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Quality Program Manager at Evergreen Nephrology, Remote (United States)

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.

Role 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 validation
• Identify compliance gaps and partner cross-functionally to implement corrective actions
• Reinforce NCQA-aligned practices across frontline teams
• Support training and education related to accreditation standards and documentation requirements
• Other duties consistent with this role, as assigned.

Required Qualifications

• 3–5+ years of experience in healthcare operations, quality, or population health
• Experience with HEDIS, Medicare Stars, or similar quality programs
• Prior experience leading teams or supervising frontline staff
• Strong understanding of care gap closure workflows and clinical operations
• Ability to use data to drive execution and performance improvement
• NCQA accreditation or regulatory compliance
• Experience supporting audits, surveys or readiness efforts
• 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 value-based care models
• Exposure to CKD/ESKD or chronic care management programs
• Familiarity with documentation and coding practices impacting quality performance

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.