Utilization Review Nurse Jobs in USA with Visa Sponsorship
Utilization review nurses are in consistent demand across U.S. health systems, and many employers sponsor H-1B visa or TN visas for qualified candidates. You'll need an active RN license, a nursing degree, and typically two or more years of clinical experience to qualify. For detailed occupation requirements, see the O*NET profile.
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Get Access To All JobsINTRODUCTION
Hi, we're Oscar. We're hiring a Utilization Review Nurse, BPO Supervisor to join our team.
Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
ABOUT THE ROLE
You will provide daily oversight and management of the team. You will own the daily Nurse off-shore team operations, including queue and volume throughput and staffing, and also serves as the primary escalation point for their teams. You will support strategic and clinical initiatives.
You will report into the Manager, Utilization Review.
WORK LOCATION: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote
PAY TRANSPARENCY: The base pay for this role is: $91,980 - $120,629 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.
Responsibilities:
- Own daily workforce management, including staffing and queue assignments, PTO/leave, and payroll/compensation.
- Manage queue on a daily basis, ensuring compliance with regulatory timelines, staff coverage, and coordination with internal teams for forecasting and timely handling of ad hoc escalations.
- Ensure on-shore team adheres to department policies and workflows and serve as continual champion of the Oscar mission.
- Drive and own the success of clinical auditing and performance through ongoing evaluations; effectively use Oscar tools to monitor and trend nurse productivity and auditing data for assessment and reporting.
- Support the onboarding and training of newly-hired clinicians and partner with the Clinical Quality & Training team on the development and maintenance of clinical training and resource material.
- Partner with the Talent Acquisition team on clinical hiring initiatives.
- Complete medical necessity and level of care reviews using clinical judgment and the Plan's designated clinical guidelines, if applicable.
- Comply with department performance and quality metrics, and adhere to training and remediation requirements.
- Compliance with all applicable laws and regulations.
- Other duties as assigned.
REQUIREMENTS
- 3+ years of utilization review experience at a managed care plan or provider organization.
- Active, unrestricted Registered Nurse (RN) licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC).
- 2+ years of off-shore managing vendor experience.
- 2+ years of leadership experience.
- Associate Degree and/or Bachelors of Nursing from an accredited school of nursing.
- 5+ years healthcare experience (including at least 2 years clinical practice in an acute care setting).
- Milliman (MCG) experience.
BONUS POINTS:
- Bachelors of Nursing (BSN) degree.
- Masters of Science in Nursing (MSN) degree, or MBA/Healthcare administration degree.
- Project management certification (e.g. Six Sigma, SCRUM, Agile).
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
PAY TRANSPARENCY: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
REASONABLE ACCOMMODATION: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
CALIFORNIA RESIDENTS: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.
INTRODUCTION
Hi, we're Oscar. We're hiring a Utilization Review Nurse, BPO Supervisor to join our team.
Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family.
ABOUT THE ROLE
You will provide daily oversight and management of the team. You will own the daily Nurse off-shore team operations, including queue and volume throughput and staffing, and also serves as the primary escalation point for their teams. You will support strategic and clinical initiatives.
You will report into the Manager, Utilization Review.
WORK LOCATION: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote
PAY TRANSPARENCY: The base pay for this role is: $91,980 - $120,629 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses.
Responsibilities:
- Own daily workforce management, including staffing and queue assignments, PTO/leave, and payroll/compensation.
- Manage queue on a daily basis, ensuring compliance with regulatory timelines, staff coverage, and coordination with internal teams for forecasting and timely handling of ad hoc escalations.
- Ensure on-shore team adheres to department policies and workflows and serve as continual champion of the Oscar mission.
- Drive and own the success of clinical auditing and performance through ongoing evaluations; effectively use Oscar tools to monitor and trend nurse productivity and auditing data for assessment and reporting.
- Support the onboarding and training of newly-hired clinicians and partner with the Clinical Quality & Training team on the development and maintenance of clinical training and resource material.
- Partner with the Talent Acquisition team on clinical hiring initiatives.
- Complete medical necessity and level of care reviews using clinical judgment and the Plan's designated clinical guidelines, if applicable.
- Comply with department performance and quality metrics, and adhere to training and remediation requirements.
- Compliance with all applicable laws and regulations.
- Other duties as assigned.
REQUIREMENTS
- 3+ years of utilization review experience at a managed care plan or provider organization.
- Active, unrestricted Registered Nurse (RN) licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC).
- 2+ years of off-shore managing vendor experience.
- 2+ years of leadership experience.
- Associate Degree and/or Bachelors of Nursing from an accredited school of nursing.
- 5+ years healthcare experience (including at least 2 years clinical practice in an acute care setting).
- Milliman (MCG) experience.
BONUS POINTS:
- Bachelors of Nursing (BSN) degree.
- Masters of Science in Nursing (MSN) degree, or MBA/Healthcare administration degree.
- Project management certification (e.g. Six Sigma, SCRUM, Agile).
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
PAY TRANSPARENCY: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
REASONABLE ACCOMMODATION: Oscar applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
CALIFORNIA RESIDENTS: For information about our collection, use, and disclosure of applicants’ personal information as well as applicants’ rights over their personal information, please see our Privacy Policy.
See all 33+ Utilization Review Nurse Jobs
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Get Access To All JobsTips for Finding Visa Sponsorship as an Utilization Review Nurse
Verify your RN license transfers
U.S. employers require an active state RN license before sponsorship can begin. Start the NCLEX-RN and Nursys endorsement process early, licensing delays are the most common reason sponsorship timelines slip for internationally trained nurses.
Target large health systems and insurers
Large hospital networks, managed care organizations, and national insurers sponsor utilization review nurses far more consistently than smaller practices. These employers have established immigration processes and dedicated HR teams familiar with H-1B and TN petitions.
Australian and Canadian nurses have a faster path
Australian RNs can pursue the E-3 visa, which has no lottery and is available year-round. Canadian nurses often qualify under TN status with a job offer and nursing degree documentation, bypassing the H-1B cap entirely.
Highlight clinical depth in your application
Utilization review requires documented clinical judgment, not just bedside experience. Emphasize case management, prior authorization decisions, or InterQual and Milliman criteria knowledge, these signal the specialty occupation depth H-1B petitions require.
Expect a degree equivalency evaluation if trained abroad
USCIS requires credential evaluations for internationally trained nurses. Organizations like CGFNS or NACES-approved evaluators can certify that your nursing degree meets U.S. bachelor's degree equivalency, which is essential for specialty occupation classification.
Get your offer letter before the employer files
Sponsorship cannot begin without a formal written job offer. Secure the offer, confirm the employer will petition on your behalf, and clarify whether they cover filing fees before accepting, some employers deduct legal costs from compensation.
Frequently Asked Questions
Does utilization review nursing qualify as a specialty occupation for H-1B purposes?
Yes, in most cases. USCIS has approved utilization review nurses under the H-1B visa when the role requires applying clinical criteria, interpreting medical necessity guidelines, and making coverage determinations that necessitate an RN license and a bachelor's degree in nursing. Roles framed around administrative tasks rather than clinical judgment face higher denial risk, so the job description language in the petition matters significantly.
Can I work as a utilization review nurse on a TN visa?
Canadian and Mexican nurses qualify for TN status, and utilization review is generally accepted because it falls under the nurse category in the USMCA profession list. You'll need your nursing degree, a valid RN license, and a job offer letter specifying the role. TN status is granted at the border or port of entry for Canadians and through consular processing for Mexican nationals, with no cap or lottery involved.
How do I find utilization review nursing jobs that offer visa sponsorship?
Most general job boards don't filter specifically for visa sponsorship, which wastes significant time. Migrate Mate is built specifically for internationally trained professionals and lists utilization review nursing roles from employers willing to sponsor. Filtering by sponsorship type upfront means you're only seeing roles where the employer has already committed to supporting foreign workers, which dramatically improves your odds of a successful application.
Do I need a bachelor's degree in nursing, or will an associate degree qualify?
For H-1B classification, USCIS expects at minimum a bachelor's degree in a directly related field. An Associate Degree in Nursing (ADN) alone generally won't satisfy specialty occupation requirements unless combined with significant additional education or a credential evaluation showing equivalency to a U.S. bachelor's degree. A BSN is the safest path. For TN and E-3 visas, the requirements follow the profession definition rather than specialty occupation standards, so an ADN combined with licensure may suffice depending on how the offer is structured.
What's the H-1B approval rate for utilization review nurses, and is denial common?
USCIS doesn't publish approval rates broken down by job title, but nursing-related H-1B petitions have historically faced more scrutiny than other healthcare roles because officers sometimes question whether nursing meets specialty occupation criteria. Strong petitions document the analytical and clinical judgment demands of utilization review specifically, reference InterQual or Milliman criteria use, and include a detailed position description from the employer. Working with an immigration attorney experienced in healthcare H-1B petitions substantially reduces denial risk.
What is the prevailing wage requirement for sponsored Utilization Review Nurse 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.