable, analytics-ready datasets
- Health care industry experience, value-based care preferred
- Proven hands-on knowledge of turning data into relevant reports and visualizations
- Strong organizational, analytical, multi-tasking, documentation, presentation, and problem-solving skills
- Ability to communicate effectively in both oral and written form to a widely diverse audience
- Strong business acumen and interpersonal skills
- Working understanding of healthcare privacy and security practices
- Experience with healthcare data (EMR and/or claims) preferred
- High curiosity and a growth mindset
- Intermediate skills with MS Office Suite of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Compensation
The pay range for this role is $75,000 to $95,000 annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.
This role is also eligible for an annual bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- 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 after six months of tenure
- Paid parental leave
- A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.
Nurse Care Manager
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
This role may be filled by a Registered Nurse (RN) or a licensed Physical Therapist (PT) meeting equivalent qualification criteria. As a Post Acute Nurse Care Manager, you are responsible for collaborating with Skilled Nursing Facilities to manage nephrology patients who are receiving skilled nursing care after acute hospitalization. This role focuses on ensuring their skilled nursing stay promotes efficiency as well as meeting their specialized needs based on their individual conditions with a coordinated plan to discharge to home or community. Your job duties will include taking full ownership of patient care management within your caseload, including engaging with Skilled Nursing Facility staff, providers, patients, and their caregivers. You will perform assessments to identify needs based on individual values, goals, and preferences.
While this position is fully remote, you must be able to work 8:30am – 5pm in the Central or Eastern time zone.
Role Responsibilities
Some responsibilities may vary based on specific patient programs, but this role's primary duties include the following:
- Manage the overall care management of patient caseload by leveraging experience, expertise, and knowledge in both the nursing field and value-based care operations.
- Facilitate seamless transitions for nephrology patients from a Skilled Nursing Facility to home or community.
- Collaborate with hospital discharge planners, providers and SNF staff to ensure patients’ needs are addressed.
- Monitor patient progress in skilled nursing facilities and identify barriers to timely discharge.
- Actively participate in clinical huddles, IDT meetings, and patient care conferences for patients under your care management.
- Develop and implement strategies to optimize length of stay while maintaining high-quality care.
- Support seamless transitions of care as patients move between care settings, proactively addressing potential barriers and collaborating with internal and external care team stakeholders.
- Establish trusting relationships with patients and families to provide clinical and emotional support and foster collaboration throughout their care journey.
- Perform assessments and identify the needs, including social determinants of health, of caseload patients and caregivers based on values, care goals, and individual preferences, and translating these into patient-centric actionable care plans.
- Identify and develop SNF stakeholders and foster relationships for communication and coordination of care.
- Identify areas for improvement in post-acute care processes and share or implement evidence-based solutions.
- Engage in continuous, organizational process improvement to identify opportunities and execute action plans to optimize care management workflows, patient engagement processes, customer/patient care efforts, and other protocols.
- Prepare reports and other deliverables to communicate program changes or developments to appropriate stakeholders
- Collect data to prepare and deliver reports alongside program leaders on program success, patient outcomes, and patient/caregiver satisfaction.
- Other duties consistent with this role, as assigned.
Required Qualifications
- One of the two following qualifications is required in the state of Illinois:
- A Bachelor’s degree in nursing (BSN) with an active RN license (compact license preferred where applicable) and/or;
- A Bachelor’s or Master’s degree in Physical Therapy with an active PT license
- Minimum 3-5 years of experience in telephonic care management and post-acute care
- Active license in good standing in the state of Illinois
- Experience in Utilization Management and/or Utilization Review
- Experience in specialty care including kidney care or related field
- Excellent communication, problem-solving and organizational skills
- Knowledge of value-based care models and strategies to reduce readmissions
- Experience with team-based care and have excellent collaboration skills
- Excellent working knowledge of community resources
- Strong understanding of skilled nursing facility operations and regulations strongly preferred.
- Intermediate skills with MS Office Suite of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Compensation
The pay range for this role is $90,000 to $103,000 annually. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.
This role is also eligible for a quarterly bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- 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
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.
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 & Gap Closure
- Manage an assigned panel of patients, monitoring and prioritizing HEDIS and Stars care gaps across preventive care, chronic disease management, and coordination of care.
- Conduct proactive patient outreach through phone, electronic and other approved communication channels to educate, motivate, and support patients to complete screenings, labs, immunizations, specialty appointments, and other recommended care.
- The Quality Improvement Specialist plays a pivotal role in patient care coordination as the gateway to closing quality gaps and improving overall patient well-being.
- Identify and address patient level barriers such as transportation, scheduling, care plan confusion, or limited health literacy or other social barriers, leveraging internal resources and escalation pathways when appropriate.
- Reinforce provider directed care plans and ensure clear, timely communication between patients, practices and Evergreen care teams.
- Track outreach effectiveness, gap closure progress over time, and patient responsiveness, maintaining accurate and 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 for providers and patients.
- Participate in quality initiatives that are cross functional and designed to improve performance at scale.
- Maintain accurate, timely documentation in EMRs and quality systems.
- Adhere to Evergreen’s compliance standards, HIPAA guidelines, and all regulatory requirements.
- Perform additional responsibilities aligned with Evergreen’s value-based care and quality improvement objectives.
- Other duties consistent with this role, as assigned.
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 of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Preferred Qualifications
- Hands-on experience with HEDIS and Medicare Stars measures, including gap identification and closure workflows
- Experience in nephrology, CKD/ESRD, or chronic disease management
- Medical Assistant or LPN license
- Bachelor’s degree in health-related field preferred, or equivalent healthcare experience
Compensation
The pay range for this role is $20-$24/hr. Exact pay is determined based on experience, education, demand for the role, and other role-specific factors.
This role is also eligible for an annual bonus.
Benefits
Evergreen Nephrology’s total rewards program is designed to support you in and outside of work. You can expect:
- 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
Evergreen Nephrology is an equal opportunity employer. Applicants will not be discriminated against because of race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, citizenship status, disability, ancestry, marital status, veteran status, medical condition or any other protected category under local, state or federal laws.
If you are an applicant with a disability who requires reasonable accommodation for any part of the hiring process, please contact us for assistance at recruiting@evergreennephrology.com.
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