H-1B Visa Utilization Review Nurse Jobs
Utilization Review Nurses assess medical necessity and coordinate care approvals, making the role a recognized specialty occupation for H-1B visa classification. Employers in managed care, health insurance, and hospital systems routinely sponsor H-1B visas for RNs in UR roles, particularly those with BSN credentials and clinical experience in case management or prior authorization.
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As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. This position may be required to access and administer medications within their scope of practice and according to state law.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
Essential Functions
- Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review.
- Communication to third-party payers for initial and concurrent clinical review.
- Reviews patient chart to ensure patient continues to meet medical necessity.
- Documentation of all actions and information shared with care team members or third-party payer.
- Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay.
- Discusses with physicians the appropriateness of resource utilization.
- Tracks length of stay (LOS) and resource utilization to identify at risk patients.
- Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources.
- Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation.
- Participant in UR Committee as needed.
- Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days.
- Prepares appeals on denied cases when appropriate.
- At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role.
Knowledge / Skills / Abilities
- Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment.
- Ability to perform the essential functions of the job as outlined above.
- Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills.
- Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria.
- The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.
- Ability to work autonomously and as a team member.
Qualifications
Required
One year Utilization Review or Case Management experience.
Licenses Required
Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah.
Additional license requirements as determined by the hiring department.
Qualifications (Preferred)
Preferred
- Knowledge of ICD-10, CPT Codes, and medications HCPCS
- Knowledge of CMS Regulations.
Working Conditions and Physical Demands
Employee must be able to meet the following requirements with or without an accommodation.
This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients.
Physical Requirements
Carrying, Color Determination, Crawling, Far Vision, Lifting, Listening, Manual Dexterity, Near Vision, Pulling and/or Pushing, Reaching, Sitting, Speaking, Standing, Stooping and Crouching, Walking
Multi-lingual Candidates Welcomed
To inquire about this posting, email: careers@hsc.utah.edu
EEO Statement
University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patient populations.
All qualified individuals are encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.
University of Utah Health Hospitals and Clinics, a part of The University of Utah, is an Affirmative Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran's status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both.
To request a reasonable accommodation for a disability, please contact the University of Utah Health Hospitals and Clinics Human Resources office at 801-581-6500. If you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity (OEO). More information, including the Director/Title IX Coordinator's office address, electronic mail address, and telephone number can be located at: www.utah.edu/nondiscrimination/
Online reports may be submitted at eoe.utah.edu/
The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Hospitals and Clinics Human Resources at (801) 581-6500 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or Hospitals and Clinics Human Resources at (801) 581-6500 if you have questions regarding the post-retirement rules.
This position may require the successful completion of a criminal background check and/or drug screen.
Requisition Number 84084
Reg/Temp Regular
Employment Type Full-Time
Shift Day
Work Schedule M-F 8:30-5
Location Name Midvalley Ambulatory Care Pharmacy
Workplace Set Up Remote
City Murray
State UT
Department UUH CST 11C Pharmacy Clncl Spt
Category Nursing
Workplace Set Up Remote
Overview
As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA
This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. This position may be required to access and administer medications within their scope of practice and according to state law.
Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes.
Responsibilities
Essential Functions
- Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review.
- Communication to third-party payers for initial and concurrent clinical review.
- Reviews patient chart to ensure patient continues to meet medical necessity.
- Documentation of all actions and information shared with care team members or third-party payer.
- Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay.
- Discusses with physicians the appropriateness of resource utilization.
- Tracks length of stay (LOS) and resource utilization to identify at risk patients.
- Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources.
- Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation.
- Participant in UR Committee as needed.
- Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days.
- Prepares appeals on denied cases when appropriate.
- At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role.
Knowledge / Skills / Abilities
- Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment.
- Ability to perform the essential functions of the job as outlined above.
- Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills.
- Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria.
- The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual.
- Ability to work autonomously and as a team member.
Qualifications
Required
One year Utilization Review or Case Management experience.
Licenses Required
Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah.
Additional license requirements as determined by the hiring department.
Qualifications (Preferred)
Preferred
- Knowledge of ICD-10, CPT Codes, and medications HCPCS
- Knowledge of CMS Regulations.
Working Conditions and Physical Demands
Employee must be able to meet the following requirements with or without an accommodation.
This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients.
Physical Requirements
Carrying, Color Determination, Crawling, Far Vision, Lifting, Listening, Manual Dexterity, Near Vision, Pulling and/or Pushing, Reaching, Sitting, Speaking, Standing, Stooping and Crouching, Walking
Multi-lingual Candidates Welcomed
To inquire about this posting, email: careers@hsc.utah.edu
EEO Statement
University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patient populations.
All qualified individuals are encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.
University of Utah Health Hospitals and Clinics, a part of The University of Utah, is an Affirmative Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran's status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both.
To request a reasonable accommodation for a disability, please contact the University of Utah Health Hospitals and Clinics Human Resources office at 801-581-6500. If you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity (OEO). More information, including the Director/Title IX Coordinator's office address, electronic mail address, and telephone number can be located at: www.utah.edu/nondiscrimination/
Online reports may be submitted at eoe.utah.edu/
The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Hospitals and Clinics Human Resources at (801) 581-6500 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or Hospitals and Clinics Human Resources at (801) 581-6500 if you have questions regarding the post-retirement rules.
This position may require the successful completion of a criminal background check and/or drug screen.
Requisition Number 84084
Reg/Temp Regular
Employment Type Full-Time
Shift Day
Work Schedule M-F 8:30-5
Location Name Midvalley Ambulatory Care Pharmacy
Workplace Set Up Remote
City Murray
State UT
Department UUH CST 11C Pharmacy Clncl Spt
Category Nursing
Workplace Set Up Remote
See all 33+ H-1B Visa Utilization Review Nurse Jobs
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Get Access To All JobsTips for Finding H-1B Visa Sponsorship as an Utilization Review Nurse
Verify your UR role qualifies
USCIS requires specialty occupation status, meaning your position must typically require a BSN or higher. Confirm your job description explicitly states a specific nursing degree, not just "healthcare background," before applying to H-1B-sponsoring employers.
Check prevailing wages before negotiating
Use the OFLC Wage Search to look up Level I through Level IV wages for Registered Nurses in your target metro area. Your offered salary must meet the certified LCA wage, so knowing the floor protects you during offer negotiations.
Target managed care and insurance employers
Health insurers and utilization management organizations file H-1B petitions for UR nurses more consistently than staffing agencies. Search Migrate Mate to find employers with verified H-1B LCA filing history specifically in UR and case management roles.
Gather your NCLEX and licensure documents early
Your employer's immigration counsel will need your active RN license, NCLEX pass documentation, and BSN transcripts for the H-1B petition. Multi-state compact licenses simplify remote UR roles but confirm your license covers the employer's filing state.
Ask about cap-exempt employer options
Hospitals affiliated with nonprofit research institutions or universities may qualify as cap-exempt H-1B sponsors, letting you start without waiting for the April lottery. UR nurses employed by academic medical centers should ask HR whether the facility holds cap-exempt status.
Clarify remote work LCA requirements at offer
Remote UR roles require the employer to file a separate LCA for each state where you work. Before accepting a fully remote offer, confirm your employer is prepared to certify worksite locations with DOL, since incomplete LCA coverage is a common compliance issue.
H-1B Visa Utilization Review Nurse: Frequently Asked Questions
Does a Utilization Review Nurse role qualify as a specialty occupation for H-1B purposes?
Yes, if the position requires a BSN or higher as a minimum entry requirement. USCIS evaluates specialty occupation status based on the degree requirement attached to the specific role, not the job title. Ensure your offer letter and the employer's internal job description both specify a bachelor's degree in nursing, not a more general healthcare credential, to support the petition.
Which types of employers sponsor H-1B visas for Utilization Review Nurses?
Health insurers, managed care organizations, hospital systems with in-house UR departments, and third-party utilization management vendors are the most active H-1B sponsors for this role. Staffing agencies can also file H-1B petitions but require a valid end-client employer relationship. Browse Migrate Mate to identify employers with confirmed LCA filing history in UR and case management occupations.
Can I work remotely as a Utilization Review Nurse on an H-1B visa?
Yes, but your employer must certify a Labor Condition Application that covers every state where you perform work. For fully remote UR roles, DOL requires a separate LCA for each physical worksite location, including your home address. If you relocate or work from multiple states, your employer must update the LCA accordingly to remain compliant.
Does my RN license need to match the state where my H-1B employer is based?
Your license must cover the state where work is actually performed, not necessarily where the employer is incorporated. For remote UR positions, that means your home state. Nurses holding a Nurse Licensure Compact license cover most member states automatically, but you'll need individual state licenses for non-compact states. Confirm your license coverage before signing an offer for a remote role.
How does the H-1B lottery affect my timeline for starting a Utilization Review Nurse position?
Cap-subject H-1B petitions are filed in April for an October 1 start date, meaning a job offer accepted in early spring won't translate to authorized work until the following fiscal year. If your target employer is a nonprofit hospital or academic medical center with cap-exempt status, this delay doesn't apply and employment can begin as soon as USCIS approves the petition.