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 are seeking a Manager, Utilization Management to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Manager, Utilization Management plays a vital role in overseeing the evaluation and authorization of healthcare services to ensure appropriate, cost-effective care delivery. This position is responsible for overseeing the utilization management process to ensure efficient and effective use of resources. The Manager, Utilization Management is also responsible for developing and implementing utilization management policies and procedures to ensure compliance with regulatory requirements and industry standards. The Manager, Utilization Management will lead a team of utilization management personnel to review and authorize medical services, ensuring that they are medically necessary and appropriate. The Manager, Utilization Management’s role is vital in ensuring that patients receive the highest quality of care while managing costs for the organization.
Minimum Qualifications:
- Bachelor's degree in nursing, healthcare administration, or related field
- 3 years of experience in utilization management or related field
- Experience leading a team of utilization management professionals
- Strong knowledge of regulatory requirements and industry standards
- Relevant experience may substitute for the educational requirement on a year-for-year basis
Preferred Qualifications:
- Master's degree in nursing, healthcare administration, or related field
- Experience working in a managed care organization
- Certification in utilization management or related field
Responsibilities:
- Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
- Lead and manage a team of utilization management personnel to review and authorize medical services, ensuring that they are medically necessary and appropriate.
- Manage utilization management processes to ensure efficient and effective use of resources.
- Utilize established utilization management guidelines to review and authorize medical services.
- Ensure that medical services are medically necessary and appropriate.
- Implement utilization management activities in accordance with established policies and procedures.
- Ensure compliance with regulatory requirements and industry standards.
- Perform other duties as assigned.
We are seeking a Manager, Utilization Management to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.
About the Role:
The Manager, Utilization Management plays a vital role in overseeing the evaluation and authorization of healthcare services to ensure appropriate, cost-effective care delivery. This position is responsible for overseeing the utilization management process to ensure efficient and effective use of resources. The Manager, Utilization Management is also responsible for developing and implementing utilization management policies and procedures to ensure compliance with regulatory requirements and industry standards. The Manager, Utilization Management will lead a team of utilization management personnel to review and authorize medical services, ensuring that they are medically necessary and appropriate. The Manager, Utilization Management’s role is vital in ensuring that patients receive the highest quality of care while managing costs for the organization.
Minimum Qualifications:
- Bachelor's degree in nursing, healthcare administration, or related field
- 3 years of experience in utilization management or related field
- Experience leading a team of utilization management professionals
- Strong knowledge of regulatory requirements and industry standards
- Relevant experience may substitute for the educational requirement on a year-for-year basis
Preferred Qualifications:
- Master's degree in nursing, healthcare administration, or related field
- Experience working in a managed care organization
- Certification in utilization management or related field
Responsibilities:
- Demonstrate commitment to Our Mission and models ILS Experience Standards of Excellence.
- Lead and manage a team of utilization management personnel to review and authorize medical services, ensuring that they are medically necessary and appropriate.
- Manage utilization management processes to ensure efficient and effective use of resources.
- Utilize established utilization management guidelines to review and authorize medical services.
- Ensure that medical services are medically necessary and appropriate.
- Implement utilization management activities in accordance with established policies and procedures.
- Ensure compliance with regulatory requirements and industry standards.
- Perform other duties as assigned.
See all 136+ H-1B Visa Utilization Management Nurse Jobs
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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.