Review Nurse- Value Based Services

Evara Health; Clearwater (FL); On-site; USD 50,000 - 65,000; Full time

Benefits offered by this job

15 days of paid time off

Free gym membership

403(b) retirement plan with employer contributions

Tuition reimbursement up to $1,500 annually

Comprehensive insurance plans

Employee Assistance Program (EAP)

Job summary

Evara Health in Clearwater, Florida, is looking for a dedicated LPN to deliver essential patient care. The role involves clinical reviews, managing patient outreach, and collaborating with care teams.

Qualified candidates will have a supportive work environment, opportunities for professional growth, and a comprehensive benefits package.

You’ll make a significant impact on communities through your work while enjoying generous time off and wellness perks.

Qualifications

• Graduate of an accredited LPN program.
• Minimum two (2) years of experience as an LPN in healthcare.
• Minimum one (1) year of experience as a Utilization Review Nurse or Case Manager.

Responsibilities

• Conduct comprehensive reviews of assigned patient populations.
• Manage ongoing outreach to patients.
• Maintain accurate and timely documentation of patient interactions.
• Work closely with providers and care teams on care plans.
• Schedule and manage patient appointments for care reviews.
• Adhere to organizational policies and confidentiality standards.
• Utilize analytics tools to monitor performance.

Skills

Clinical knowledge

Patient outreach

Documentation accuracy

Team collaboration

Data analytics

Education

Graduate of accredited LPN program

2 years experience as LPN

1 year as Utilization Review Nurse or Case Manager

Job description

Join Evara Health—Driven by Purpose, Powered by People.

Evara Health provides essential, high-quality care to the communities who need it most through 17 centers and mobile units offering primary care, dental, behavioral health, pediatrics, and more. Evara Health is recognized for its innovative, team-based approach, commitment to community health, and dedication to making healthcare accessible for all. Our people fuel our impact. Team members come for the purpose and stay for the supportive culture and strong, community-focused teams.

About this Role:

• Clinical Review and Care Gap Analysis: Conduct comprehensive reviews of assigned patient populations to assess medical complexity, chronic conditions, and social determinants of health. Identify gaps in care using clinical knowledge, internal protocols, and payer guidelines, and determine appropriate medical or non-medical interventions.
• Patient Outreach and Education: Manage an assigned caseload by performing ongoing outreach to patients, promoting preventive care, encouraging healthy behaviors, and providing education to empower patients in making informed healthcare decisions.
• Documentation and Reporting: Maintain accurate and timely documentation of all patient interactions, case notes, and outcome measures within required timeframes (within 24 hours). Track and report on quality metrics, ensuring all required measures are completed and submitted appropriately.
• Team Collaboration and Care Coordination: Work closely with providers, care teams, and program leadership to review cases, align on care plans, and support coordinated, patient-centered care. Participate in regular case reviews and performance discussions with leadership.
• Appointment Coordination and Program Support: Schedule and manage patient appointments related to care reviews and value-based initiatives. Perform plan-specific activities such as Health Risk Assessments, Annual Wellness outreach, and other required engagement efforts.
• Compliance and Confidentiality: Adhere to all organizational policies, regulatory requirements, and confidentiality standards, including HIPAA and value-based care program guidelines, ensuring the protection of patient and organizational information.
• Data-Driven Quality Improvement: Utilize analytics tools, HEDIS measures, and reporting systems to monitor performance, close care gaps, and optimize patient outcomes. Apply knowledge of clinical documentation, billing, and coding practices to support value-based care initiatives.

Education and Experience:

• Graduate of an accredited LPN program
• Minimum two (2) years of experience as an LPN in healthcare
• Minimum one (1) year of experience as a Utilization Review Nurse or Case Manager

Licenses, Certification, or Registration:

• Active and unencumbered LPN License in the State of Florida
• Current BLS Certification

Why You'll Love Working Here:

• Impact: Every day, you’ll make a significant impact on our patients’ lives, leading efforts that go beyond healthcare to ensure community wellbeing.
• Growth: We support your professional development through continuous learning and opportunities to grow within Evara Health.
• Recognition: As part of our team, your hard work will be recognized and rewarded, contributing to your professional fulfillment and job satisfaction.

Benefits:

• Generous Time Off: 15 days of paid time off with an option to cash out unused days
• Holidays: 10 paid holidays and an additional 1 day off for your birthday.
• Wellness Perks: Enjoy a free gym membership to support your health and fitness goals.
• Retirement Planning: 403(b) with 2% employer contribution up to 4% match
• Continuing Education: Tuition reimbursement eligibility which includes $1,500 per year.
• Comprehensive Insurance Plans: Medical, Dental, Vision, Life, Short & Long-Term Disability + extra coverage options.
• Employee Assistance Program (EAP): Confidential counseling, legal & financial advice through EAP

This position requires a Level 2 background screening through the Florida Care Provider Background Screening Clearinghouse.