Nurse Reviewer

Staffing Solutions Organization LLC (SSO)

3d•$73,000 - $81,000•Hybrid

About The Position

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.

Requirements

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.
Bachelor’s degree in any field (Nursing preferred)
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.
Active Illinois Registered Professional Nurse (RN) license required.

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.