H-1B Visa Utilization Management Nurse Jobs
Utilization Management Nurses review medical necessity, authorize care, and work directly with payers and providers, a role USCIS classifies as a specialty occupation requiring at least a bachelor's degree in nursing. H-1B visa sponsorship is common at health systems, managed care organizations, and insurance carriers with active LCA filing history.
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Get Access To All JobsWe’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Registered Nurse (RN) – Utilization Management
Remote | Work from Home | 24/7 Operations
Are you an experienced RN looking to transition from bedside care while continuing to make a meaningful impact on patient outcomes? Join our Utilization Management team and use your clinical expertise to help ensure members receive appropriate, high-quality, and cost-effective healthcare services.
- Review clinical documentation and apply evidence-based criteria, policies, and clinical judgment to support coverage determinations
- Assess, coordinate, monitor, and evaluate healthcare services across the continuum of care
- Collaborate with providers and care teams to facilitate appropriate treatment plans and care coordination
- Identify opportunities to improve healthcare quality, effectiveness, and benefit utilization
- Connect members to additional programs and resources that support positive health outcomes
- Serve as a clinical resource and consultant to internal and external stakeholders
WHAT YOU BRING - REQUIRED
- Active, unrestricted RN license in your state of residence
- 2+ years of adult acute care and/or critical care nursing experience
- Strong clinical assessment, critical thinking, and communication skills
- Ability to manage multiple priorities in a fast-paced, technology-driven environment
- Proficiency navigating multiple computer systems
- Associate Degree in Nursing required
Preferred Qualifications
- 2+ years of Med-Surg or specialty nursing experience
- Managed Care or Utilization Management experience
- Residence in the North Central Time Zone preferred
- BSN preferred
Schedule & Work Environment
- Utilization Management is a 24/7 operation
- Schedules may include evenings, weekends, and holidays
- Computer-based role with productivity and quality expectations
- Frequent collaboration with providers, members, and interdisciplinary teams
Why Join Us?
- Apply your clinical expertise in a rewarding non-bedside nursing role
- Help improve healthcare quality and member outcomes
- Work remotely while collaborating with an experienced clinical team
- Build valuable experience in Utilization Management and Managed Care
If you're an RN who enjoys clinical decision-making, care coordination, and making a difference at a broader level, we'd love to hear from you. Apply today!
Work from Home Requirements:
- You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.
- A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
- Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
- The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
- If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.
Technical and Logistical Requirements:
- Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
- Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
- Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
- Systems Access & Security: Ability to log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
- Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
- Future Growth: Openness to learning new skills in the future as the workplace environment evolves.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$26.01 - $56.14
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 10/03/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Registered Nurse (RN) – Utilization Management
Remote | Work from Home | 24/7 Operations
Are you an experienced RN looking to transition from bedside care while continuing to make a meaningful impact on patient outcomes? Join our Utilization Management team and use your clinical expertise to help ensure members receive appropriate, high-quality, and cost-effective healthcare services.
- Review clinical documentation and apply evidence-based criteria, policies, and clinical judgment to support coverage determinations
- Assess, coordinate, monitor, and evaluate healthcare services across the continuum of care
- Collaborate with providers and care teams to facilitate appropriate treatment plans and care coordination
- Identify opportunities to improve healthcare quality, effectiveness, and benefit utilization
- Connect members to additional programs and resources that support positive health outcomes
- Serve as a clinical resource and consultant to internal and external stakeholders
WHAT YOU BRING - REQUIRED
- Active, unrestricted RN license in your state of residence
- 2+ years of adult acute care and/or critical care nursing experience
- Strong clinical assessment, critical thinking, and communication skills
- Ability to manage multiple priorities in a fast-paced, technology-driven environment
- Proficiency navigating multiple computer systems
- Associate Degree in Nursing required
Preferred Qualifications
- 2+ years of Med-Surg or specialty nursing experience
- Managed Care or Utilization Management experience
- Residence in the North Central Time Zone preferred
- BSN preferred
Schedule & Work Environment
- Utilization Management is a 24/7 operation
- Schedules may include evenings, weekends, and holidays
- Computer-based role with productivity and quality expectations
- Frequent collaboration with providers, members, and interdisciplinary teams
Why Join Us?
- Apply your clinical expertise in a rewarding non-bedside nursing role
- Help improve healthcare quality and member outcomes
- Work remotely while collaborating with an experienced clinical team
- Build valuable experience in Utilization Management and Managed Care
If you're an RN who enjoys clinical decision-making, care coordination, and making a difference at a broader level, we'd love to hear from you. Apply today!
Work from Home Requirements:
- You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.
- A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
- Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
- The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
- If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.
Technical and Logistical Requirements:
- Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
- Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
- Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
- Systems Access & Security: Ability to log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
- Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
- Future Growth: Openness to learning new skills in the future as the workplace environment evolves.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$26.01 - $56.14
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 10/03/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
See all 110+ H-1B Visa Utilization Management Nurse Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new H-1B Visa Utilization Management Nurse Jobs.
Get Access To All JobsTips for Finding H-1B Visa Sponsorship as an Utilization Management Nurse
Verify your NCLEX and licensure transfers
Your RN license must be valid in the state where the employer is headquartered or where you'll work remotely. Multi-state compact licenses don't automatically cover all positions, so confirm portability before your employer files the LCA.
Target managed care organizations over staffing agencies
Health plans, utilization review firms, and integrated delivery networks file LCAs directly for UM Nurse roles. Staffing agencies can sponsor H-1B visas, but the cap-subject lottery adds risk that a direct hire avoids.
Search LCA filings by SOC code for UM roles
Utilization Management Nurses typically file under SOC 29-1141 (Registered Nurses). Use Migrate Mate to filter employers with verified LCA history for that code, so you're targeting companies with a documented H-1B filing track record.
Clarify remote work arrangements before the LCA is filed
DOL requires a separate LCA for each worksite, including home offices used for remote UM work. If you'll review cases from home, confirm your employer will file a worksite-specific LCA listing your home address.
Check the OFLC Wage Search before negotiating your offer
UM Nurse roles span wage levels I through IV depending on supervisory duties and case complexity. Run your job title and location through the OFLC Wage Search to verify your offer meets the prevailing wage before your employer certifies the LCA.
Ask employers about cap-exempt filing pathways
Hospitals affiliated with nonprofit research institutions or universities may qualify as cap-exempt H-1B employers. A cap-exempt filing bypasses the lottery entirely, which matters most if you're mid-career and can't afford another registration cycle.
H-1B Visa Utilization Management Nurse: Frequently Asked Questions
Does a Utilization Management Nurse role qualify as an H-1B specialty occupation?
Yes. USCIS treats UM Nurse positions as specialty occupations because the role requires at least a Bachelor of Science in Nursing and an active RN license. The job's clinical judgment component, applying evidence-based criteria like InterQual or Milliman to authorize care, supports the degree requirement that specialty occupation status demands.
Which types of employers sponsor H-1B visas for Utilization Management Nurses?
Managed care organizations, commercial health insurers, third-party utilization review firms, and large integrated health systems are the most active sponsors for UM Nurse roles. You can browse employers with verified LCA filing history for registered nurse occupations on Migrate Mate, which filters by SOC code and location.
Can I work remotely as a Utilization Management Nurse on an H-1B visa?
Yes, but DOL requires your employer to file a Labor Condition Application that lists every worksite where you'll perform H-1B work, including a home office. If your remote arrangement changes after the LCA is certified, your employer may need to file an amended LCA. Confirm this with your employer before accepting a remote-first offer.
What happens to my H-1B status if I move from a clinical nursing role into utilization management?
A move from bedside nursing to a UM Nurse position typically requires an H-1B amendment because the SOC code, wage level, and job duties change. Your employer files an amended I-129 with a new LCA before or concurrent with the role change. You can continue working during the amendment if your employer files before your duties shift.
How do I identify whether a UM Nurse job listing is likely to offer H-1B sponsorship?
Look for postings from health plans, utilization review contractors, and hospital systems that have previously filed LCAs for nursing roles. Listings that specify clinical review platforms like InterQual or Milliman signal a structured role with defined specialty occupation duties, which makes H-1B sponsorship more straightforward. USCIS is more likely to approve petitions where the degree requirement is clearly tied to the job functions.