Nurse Reviewer

Staffing Solutions Organization LLC (SSO); Illinois; Hybrid; USD 70,000 - 95,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k) with discretionary employer 120

Paid time off and holidays

Flexible spending accounts

Additional employee perks

Job summary

Staffing Solutions Organization LLC (SSO) is seeking a Nurse Reviewer to conduct provider compliance reviews, onsite visits, and evaluate documentation to ensure adherence to state regulations and program requirements. You will work independently with sound judgment to guide provider improvement and statewide oversight.

Remote work with 2–3 on‑site provider visits per week across Illinois; travel as required.

Qualifications

• Bachelor’s degree in any field (Nursing preferred).
• Minimum 2 years of clinical experience with providers.
• Minimum 1 year of experience conducting quality assurance reviews.

Responsibilities

• Build and maintain effective relationships with providers and users to support high‑quality customer service.
• Evaluate providers for compliance with applicable state and program regulations.
• Coordinate and schedule on‑site provider visits; clearly communicate visit requirements.
• Conduct compliance interviews with providers and gather all necessary information.
• Review provider documentation, policies, and business practices for regulatory alignment.
• Collect, organize, and submit documentation supporting compliance findings.
• Utilize technology and web‑based systems to convert paper documentation to electronic format.
• Conduct in‑person assessments of provider sites to evaluate compliance with oversight requirements.
• Summarize on‑site visit findings accurately and professionally.
• Exercise independent judgment to evaluate compliance and make final determinations based on documented evidence.
• Identify deficiencies and recommend appropriate next steps to support provider improvement.
• Analyze trends in non‑compliance and identify gaps in provider business processes.
• Provide timely recommendations and updates to the Supervisor.
• Maintain HIPAA standards and confidentiality at all times.
• Perform other duties as assigned.

Skills

Strong interpersonal skills

Active listening

Written and verbal communication

Attention to detail

Ability to travel

Education

Bachelor’s degree (Nursing preferred)

Tools

MS Word

Excel

Outlook

Web‑based applications

Job description

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world‑class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Location: Remote with on‑site visits across Illinois

Position Overview

The Nurse Reviewer conducts provider compliance reviews to ensure adherence to state regulations, quality standards, and program requirements. This role includes conducting onsite visits, evaluating documentation, and determining provider compliance. The Nurse Reviewer works independently, exercises sound judgment, and provides recommendations that guide provider improvement and support statewide oversight efforts.

Duties & Responsibilities

• Build and maintain effective relationships with providers and users to support high‑quality customer service.
• Evaluate providers for compliance with applicable state and program regulations.
• Coordinate and schedule on‑site provider visits; clearly communicate visit requirements.
• Conduct compliance interviews with providers and gather all necessary information.
• Review provider documentation, policies, and business practices for regulatory alignment.
• Collect, organize, and submit documentation supporting compliance findings.
• Utilize technology and web‑based systems to convert paper documentation to electronic format.
• Conduct in‑person assessments of provider sites to evaluate compliance with oversight requirements.
• Summarize on‑site visit findings accurately and professionally.
• Exercise independent judgment to evaluate compliance and make final determinations based on documented evidence.
• Identify deficiencies and recommend appropriate next steps to support provider improvement.
• Analyze trends in non‑compliance and identify gaps in provider business processes.
• Provide timely recommendations and updates to the Supervisor.
• Maintain HIPAA standards and confidentiality at all times.
• Perform other duties as assigned.

Required Skills

• Strong interpersonal skills with the ability to relate well to staff and providers.
• Active listening and effective communication skills.
• Proficiency in MS Word, Excel, Outlook, and web‑based applications.
• Process‑oriented and results‑driven work approach.
• Ability to foster teamwork and collaborate across levels of management and staff.
• Ability to work independently and within a team environment.
• Excellent written and verbal communication skills and customer‑service techniques.
• High accuracy, strong attention to detail, and commitment to quality.
• Proven ability to meet deadlines and follow strict standards.
• Ability to travel regularly to provider sites across Illinois.

Education

• Bachelor’s degree in any field (Nursing preferred)

Experience

• Minimum 2 years of clinical experience working with critical care providers, public health providers, or providers serving children, older adults, individuals with traumatic brain injury, or individuals with developmental disabilities.
• Minimum 1 year of experience conducting quality assurance reviews.

Working Conditions

• Remote work with 2–3 on‑site provider visits per week throughout the state of Illinois.

Benefits (Through SSO)

SSO offers a competitive benefits package that supports your health, financial well‑being, and long‑term growth, including:

• Medical, dental, and vision insurance
• 401(k) with discretionary employer match
• Paid time off and holidays
• Flexible spending accounts
• Additional employee perks

Keyword Search Terms

Nurse Reviewer, RN Reviewer, Provider Management Specialist, Compliance Nurse, Healthcare Quality Review, Provider Compliance, Medicaid Compliance, Clinical Reviewer, Illinois RN, Site Visit Nurse, Healthcare Auditor, Public Health Nursing, QA Nurse, Provider Monitoring.

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience.As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.

Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship (including H-1B sponsorship) by SSO and under the federal laws relating to the F-1 STEM EAD program, this position is not eligible to support a STEM EAD extension application.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E-Verify participant.