Clinical Case Review Jobs in USA with Visa Sponsorship
Clinical Case Review roles qualify for H-1B visa, O-1 visa, and EB-2 NIW sponsorship when the position requires a clinical degree and involves complex medical judgment. Employers in hospital systems, managed care organizations, and insurance companies regularly sponsor qualified candidates for these positions. For detailed occupation requirements, see the O*NET profile.
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Get Access To All JobsINTRODUCTION
The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
- Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
- Collects data and analyzes information to make decisions regarding certification or denial of treatment
- Documents all work in the appropriate manner
- Promotes utilization review services with stakeholders
- Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
- Additional duties as assigned
KNOWLEDGE & SKILLS:
- Must have thorough knowledge of both CPT and ICD coding
- Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers
- Effective organization skills in a high-volume, fast-paced environment
- Strong time management skills with the ability to meet designated deadlines
- Excellent written and verbal communication skills
- Ability to work both independently and within a team environment
- Strong interpersonal skills
- Ability to utilize Microsoft Office including Excel spreadsheets
- Knowledge of the workers’ compensation claims process preferred
- Knowledge of outpatient utilization review preferred
EDUCATION & EXPERIENCE:
- Graduate of accredited school of nursing with an associate’s degree, Bachelor of Science degree or Bachelor of Science in Nursing
- Current Nursing licensure in the state of operation required; RN is required unless local state regulations permit LVN/LPN
- 4 or more years of recent clinical experience
- Prospective, concurrent, and retrospective utilization review experience preferred
- Experience in the clinical areas of OR, ICU, CCU, ER and/or orthopedics preferred
PAY RANGE
CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $30.64 - $45.80 per hour
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL:
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
INTRODUCTION
The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the goals of the Case Management department and of CorVel.
This is a remote position.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
- Identifies the necessity of the review process and communicates issues of concern to the appropriate claims staff/customer
- Collects data and analyzes information to make decisions regarding certification or denial of treatment
- Documents all work in the appropriate manner
- Promotes utilization review services with stakeholders
- Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)
- Additional duties as assigned
KNOWLEDGE & SKILLS:
- Must have thorough knowledge of both CPT and ICD coding
- Ability to interface with claims staff, attorneys, physicians and their representatives, as well as advisors/clients and coworkers
- Effective organization skills in a high-volume, fast-paced environment
- Strong time management skills with the ability to meet designated deadlines
- Excellent written and verbal communication skills
- Ability to work both independently and within a team environment
- Strong interpersonal skills
- Ability to utilize Microsoft Office including Excel spreadsheets
- Knowledge of the workers’ compensation claims process preferred
- Knowledge of outpatient utilization review preferred
EDUCATION & EXPERIENCE:
- Graduate of accredited school of nursing with an associate’s degree, Bachelor of Science degree or Bachelor of Science in Nursing
- Current Nursing licensure in the state of operation required; RN is required unless local state regulations permit LVN/LPN
- 4 or more years of recent clinical experience
- Prospective, concurrent, and retrospective utilization review experience preferred
- Experience in the clinical areas of OR, ICU, CCU, ER and/or orthopedics preferred
PAY RANGE
CorVel uses a market-based approach to pay and our salary ranges may vary depending on your location. Pay rates are established taking into account the following factors: federal, state, and local minimum wage requirements, the geographic location differential, job-related skills, experience, qualifications, internal employee equity, and market conditions. Our ranges may be modified at any time.
For leveled roles (I, II, III, Senior, Lead, etc.) new hires may be slotted into a different level, either up or down, based on assessment during interview process taking into consideration experience, qualifications, and overall fit for the role. The level may impact the salary range and these adjustments would be clarified during the offer process.
Pay Range: $30.64 - $45.80 per hour
A list of our benefit offerings can be found on our CorVel website: CorVel Careers | Opportunities in Risk Management
In general, our opportunities will be posted for up to 1 year from date of posting, or until we have selected candidate(s) to fulfill the opening, whichever comes first.
ABOUT CORVEL:
CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).
A comprehensive benefits package is available for full-time regular employees and includes Medical (HDHP) w/Pharmacy, Dental, Vision, Long Term Disability, Health Savings Account, Flexible Spending Account Options, Life Insurance, Accident Insurance, Critical Illness Insurance, Pre-paid Legal Insurance, Parking and Transit FSA accounts, 401K, ROTH 401K, and paid time off.
CorVel is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
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Get Access To All JobsTips for Finding Clinical Case Review Jobs
Clarify the degree requirement upfront
Clinical Case Review roles that require an RN, MD, or clinical master's degree qualify as specialty occupations under H-1B standards. Confirm the job posting specifies a required degree in a clinical field before applying, not just a preferred one.
Target managed care and insurance employers
Hospital systems, managed care organizations, and large health insurers have established H-1B sponsorship infrastructure. These employers file LCAs and I-129 petitions regularly, making them far more likely to sponsor than smaller clinical practices or outpatient clinics.
Understand how your clinical credential maps to visa eligibility
An RN license alone may not satisfy specialty occupation requirements for every Case Review role. Roles requiring a BSN or higher, combined with clinical review protocols, strengthen your H-1B petition and reduce the risk of a Request for Evidence.
Highlight independent clinical judgment in your resume
USCIS evaluates whether the role requires theoretical and practical application of specialized knowledge. Frame your experience around complex case analysis, utilization review decisions, and clinical criteria application rather than administrative coordination tasks.
Ask about cap-exempt sponsorship if you qualify
If you currently work or have worked at a nonprofit hospital, university health system, or government research institution, you may qualify for cap-exempt H-1B filing, bypassing the lottery and allowing year-round petition submission with faster processing.
Consider the EB-2 NIW pathway if you have advanced credentials
Clinical Case Reviewers with an MD, PhD, or clinical master's and a track record of improving population health outcomes may qualify for the EB-2 National Interest Waiver, which eliminates the PERM labor certification requirement and allows self-petition without employer involvement.
Frequently Asked Questions
Does Clinical Case Review qualify as a specialty occupation for H-1B purposes?
Yes, when the role requires a bachelor's degree or higher in a specific clinical field such as nursing, social work, or medicine. Positions requiring a BSN, MSW, or MD to perform utilization review and clinical criteria evaluation consistently meet USCIS specialty occupation standards. Roles where any general degree satisfies the requirement are harder to sponsor under H-1B visa.
Which visa categories are most common for Clinical Case Review sponsorship?
H-1B is the most common pathway, particularly for RNs and clinicians with a bachelor's degree or higher in a specific field. O-1A is an option for reviewers with published research or national recognition in clinical quality. EB-2 NIW suits candidates with advanced degrees who can demonstrate their work benefits U.S. healthcare at a national level. Browse open Clinical Case Review roles on Migrate Mate to see which employers are actively sponsoring.
Do employers typically sponsor Clinical Case Review roles, or is it uncommon?
Sponsorship is moderately common in this field, but concentrated among large employers. National health insurers, Blue Cross Blue Shield affiliates, large hospital networks, and managed care organizations have the legal infrastructure and volume to justify sponsorship costs. Smaller regional plans and outpatient practices rarely sponsor. Filtering by employer type before applying saves time.
Can an RN license substitute for a bachelor's degree in an H-1B petition for this role?
Not on its own. USCIS requires a U.S. bachelor's degree or its equivalent in a specific specialty, not just a professional license. However, an RN license combined with a BSN satisfies the degree requirement. If you hold a foreign nursing diploma without a bachelor's degree equivalent, a credential evaluation may help establish equivalency through a combination of education and experience under the three-for-one rule.
What approval rates look like for Clinical Case Review H-1B petitions?
Healthcare specialty occupations, including clinical review roles, have historically faced higher RFE rates than IT or engineering fields because USCIS scrutinizes whether the position genuinely requires a degree in a specific specialty. Employers with strong legal representation and detailed job descriptions linking the role to specialized clinical knowledge see better outcomes. Petitions that clearly distinguish the role from general medical administration or nursing coordinator positions perform better.
What is the prevailing wage requirement for sponsored Clinical Case Review 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.