Manage a caseload of nephrology patients in Skilled Nursing Facilities to ensure efficient care and seamless transitions to home or community settings. Collaborate with providers and discharge planners to develop patient-centric care plans and optimize length of stay.
Evergreen Nephrology
12 Remote Job Openings at Evergreen Nephrology
The Care Coordinator manages proactive outreach and care plans for patients with complex chronic conditions like kidney disease. They coordinate communication between patients and providers while ensuring documentation compliance for Medicare billing.
Coordinate comprehensive clinical care for kidney disease patients by identifying social determinants of health and navigating resources. Act as the primary point of contact to ensure seamless transitions of care and patient advocacy across an interdisciplinary team.
Responsible for ensuring operational compliance with NCQA accreditation and regulatory requirements. This includes developing compliance documents, monitoring gaps, and coordinating accreditation surveys.
Manage a patient panel of individuals with kidney disease, focusing on transitions of care post-hospitalization. Develop comprehensive, patient-centric care plans and coordinate with interdisciplinary teams to improve patient outcomes and reduce fragmentation.
Lead the day-to-day execution of clinical quality programs and manage the performance of Quality Improvement Specialists. Ensure operational alignment with NCQA standards and drive care gap closure across value-based care programs.
The CKD RN Navigator provides care coordination, education, and support for patients with chronic kidney disease to optimize outcomes and ensure seamless transitions to ESKD. This includes identifying care gaps, managing referrals for dialysis access, and collaborating with an interdisciplinary clinical team.
Care Coordinator - CKD Navigation
Evergreen Nephrology
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Full Time
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a month ago
Evergreen Nephrology
The Care Coordinator manages patient enrollment and implements comprehensive care plans focusing on Social Determinants of Health. They act as a primary point of contact to help patients navigate the healthcare system and access community resources.
Vice President, Clinical Operations
Evergreen Nephrology
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Full Time
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a month ago
Evergreen Nephrology
Lead the performance, scalability, and continuous improvement of enterprise clinical programs including CKD Navigation and Post-Acute Care. Translate clinical strategies into scalable operating models and technology requirements to improve patient outcomes and reduce the total cost of care.
The Quality Improvement Specialist serves as a connector between patients, providers, and internal teams to identify and close quality gaps through data-driven collaboration. They manage a patient panel, conduct proactive outreach, and educate providers on documentation standards and performance measures.
The Manager of Reporting & Analytics will lead a team to develop data-driven solutions, dashboards, and reports that improve clinical and operational performance. They will collaborate with cross-functional teams to gather requirements, ensure data quality, and provide actionable insights to stakeholders.
The Community Health Worker supports patient-centered care by coordinating services, connecting patients to community resources, and acting as a trusted liaison between vulnerable populations and support systems. This role involves leading comprehensive care coordination with a focus on identifying and addressing Social Determinants of Health while partnering with the interdisciplinary care team.
