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 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.
See All Utilization Review Nurse JobsOverview
Showing 5 of 91+ Utilization Review Nurse jobs
Have you applied for this role?
Have you applied for this role?
Have you applied for this role?
Have you applied for this role?
Have you applied for this role?
See all 91+ Utilization Review Nurse jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Utilization Review Nurse roles.
Get Access To All JobsOverview:
Department: Psych Acute Adult
Schedule: Full-Time, Days, 8am-4:30pm
Facility: Prime Healthcare Mercy Medical
Location: Aurora, IL 60506
Responsibilities:
- Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.
- Conducts medical necessity review of all admissions.
- Utilizes approved clinical review criteria to determine medical necessity for admission including appropriate patient status and continued stay reviews.
- Communicates all medical necessity review outcomes and denials to case management staff and providers.
- Engage in denial management protocols including Peer to Peer with Physicians and Reconsideration reviews.
- Accurate and timely recording of data in the Authorization tool.
- Prioritizes patient reviews based on situational analysis.
- Directs physician and patient communication regarding non-coverage of benefits and continued stay denials.
QUALIFICATIONS
- Two (2) years clinical experience as a Case Manager in an acute care, post-acute, or payer setting within the last 5 years.
- Utilization review and denial management experience required.
- Current state RN licensure required.
- Must be able to communicate in English (Speak, Write).
- Demonstrates:
- excellent communication skills both verbal and written
- ability to facilitate and collaborate with an interdisciplinary team
- flexibility to manage multiple complex cases simultaneously
- attention to detail and follow-up
- critical thinking and problem-solving skills.
- Current BLS certificate.
- Case Management Certification (CCM) preferred.
- Current knowledge Clinical Criteria including Milliman are Guidelines and InterQual Guidelines for severity of illness if service.
- Current knowledge of CMS guidelines for clinical review and conditions of Participation.
PAY TRANSPARENCY:
Mercy Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $35.35 to $53.58 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being.
EMPLOYMENT STATUS: Full Time
SHIFT: Days
EQUAL EMPLOYMENT OPPORTUNITY:
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories.
Overview:
Department: Psych Acute Adult
Schedule: Full-Time, Days, 8am-4:30pm
Facility: Prime Healthcare Mercy Medical
Location: Aurora, IL 60506
Responsibilities:
- Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management.
- Conducts medical necessity review of all admissions.
- Utilizes approved clinical review criteria to determine medical necessity for admission including appropriate patient status and continued stay reviews.
- Communicates all medical necessity review outcomes and denials to case management staff and providers.
- Engage in denial management protocols including Peer to Peer with Physicians and Reconsideration reviews.
- Accurate and timely recording of data in the Authorization tool.
- Prioritizes patient reviews based on situational analysis.
- Directs physician and patient communication regarding non-coverage of benefits and continued stay denials.
QUALIFICATIONS
- Two (2) years clinical experience as a Case Manager in an acute care, post-acute, or payer setting within the last 5 years.
- Utilization review and denial management experience required.
- Current state RN licensure required.
- Must be able to communicate in English (Speak, Write).
- Demonstrates:
- excellent communication skills both verbal and written
- ability to facilitate and collaborate with an interdisciplinary team
- flexibility to manage multiple complex cases simultaneously
- attention to detail and follow-up
- critical thinking and problem-solving skills.
- Current BLS certificate.
- Case Management Certification (CCM) preferred.
- Current knowledge Clinical Criteria including Milliman are Guidelines and InterQual Guidelines for severity of illness if service.
- Current knowledge of CMS guidelines for clinical review and conditions of Participation.
PAY TRANSPARENCY:
Mercy Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $35.35 to $53.58 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being.
EMPLOYMENT STATUS: Full Time
SHIFT: Days
EQUAL EMPLOYMENT OPPORTUNITY:
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories.
How to Get 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.
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.
Utilization Review Nurse jobs are hiring across the US. Find yours.
Find Utilization Review Nurse JobsSee all 91+ Utilization Review Nurse jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new Utilization Review Nurse roles.
Get Access To All JobsFrequently 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 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.
See which Utilization Review Nurse employers are hiring and sponsoring visas right now.
Search Utilization Review Nurse Jobs