Green Card Utilization Management Nurse Jobs
Utilization Management Nurse roles qualify for EB-2 and EB-3 green card sponsorship through the PERM labor certification process. Employers file on your behalf, covering clinical necessity review, prior authorization, and discharge planning. Sponsorship leads to permanent residency, not a temporary status that expires.
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Get Access To All JobsINTRODUCTION
The Manager of Utilization Management provides daily oversight for Case Management teams (which includes RN’s, Social Workers, and Coordinators). The Manager of Utilization Management is responsible for ensuring high quality, cost-effective, and appropriate allocation of member services, treatments, and resources. The Manager of Utilization Management serves as a resource to Healthfirst’s care management team, members, and outside medical providers.
DUTIES/RESPONSIBILITIES:
- Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, referrals, and other plan services
- Develops and monitors goals for staff; provides ongoing feedback and coaching; conducts annual performance reviews; leads by example; and ensures an atmosphere of open communication, teamwork, and ownership and empowerment to make informed decisions
- Collaborates with medical staff and reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems
- Allocate, monitor, and control resources while delegating and monitoring workloads
- Develops and analyzes operational and analytical reports to monitor and track operational efficiency
- Properly documents utilization management activities and rationale for all decisions in electronic medical records systems
- Functions as a clinical resource for the multi-disciplinary care team on an ongoing basis in order to maximize the quality of patient care while achieving effective medical cost management
- Additional duties as assigned
MINIMUM QUALIFICATIONS:
- Associate’s degree
- RN, LPN, LMSW, LMHC, LCSW, or any other relevant clinical license
- Work experience demonstrating verbal and written communication skills
- Experience working independently in a fast-paced environment that requires problem solving skills and handling multiple priorities simultaneously
- Experience with Microsoft Office Suite applications including Excel, Word, Power Point and Outlook
PREFERRED QUALIFICATIONS:
- RN, LPN, LMSW, LMHC, LCSW, or any other relevant clinical license
- Master’s degree in a related discipline
- Demonstrated professionalism and leadership skills along with the ability to train, develop, direct, and support staff
- Experience in managed care, case management, identifying alternative care options, and discharge planning across a variety of treatment settings for high risk, complex populations
- Certified Case Manager
- Interqual, Milliman, and/or TruCare knowledge
- Knowledge of Centers for Medicare & Medicaid Services (CMS), New York State Department of Health (NYSDOH), or MLTCP regulations governing medical management in managed care
- Work experience in managed care or healthcare industry in utilization management including preauthorization of outpatient or inpatient services
- Knowledge of utilization management/quality management case philosophies and reporting requirements to NY state and federal agencies.
COMPLIANCE & REGULATORY RESPONSIBILITIES:
The Manager is responsible for ensuring regulatory compliance with CMS, DOH, internal, and other relevant rules.
HIRING RANGE:
- Greater New York City Area (NY, NJ, CT residents): $116,800 - $168,810
- All Other Locations (within approved locations): $99,700 - $148,325
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.
INTRODUCTION
The Manager of Utilization Management provides daily oversight for Case Management teams (which includes RN’s, Social Workers, and Coordinators). The Manager of Utilization Management is responsible for ensuring high quality, cost-effective, and appropriate allocation of member services, treatments, and resources. The Manager of Utilization Management serves as a resource to Healthfirst’s care management team, members, and outside medical providers.
DUTIES/RESPONSIBILITIES:
- Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, referrals, and other plan services
- Develops and monitors goals for staff; provides ongoing feedback and coaching; conducts annual performance reviews; leads by example; and ensures an atmosphere of open communication, teamwork, and ownership and empowerment to make informed decisions
- Collaborates with medical staff and reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems
- Allocate, monitor, and control resources while delegating and monitoring workloads
- Develops and analyzes operational and analytical reports to monitor and track operational efficiency
- Properly documents utilization management activities and rationale for all decisions in electronic medical records systems
- Functions as a clinical resource for the multi-disciplinary care team on an ongoing basis in order to maximize the quality of patient care while achieving effective medical cost management
- Additional duties as assigned
MINIMUM QUALIFICATIONS:
- Associate’s degree
- RN, LPN, LMSW, LMHC, LCSW, or any other relevant clinical license
- Work experience demonstrating verbal and written communication skills
- Experience working independently in a fast-paced environment that requires problem solving skills and handling multiple priorities simultaneously
- Experience with Microsoft Office Suite applications including Excel, Word, Power Point and Outlook
PREFERRED QUALIFICATIONS:
- RN, LPN, LMSW, LMHC, LCSW, or any other relevant clinical license
- Master’s degree in a related discipline
- Demonstrated professionalism and leadership skills along with the ability to train, develop, direct, and support staff
- Experience in managed care, case management, identifying alternative care options, and discharge planning across a variety of treatment settings for high risk, complex populations
- Certified Case Manager
- Interqual, Milliman, and/or TruCare knowledge
- Knowledge of Centers for Medicare & Medicaid Services (CMS), New York State Department of Health (NYSDOH), or MLTCP regulations governing medical management in managed care
- Work experience in managed care or healthcare industry in utilization management including preauthorization of outpatient or inpatient services
- Knowledge of utilization management/quality management case philosophies and reporting requirements to NY state and federal agencies.
COMPLIANCE & REGULATORY RESPONSIBILITIES:
The Manager is responsible for ensuring regulatory compliance with CMS, DOH, internal, and other relevant rules.
HIRING RANGE:
- Greater New York City Area (NY, NJ, CT residents): $116,800 - $168,810
- All Other Locations (within approved locations): $99,700 - $148,325
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.
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Get Access To All JobsTips for Finding Green Card Sponsorship as an Utilization Management Nurse
Verify your CGFNS credential evaluation early
USCIS requires foreign nursing credentials to be evaluated before PERM can proceed. Start your Commission on Graduates of Foreign Nursing Schools evaluation well ahead of any offer, since delays here stall the entire green card timeline.
Target health systems with UR department infrastructure
Large hospital systems and managed care organizations regularly file PERM for Utilization Management Nurses because they have dedicated HR and legal teams. Prioritize employers whose UM departments operate across multiple payers, not single-facility clinics.
Confirm the prevailing wage tier before accepting an offer
Run your target job title and location through the OFLC Wage Search before negotiating. PERM requires your offered salary to meet the prevailing wage, and a Level I or Level II designation affects your long-term compensation floor.
Search green card sponsoring UM roles on Migrate Mate
Filter by EB-2 or EB-3 sponsorship and Utilization Management Nurse to surface employers who have already filed PERM for this exact role. Migrate Mate surfaces that employer history so you're not guessing at willingness.
Understand how EB-3 filing protects your priority date
Once your employer files the I-140, your priority date is locked in even if you change jobs under AC21 portability. Request that your employer file the I-140 concurrently with PERM approval to bank that date as early as possible.
Ask employers whether they use E-Verify before your PERM starts
Some states and federal contractors require E-Verify enrollment, which affects onboarding timing. Confirming this before PERM is filed prevents work authorization gaps if your adjustment of status takes longer than expected.
Green Card Utilization Management Nurse: Frequently Asked Questions
Do Utilization Management Nurse roles qualify for EB-2 or EB-3 green card sponsorship?
Most Utilization Management Nurse positions qualify under EB-3, which covers skilled workers and professionals requiring a bachelor's degree or its equivalent. Candidates with a master's degree in nursing or a clinical specialty, or those with strong credentials and substantial experience, may qualify under EB-2. Your employer's immigration attorney determines the appropriate category based on the job description and your qualifications.
How is green card sponsorship different from H-1B sponsorship for this role?
Green card sponsorship through PERM and I-140 leads to permanent residency, with no annual renewal or status expiration. H-1B visa is temporary and subject to annual lottery uncertainty. EB-3 green card filings face no annual cap at the petition level, though visa number availability by country affects final adjustment timelines. For many applicants, the green card path offers greater long-term stability.
What does the PERM labor certification process involve for a Utilization Management Nurse?
Your employer files a PERM application with DOL certifying that no qualified U.S. worker was available for the role at the prevailing wage. This requires the employer to conduct recruitment steps, including job postings, before filing. PERM approval typically takes six to eighteen months, after which the employer files I-140 with USCIS to petition for your classification.
Where can I find Utilization Management Nurse jobs that offer green card sponsorship?
Migrate Mate lets you filter job listings specifically by EB-2 or EB-3 sponsorship and job title. Because many employers do not prominently advertise green card sponsorship in standard postings, searching a platform that indexes actual PERM filing history gives you a far more accurate picture of which employers are genuinely willing to sponsor.
Can I change employers during my green card process as a Utilization Management Nurse?
Yes, under AC21 portability, you can change to a same or similar occupation after your I-140 is approved and your I-485 has been pending for at least 180 days. Utilization Management Nurse roles generally fall within the same O*NET occupational group, so a move to another UM position at a different employer typically qualifies without losing your priority date.