TN Visa Utilization Management Specialist Jobs
Utilization Management Specialist roles qualify for TN visa sponsorship under the USMCA treaty's Medical/Health Information Specialist category, requiring a relevant bachelor's degree in health administration, nursing, or a clinical field. Canadian citizens can apply at any port of entry; Mexican citizens go through consular processing. No lottery, no cap uncertainty.
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Get Access To All JobsEmployment Type:
Full time
Shift:
Day Shift
Position Summary
The Utilization Management (UM) Registered Nurse is responsible for reviewing medical services and treatment plans to ensure the delivery of appropriate, cost-effective, and high-quality patient care. Using established clinical guidelines, regulatory requirements, and health plan policies, the UM RN collaborates with providers, interdisciplinary care teams, and patients to support optimal health outcomes while promoting the efficient use of healthcare resources.
Key Responsibilities
- Conduct concurrent utilization reviews to determine and validate the appropriate level of care using established criteria, including InterQual and Milliman guidelines.
- Initiate, manage, and track admission authorizations and payer communications.
- Review and monitor insurance denials, support appeals processes, and identify opportunities for utilization management process improvements.
- Collaborate with physicians, case managers, and interdisciplinary care teams to optimize care plans and facilitate timely, effective discharge planning.
- Ensure clinical documentation accurately reflects severity of illness, medical necessity, and appropriate resource utilization.
- Partner with Finance, Health Information Management (HIM), Admitting, and other key departments to support utilization management activities and organizational goals.
- Work closely with care coordination teams to promote high-quality, patient-centered, and cost-effective outcomes.
- Maintain compliance with regulatory, accreditation, and payer requirements.
Minimum Qualifications
Required
- Graduate of an accredited School of Nursing.
- Current, unrestricted Connecticut Registered Nurse (RN) license.
Preferred
- Bachelor of Science in Nursing (BSN).
- Three (3) or more years of Utilization Management, Utilization Review, Case Management, or related experience in an acute care hospital setting.
- Experience utilizing InterQual and/or Milliman clinical criteria.
Position Highlights
- Full-time, 40 hours per week
- Hybrid work schedule
About Saint Francis Hospital
Saint Francis Hospital has been a trusted healthcare leader in Connecticut since 1897. As a member of Trinity Health Of New England and Trinity Health, one of the nation's largest Catholic healthcare systems, Saint Francis is committed to delivering exceptional patient care, advancing medical innovation, and serving the community. Saint Francis Hospital is a 617-bed Level I Trauma Center and major teaching hospital offering a comprehensive range of specialized services. Notable programs and affiliated entities include the Comprehensive Women's Health Center, the Connecticut Joint Replacement Institute, and Smilow Cancer Hospital. Through a commitment to excellence, compassion, and innovation, Saint Francis continues to provide high-quality care to patients across the region.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Employment Type:
Full time
Shift:
Day Shift
Position Summary
The Utilization Management (UM) Registered Nurse is responsible for reviewing medical services and treatment plans to ensure the delivery of appropriate, cost-effective, and high-quality patient care. Using established clinical guidelines, regulatory requirements, and health plan policies, the UM RN collaborates with providers, interdisciplinary care teams, and patients to support optimal health outcomes while promoting the efficient use of healthcare resources.
Key Responsibilities
- Conduct concurrent utilization reviews to determine and validate the appropriate level of care using established criteria, including InterQual and Milliman guidelines.
- Initiate, manage, and track admission authorizations and payer communications.
- Review and monitor insurance denials, support appeals processes, and identify opportunities for utilization management process improvements.
- Collaborate with physicians, case managers, and interdisciplinary care teams to optimize care plans and facilitate timely, effective discharge planning.
- Ensure clinical documentation accurately reflects severity of illness, medical necessity, and appropriate resource utilization.
- Partner with Finance, Health Information Management (HIM), Admitting, and other key departments to support utilization management activities and organizational goals.
- Work closely with care coordination teams to promote high-quality, patient-centered, and cost-effective outcomes.
- Maintain compliance with regulatory, accreditation, and payer requirements.
Minimum Qualifications
Required
- Graduate of an accredited School of Nursing.
- Current, unrestricted Connecticut Registered Nurse (RN) license.
Preferred
- Bachelor of Science in Nursing (BSN).
- Three (3) or more years of Utilization Management, Utilization Review, Case Management, or related experience in an acute care hospital setting.
- Experience utilizing InterQual and/or Milliman clinical criteria.
Position Highlights
- Full-time, 40 hours per week
- Hybrid work schedule
About Saint Francis Hospital
Saint Francis Hospital has been a trusted healthcare leader in Connecticut since 1897. As a member of Trinity Health Of New England and Trinity Health, one of the nation's largest Catholic healthcare systems, Saint Francis is committed to delivering exceptional patient care, advancing medical innovation, and serving the community. Saint Francis Hospital is a 617-bed Level I Trauma Center and major teaching hospital offering a comprehensive range of specialized services. Notable programs and affiliated entities include the Comprehensive Women's Health Center, the Connecticut Joint Replacement Institute, and Smilow Cancer Hospital. Through a commitment to excellence, compassion, and innovation, Saint Francis continues to provide high-quality care to patients across the region.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
See all 37+ TN Visa Utilization Management Specialist Jobs
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Get Access To All JobsTips for Finding TN Visa Sponsorship as an Utilization Management Specialist
Align your credentials to clinical criteria
TN visa approval for this role depends on demonstrating a direct link between your degree field and utilization review work. A nursing or health information degree travels better than a general business credential, so request official transcripts and a credential evaluation before applying.
Target health systems with utilization departments
Large hospital networks, managed care organizations, and third-party administrators run dedicated UM teams and file TN petitions regularly. Filter your search to employers with in-house HR or immigration coordinators who already understand the Medical/Health Information Specialist category.
Clarify TN eligibility before the offer stage
Ask the hiring manager during final interviews whether their HR team has processed TN visas before. An employer unfamiliar with TN may default to H-1B visa timelines, stalling your start date when a same-day Canadian port-of-entry approval was available the whole time.
Use Migrate Mate to find sponsoring employers
Search for Utilization Management Specialist roles with confirmed TN sponsorship using Migrate Mate, which filters positions by visa type so you're not sorting through listings that exclude Canadian and Mexican applicants or require H-1B status only.
Prepare your support letter with specific UM functions
Your employer's TN support letter must describe your duties in clinical review terms, such as applying InterQual or Milliman criteria, coordinating with payers, and managing prior authorization workflows. Generic job descriptions increase the risk of a secondary inspection at the border.
Understand Mexican TN processing before accepting an offer
Mexican citizens cannot use the Canadian port-of-entry shortcut and must attend a U.S. consular appointment. Factor four to eight weeks of consular scheduling into your start-date negotiation so the employer sets a realistic onboarding timeline from day one.
Utilization Management Specialist TN Visa: Frequently Asked Questions
Does a Utilization Management Specialist role qualify for a TN visa?
Yes, if your duties center on clinical review, prior authorization, or health information analysis. USCIS and CBP assess TN eligibility under the Medical/Health Information Specialist category. Your offer letter and employer support documentation must describe your responsibilities in those specific terms, and your degree must correspond to the clinical or health information field rather than a generalist discipline.
How does TN visa sponsorship compare to H-1B for this role?
TN has no annual cap and no lottery, so Canadian professionals can receive approval at a port of entry on the same day they present their documents, while H-1B requires a lottery registration in March and a start date no earlier than October 1. For Utilization Management Specialists with a qualifying degree, TN is almost always faster and more predictable than waiting through the H-1B cycle.
What degree do I need to qualify as a TN Utilization Management Specialist?
A bachelor's degree in nursing, health information management, health sciences, or a closely related clinical field is the standard basis for TN approval in this category. A degree in business or general healthcare administration may be accepted if your transcript and the job description both emphasize clinical or medical information components, but the connection must be explicit and documented.
How do I find Utilization Management Specialist jobs that offer TN visa sponsorship?
Most standard job listings don't specify TN eligibility, which means you can spend hours filtering out roles restricted to U.S. citizens or H-1B holders only. Migrate Mate lets you search specifically for UM Specialist positions with confirmed TN sponsorship, so you're connecting directly with employers who already understand the visa category and are open to Canadian and Mexican applicants.
Can I switch employers while working in the U.S. on a TN visa as a Utilization Management Specialist?
Yes. TN status is employer-specific, so you need a new TN approval before or at the time you start with a new organization. Canadian citizens can obtain the new TN at a port of entry on the day they begin the new role. Mexican citizens must go through consular processing, which requires scheduling time. Your previous employer's TN does not transfer automatically.