Remote Nurse Reviewer: Provider Compliance & Site Visits

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) 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.