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 JobsAs a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.
Job Location (Full Address):
601 Elmwood Ave, Rochester, New York, United States of America, 14642
Opening:
Worker Subtype: Regular
Time Type: Full time
Scheduled Weekly Hours: 40
Department: 500009 Utilization Management
Work Shift: UR - Day (United States of America)
Range: UR URCD 215
Compensation Range: $81,307.00 - $109,761.00
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
Responsibilities:
Works collaboratively with various departments across the entire health care system to review clinical documentation, utilizing evidence based criteria to support medical necessity and appropriate level of patient care for services provided. Reports outcome trends and patterns to UM leadership to help identify educational opportunities and performance improvement initiatives across the health care continuum. Adapts to process changes and assists with education efforts that support ongoing improvement.
ESSENTIAL FUNCTIONS
- Determines level of care per regulatory requirements. Provides level of care notifications to patients and families as needed.
- Works collaboratively with payers to ensure authorization for dates of service. Collaborates with HIM, providers, Financial Counseling and Patient Financial Services. Monitors all UM hold bills and unplanned readmission reports.
- Conducts initial and concurrent reviews, utilizing evidence based criteria through Interqual. Supports discharge appeal process. Responsible for departmental denials and appeal activity.
- Documents according to regulatory guidelines and UM RN workflow protocols. Conducts clinical documentation improvement efforts through query process.
- Meets productivity expectations established by UM department.
- Provides and supports ongoing educational needs for all UM customers.
- Other duties as assigned.
MINIMUM EDUCATION & EXPERIENCE
- Associate's degree in Nursing and 3 years of acute hospital experience required
- Bachelor's degree in Nursing (BSN) preferred
- Or equivalent combination of education and experience
- Utilization Management experience preferred
KNOWLEDGE, SKILLS AND ABILITIES
Database experience including: Interqual, Sharepoint, eRecord, ePARC, Cobius preferred
LICENSES AND CERTIFICATIONS
- RN - Registered Nurse - State Licensure and/or Compact State Licensure NYS Registered Nurse license upon hire required
The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.
As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.
Job Location (Full Address):
601 Elmwood Ave, Rochester, New York, United States of America, 14642
Opening:
Worker Subtype: Regular
Time Type: Full time
Scheduled Weekly Hours: 40
Department: 500009 Utilization Management
Work Shift: UR - Day (United States of America)
Range: UR URCD 215
Compensation Range: $81,307.00 - $109,761.00
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
Responsibilities:
Works collaboratively with various departments across the entire health care system to review clinical documentation, utilizing evidence based criteria to support medical necessity and appropriate level of patient care for services provided. Reports outcome trends and patterns to UM leadership to help identify educational opportunities and performance improvement initiatives across the health care continuum. Adapts to process changes and assists with education efforts that support ongoing improvement.
ESSENTIAL FUNCTIONS
- Determines level of care per regulatory requirements. Provides level of care notifications to patients and families as needed.
- Works collaboratively with payers to ensure authorization for dates of service. Collaborates with HIM, providers, Financial Counseling and Patient Financial Services. Monitors all UM hold bills and unplanned readmission reports.
- Conducts initial and concurrent reviews, utilizing evidence based criteria through Interqual. Supports discharge appeal process. Responsible for departmental denials and appeal activity.
- Documents according to regulatory guidelines and UM RN workflow protocols. Conducts clinical documentation improvement efforts through query process.
- Meets productivity expectations established by UM department.
- Provides and supports ongoing educational needs for all UM customers.
- Other duties as assigned.
MINIMUM EDUCATION & EXPERIENCE
- Associate's degree in Nursing and 3 years of acute hospital experience required
- Bachelor's degree in Nursing (BSN) preferred
- Or equivalent combination of education and experience
- Utilization Management experience preferred
KNOWLEDGE, SKILLS AND ABILITIES
Database experience including: Interqual, Sharepoint, eRecord, ePARC, Cobius preferred
LICENSES AND CERTIFICATIONS
- RN - Registered Nurse - State Licensure and/or Compact State Licensure NYS Registered Nurse license upon hire required
The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.
See all 40+ TN Visa Utilization Management Specialist Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new TN Visa Utilization Management Specialist Jobs.
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.