Review Nurse- Value Based Services

Evara Health; Clearwater (FL); Hybrid; USD 60,000 - 75,000; Full time

Benefits offered by this job

15 days paid time off

10 paid holidays

Free gym membership

403(b) with employer match

Tuition reimbursement $1,500/year

Medical, Dental, Vision, Life

EAP

Job summary

Evara Health is seeking a Licensed Practical Nurse (LPN) in Clearwater to perform clinical reviews and care gap analyses, manage patient outreach, and coordinate care across teams. The role emphasizes data-driven quality improvement and timely documentation within HIPAA guidelines.

The position supports value-based care initiatives, requiring local Florida licensure, BLS, and prior case management or utilization review experience.

Qualifications

• Graduate of an accredited LPN program.

Responsibilities

• Clinical Review and Care Gap Analysis: Assess medical complexity and social determinants of health to identify gaps and interventions.
• Patient Outreach and Education: Manage a caseload, promote preventive care and empower patients.
• Documentation and Reporting: Maintain timely documentation and track quality metrics.
• Team Collaboration and Care Coordination: work with providers and care teams to align on care plans.
• Appointment Coordination and Program Support: Schedule appointments and conduct health risk assessments.
• Compliance and Confidentiality: Follow HIPAA and program guidelines.

Education

LPN program graduate

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Review Nurse- Value Based Services

Full Time Admin - IC Clearwater, FL, US

30+ days ago Requisition ID: 3242

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.

Build a career that goes beyond a job—it changes lives.

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.

What sets Evara Health apart is our amazing culture and team spirit. We've set record engagement scores this year, creating an environment where our staff thrives and feels truly valued. We are able to do this through our team-based approach to work, but also in our unique benefit offerings such as:

• Generous Time Off: 15 days of paid time off with an option to cash out unused day
• 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. For more information about the background screening process, visit https://info.flclearinghouse.com .