Authorization Specialist Jobs in USA with Visa Sponsorship
Authorization Specialists working in compliance, healthcare, and financial services are regularly sponsored for H-1B visa and E-3 visas. Roles typically require a bachelor's degree in a related field, and employers file Labor Condition Applications before petitioning USCIS on your behalf. For detailed occupation requirements, see the O*NET profile.
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The Prior Authorization Nurse, National Medicaid Clinical Operations is responsible for reviewing and evaluating clinical documentation related to prior authorization requests for outpatient services. This role ensures that all requests meet medical necessity criteria and comply with health plan policies and regulatory requirements. The Prior Authorization Review Nurse works closely with healthcare providers, interdisciplinary teams, and nonclinical staff to facilitate timely and appropriate care for members. This role operates autonomously within their scope of practice, making independent clinical decisions.
Key Responsibilities:
Clinical Review:
- Conduct comprehensive clinical reviews of prior authorization requests to determine medical necessity and benefit eligibility
- Apply advanced evidence-based clinical guidelines in review decisions
- Ensure compliance with accreditation, state, and federal regulations
Communication and Coordination:
- Communicate with healthcare providers to obtain necessary clinical information and clarify requests
- Coordinate with medical directors and interdisciplinary teams to support decision-making
- Serve as a liaison between clinicians, internal departments, and members
Documentation and Reporting:
- Document all review findings and decisions in clinical documentation systems
- Ensure timely and accurate documentation of prior authorization determinations
- Support reporting initiatives and provide data for performance improvement projects
Quality Assurance:
- Implement quality assurance measures to ensure accuracy and consistency in prior authorization decisions
- Conduct regular audits and reviews to maintain high standards of service
- Identify process improvement opportunities and contribute to performance improvement projects
Education and Training:
- Educate providers and staff on prior authorization policies, criteria, and review processes
- Provide mentorship and feedback to nonclinical staff and peers to enhance workflow efficiency
- Stay current with clinical best practices and regulatory changes
We are seeking a typical Monday-Friday schedule as well as weekend coverage (i.e. Wed-Sun, Thu-Mon or Fri-Tue type schedule). This will be discussed during interview.
Use your skills to make an impact
Required Qualifications
- Licensed Registered Nurse (RN) in Illinois, with no disciplinary action (or willing to obtain Illinois licensure upon hire)
- 3+ years of clinical nursing experience
- Experience with Medicaid policies and procedures
- Proficiency in healthcare software and electronic medical records (EMR) systems
- Previous experience in utilization management
- Comprehensive knowledge of Microsoft Word, Outlook and Excel
Preferred Qualifications
- Bachelor’s degree
- Certification in Case Management (CCM) or Utilization Review (UR)
- Experience with Medicaid and Medicare policies and procedures
- Knowledge of payer policies, insurance companies and government health programs
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Become a part of our caring community
The Prior Authorization Nurse, National Medicaid Clinical Operations is responsible for reviewing and evaluating clinical documentation related to prior authorization requests for outpatient services. This role ensures that all requests meet medical necessity criteria and comply with health plan policies and regulatory requirements. The Prior Authorization Review Nurse works closely with healthcare providers, interdisciplinary teams, and nonclinical staff to facilitate timely and appropriate care for members. This role operates autonomously within their scope of practice, making independent clinical decisions.
Key Responsibilities:
Clinical Review:
- Conduct comprehensive clinical reviews of prior authorization requests to determine medical necessity and benefit eligibility
- Apply advanced evidence-based clinical guidelines in review decisions
- Ensure compliance with accreditation, state, and federal regulations
Communication and Coordination:
- Communicate with healthcare providers to obtain necessary clinical information and clarify requests
- Coordinate with medical directors and interdisciplinary teams to support decision-making
- Serve as a liaison between clinicians, internal departments, and members
Documentation and Reporting:
- Document all review findings and decisions in clinical documentation systems
- Ensure timely and accurate documentation of prior authorization determinations
- Support reporting initiatives and provide data for performance improvement projects
Quality Assurance:
- Implement quality assurance measures to ensure accuracy and consistency in prior authorization decisions
- Conduct regular audits and reviews to maintain high standards of service
- Identify process improvement opportunities and contribute to performance improvement projects
Education and Training:
- Educate providers and staff on prior authorization policies, criteria, and review processes
- Provide mentorship and feedback to nonclinical staff and peers to enhance workflow efficiency
- Stay current with clinical best practices and regulatory changes
We are seeking a typical Monday-Friday schedule as well as weekend coverage (i.e. Wed-Sun, Thu-Mon or Fri-Tue type schedule). This will be discussed during interview.
Use your skills to make an impact
Required Qualifications
- Licensed Registered Nurse (RN) in Illinois, with no disciplinary action (or willing to obtain Illinois licensure upon hire)
- 3+ years of clinical nursing experience
- Experience with Medicaid policies and procedures
- Proficiency in healthcare software and electronic medical records (EMR) systems
- Previous experience in utilization management
- Comprehensive knowledge of Microsoft Word, Outlook and Excel
Preferred Qualifications
- Bachelor’s degree
- Certification in Case Management (CCM) or Utilization Review (UR)
- Experience with Medicaid and Medicare policies and procedures
- Knowledge of payer policies, insurance companies and government health programs
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$71,100 - $97,800 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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Get Access To All JobsTips for Finding Visa Sponsorship as an Authorization Specialist
Target industries with established sponsorship pipelines
Healthcare systems, insurance companies, and financial institutions sponsor Authorization Specialists regularly. These organizations have legal teams experienced with H-1B and E-3 filings, making the process more predictable than smaller employers doing it for the first time.
Clarify the degree requirement upfront
Authorization Specialist roles qualify as specialty occupations when a specific bachelor's degree is required, not just preferred. Ask hiring managers whether the role requires a degree in a particular field, since that distinction directly affects your visa petition's eligibility.
Understand the LCA before your offer letter arrives
Your employer must file a Labor Condition Application with the Department of Labor before submitting your H-1B or E-3 petition. The LCA certifies your role meets prevailing wage standards. Knowing this step exists helps you set realistic timelines with your employer.
Australian nationals should ask about the E-3 pathway
If you hold Australian citizenship, the E-3 visa is often faster and simpler than H-1B sponsorship. There is no lottery, no annual cap pressure, and approvals are processed at consulates with appointments typically available within a few weeks.
Prepare documentation that ties your degree to the role
USCIS reviews whether your educational background directly supports the Authorization Specialist position. Gather transcripts, credential evaluations for foreign degrees, and any certifications in your field. A clear connection between your degree and job duties strengthens the petition significantly.
Start the sponsorship conversation before accepting an offer
Confirm your prospective employer has sponsored visa holders previously and knows the H-1B or E-3 process. Employers unfamiliar with immigration filings introduce delays and risk. Raising this early avoids surprises after you have already accepted the role.
Frequently Asked Questions
Does an Authorization Specialist role qualify for H-1B sponsorship?
It can qualify, but it depends on how the employer defines the position. For H-1B visa eligibility, the role must meet the specialty occupation standard, meaning a bachelor's degree in a specific field is normally required for the position, not merely preferred. Authorization roles in healthcare, insurance, and financial services are more likely to meet this threshold when they require a degree in health information management, business, or a related discipline.
What degree do I need for an Authorization Specialist visa petition?
Most successful H-1B and E-3 petitions for Authorization Specialist roles cite degrees in health information management, business administration, healthcare administration, or a related field. The key is that the degree must logically connect to the specific duties of the role. If your degree is in an unrelated area, relevant certifications and work experience can supplement the case, though a directly related degree is the strongest foundation.
How do I find Authorization Specialist jobs that offer visa sponsorship?
Browse Migrate Mate to find Authorization Specialist roles from employers who have demonstrated a willingness to sponsor work visas. Migrate Mate filters for sponsorship-ready positions, which saves time compared to applying broadly and discovering late in the process that an employer won't file. Larger healthcare networks and insurers tend to have the most active sponsorship pipelines for this role.
What is the typical H-1B approval timeline for this type of role?
Standard H-1B processing for an Authorization Specialist petition takes four to six months after filing. Premium processing, which USCIS adjudicates within 15 business days, is available for an additional fee your employer can elect to pay. Factor in the LCA certification period, which adds two to three weeks before the H-1B petition can even be submitted, so the full timeline from offer to work authorization is closer to five to seven months without premium processing.
Can an Authorization Specialist on OPT transition to H-1B sponsorship?
Yes. If you are currently working as an Authorization Specialist on OPT, your employer can file an H-1B petition during the annual cap registration window, which typically opens in March. If selected in the lottery, your H-1B status begins October 1. STEM OPT extensions can bridge the gap if your degree qualifies, giving you up to 36 months of total OPT work authorization while you pursue H-1B sponsorship.
What is the prevailing wage requirement for sponsored Authorization Specialist jobs?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.