TN Visa Utilization Management Nurse Jobs
Utilization Management Nurse roles qualify for TN visa sponsorship under the USMCA treaty's Registered Nurse category, giving Canadian and Mexican RNs a cap-free path to U.S. employment. You'll need an active U.S. state nursing license and a sponsoring employer to document the UM role as direct nursing practice.
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Get Access To All JobsJOB TITLE: Utilization Review Nurse
Duration: 5-6 Months Contract Job – possible extension
Location: 100% Remote
Schedule: first shift
Start Date: ASAP
Job Description:
remote within IL, TX, TN, NM, OK, MT Registered Nurse responsible for collaborating with healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and promote effective use of resources. Medical necessity reviews may include: drugs and biologics, inpatient admissions, outpatient services, surgical and diagnostic procedures, home health, durable medical equipment and out of network services. Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts.
Essential Duties and Responsibilities:
- Responsible for the effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient medical services for medical necessity and appropriateness of setting according to established policies and compliance guidelines.
- Uses an established set of criteria to evaluates and authorize the medical necessity of services.
- Provide notification of decisions in accordance with compliance guidelines.
- Coordinate with Medical Directors when services do not meet criteria or require additional review.
- Participation in staff meetings, regular trainings and other collaborative meetings as appropriate.
- Works with management team to achieve operational objectives and financial goals.
- Supports teams across UM Department as needed.
- Active participation and completion of all required trainings.
- Maintain Required Licensures.
- Adherence to regulatory and departmental timeframes for review of requests.
- Meet/exceed department Turn Around time, daily established productivity goals, and service levels.
- Proficient knowledge of policies and procedures, Medicare, HIPPA and NCQA standards.
- Professional demeanor and the ability to work effectively within a team or independently.
- Flexible with the ability to shift priorities when required.
- Other duties as required.
Qualifications
- Current unrestricted RN license. Multi-State License Preferred.
- Bachelor’s degree in nursing or health-care related field preferred.
- Minimum of 2 years’ experience in a regulated environment preferred.
- Minimum of 2-3 years clinical experience.
- Strong customer orientation.
- Strong organizational, planning, and communication skills.
- Working knowledge of insurance industry, medical coding (CPT/HCPCS/ICD-10), and overall claims process a plus.
- Knowledge of National Coverage Determinations, Local Coverage Determinations and MCG criteria are a plus.
- Excellent time management skills.
Knowledge, Skills, Abilities Required:
- Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers involved in the care of a member.
- Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments.
- Able to work in a dynamic, fast-paced team environment and to promote team concepts.
- Excellent typing skills.
- Substantial knowledge of Microsoft Office including SharePoint, Outlook, PowerPoint, Excel and Word.
EEO:
“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
Thanks, and regards.
JOB TITLE: Utilization Review Nurse
Duration: 5-6 Months Contract Job – possible extension
Location: 100% Remote
Schedule: first shift
Start Date: ASAP
Job Description:
remote within IL, TX, TN, NM, OK, MT Registered Nurse responsible for collaborating with healthcare providers, members, and business partners, to optimize member benefits, evaluate medical necessity and promote effective use of resources. Medical necessity reviews may include: drugs and biologics, inpatient admissions, outpatient services, surgical and diagnostic procedures, home health, durable medical equipment and out of network services. Conduct reviews in compliance with medical policy, member eligibility, benefits, and contracts.
Essential Duties and Responsibilities:
- Responsible for the effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient medical services for medical necessity and appropriateness of setting according to established policies and compliance guidelines.
- Uses an established set of criteria to evaluates and authorize the medical necessity of services.
- Provide notification of decisions in accordance with compliance guidelines.
- Coordinate with Medical Directors when services do not meet criteria or require additional review.
- Participation in staff meetings, regular trainings and other collaborative meetings as appropriate.
- Works with management team to achieve operational objectives and financial goals.
- Supports teams across UM Department as needed.
- Active participation and completion of all required trainings.
- Maintain Required Licensures.
- Adherence to regulatory and departmental timeframes for review of requests.
- Meet/exceed department Turn Around time, daily established productivity goals, and service levels.
- Proficient knowledge of policies and procedures, Medicare, HIPPA and NCQA standards.
- Professional demeanor and the ability to work effectively within a team or independently.
- Flexible with the ability to shift priorities when required.
- Other duties as required.
Qualifications
- Current unrestricted RN license. Multi-State License Preferred.
- Bachelor’s degree in nursing or health-care related field preferred.
- Minimum of 2 years’ experience in a regulated environment preferred.
- Minimum of 2-3 years clinical experience.
- Strong customer orientation.
- Strong organizational, planning, and communication skills.
- Working knowledge of insurance industry, medical coding (CPT/HCPCS/ICD-10), and overall claims process a plus.
- Knowledge of National Coverage Determinations, Local Coverage Determinations and MCG criteria are a plus.
- Excellent time management skills.
Knowledge, Skills, Abilities Required:
- Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers involved in the care of a member.
- Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments.
- Able to work in a dynamic, fast-paced team environment and to promote team concepts.
- Excellent typing skills.
- Substantial knowledge of Microsoft Office including SharePoint, Outlook, PowerPoint, Excel and Word.
EEO:
“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
Thanks, and regards.
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Get Access To All JobsTips for Finding TN Visa Sponsorship as an Utilization Management Nurse
Verify your nursing license transfers correctly
UM Nurse roles require an active U.S. state RN license, not just a Canadian or Mexican one. Start the NCLEX and endorsement process early, state boards vary on processing time, and you can't file a TN petition without a valid U.S. license in hand.
Frame your UM experience as clinical nursing
CBP officers assess whether your role constitutes registered nursing under TN criteria. Emphasize direct clinical decision-making in medical necessity reviews, not administrative or supervisory duties, so your offer letter and support documents clearly satisfy the nursing occupation requirement.
Target health plans and hospital systems with UM departments
Seek employers who already have internal UM teams, such as large hospital networks, integrated health systems, and managed care organizations. These employers understand how to structure a TN support letter for clinical roles and are less likely to conflate UM work with non-qualifying administrative functions.
Use Migrate Mate to find TN-sponsoring UM employers
Search for Utilization Management Nurse positions through Migrate Mate, which filters specifically for TN visa sponsorship opportunities. It saves time identifying which employers have experience sponsoring Canadian and Mexican nurses for U.S. clinical roles.
Understand the Mexican TN cap before accepting an offer
Mexican nationals are subject to a 5,500 annual TN allocation. Confirm with your employer that they initiate USCIS filing well before the fiscal year fills. Canadian citizens can obtain TN status directly at the port of entry, so your entry strategy differs significantly based on citizenship.
Request a detailed employer support letter covering clinical duties
Your offer letter must specify that the position requires registered nursing skills, list your clinical UM responsibilities such as concurrent review and discharge planning authorization, and state your professional credentials. A vague letter citing only cost management or administrative oversight is the most common reason CBP pushes back on UM TN petitions.
Utilization Management Nurse jobs are hiring across the US. Find yours.
Find Utilization Management Nurse JobsUtilization Management Nurse TN Visa: Frequently Asked Questions
Does a Utilization Management Nurse role qualify for TN visa status?
Yes, but the role must be structured as registered nursing practice under USMCA criteria. CBP evaluates whether the position requires clinical nursing judgment, such as conducting medical necessity reviews or authorizing care transitions. Roles framed primarily around administrative coordination or cost oversight without direct clinical decision-making are at higher risk of denial at the port of entry.
How does TN compare to H-1B for Utilization Management Nurses?
TN has no annual lottery and no numerical cap for Canadian citizens, meaning you can pursue a U.S. position without waiting years for a visa slot. H-1B requires employer sponsorship through a randomized lottery each spring, with most applicants waiting multiple cycles before selection. TN also processes faster, either at the port of entry for Canadians or through USCIS for Mexican nationals, often in weeks rather than months.
What documents does a UM Nurse need to support a TN petition?
You need a detailed employer offer letter specifying clinical nursing duties, your active U.S. state RN license, proof of Canadian or Mexican citizenship, and your nursing degree or diploma. Some employers also include a USMCA TN support memo from their immigration counsel. CBP at the border or USCIS for Mexican nationals will review all of these before approving status.
Where can I find employers offering TN visa sponsorship for UM Nurse roles?
Migrate Mate is built specifically for Canadian and Mexican professionals searching for TN visa sponsorship opportunities in the United States. You can filter for Utilization Management Nurse roles where the employer has indicated TN sponsorship, which removes the guesswork of cold-applying to companies unfamiliar with the USMCA treaty process.
Can a Mexican RN renew TN status for a Utilization Management Nurse position?
Yes, TN status is renewable in three-year increments with no maximum limit on renewals, for both Canadian and Mexican nationals. Mexican RNs renew through USCIS by filing a new petition before the current status expires. Canadians can renew at a port of entry. You'll need updated employer documentation and a valid U.S. nursing license at each renewal cycle.
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