dismissed H-1B Case: Healthcare Administration

U.S. Citizenship 
and Immigration 
Services 
MATTER OF C-S-1-, LLC 
APPEAL OF VERMONT SERVICE CENTER DECISION 
Non-Precedent Decision of the 
Administrative Appeals Office 
DATE: NOV. 29,2016 
PETITION: FORM 1-129, PETITION FOR A NONIMMIGRANT WORKER 
The Petitioner, an 11-employee medical office providing general and specialized cardiovascular 
services and diagnostics, seeks to temporarily employ the Beneficiary as a "health operations manager" 
under the H-1 B nonimmigrant classification for specialty occupations. See Immigration and Nationality 
Act (the Act) section 101(a)(15)(H)(i)(b), 8 U.S.C. § 1101(a)(15)(H)(i)(b). The H-lB program allows 
a U.S. employer to temporarily employ a qualified foreign worker in a position that requires both (a) 
the theoretical and practical application of a body of highly ,specialized knowledge and (b) the 
attainment of a bachelor's or higher degree in the specific specialty (or its equivalent) as a minimum 
prerequisite for entry into the position. 
The Director, Vermont Service Center, denied the petition. The Director concluded that the 
proffered position is not a specialty occupation. 
The matter is now before us on appeal. On appeal, the Petitioner asserts that the Director erred in 
denying the petition. 
Upon de novo review, we will dismiss the appeal. 
I 
I. LEGAL FRAMEWORK 
Section 214(i)(l) of the Act, 8 U.S.C. § 1184(i)(l), defines the term "specialty occupation" as an 
occupation thatrequires: 
(A) theoretical and practical application of a body of highly specialized 
knowledge, and 
(B) attainment of a bachelor's or higher degree in the specific specialty (or its 
equivalent) as a minimum for entry into the occupation in the United States. 
The regulation at 8 C.F.R. § 214.2(h)(4)(ii) largely restates this statutory definition, but adds a non­
exhaustive list of fields of endeavor. In addition, the regulations provide that the proffered position 
must meet one of the following criteria to qualify as a specialty occupation: 
Matter ofC-S-1-, LLC 
(1) A baccalaureate or higher degree or its equivalent is normally the minimum 
requirement for entry into the particular position; 
(2) The degree requirement is common t9 the industry in parallel positions among 
similar organizations or, in the alternative, an employer may show that its 
particular position is so complex or unique that it can be performed only by an 
individual with a degree; 
(3) The employer normally requires a degree or its equivalent for the position; or 
( 4) The nature of the specific duties [is] so specialized and complex that 
knowledge required to perform the duties is usually associated with the 
attainment of a baccalaureate or higher degree. 
8 C.F.R. § 214.2(h)(4)(iii)(A). U.S. Citizenship and Immigration Services (USCIS) has consistently 
interpreted the term "degree" in the criteria at 8 C.F.R. § 214.2(h)(4)(iii)(A) to mean not just any 
baccalaureate or higher degree, but one in a specific specialty that is directly related to the proposed 
position. See Royal Siam Corp. v. Cherto_ff, 484 F.3d 139, 147 (1st Cir. 2007) (describing "a degree 
requirement in a specific specialty" as "one that relates directly to the duties and responsibilities of a 
particular position"); Defensor v. Meissner, 201 F.3d 384, 387 (5th Cir. 2000). 
II. PROFFERED POSITION 
In the H -1 B petition, the Petitioner stated that the Beneficiary will serve as a "health operations 
manager." In response to the Director's request for evidence (RFE), the Petitioner provided the 
following job duties for the position: ' 
As a Healthcare Operations Manager, [the Beneficiary] will be responsible for the 
following in our very busy medical practice. 
• Implementing systems to control office management and overseeing of business 
affairs - 15% 
• Our medical practice is expanding and we recently purchased additional space. 
This will require planning, organizing, forecasting, leading and managing the 
expansion project of our medical practice- 10% 
• Developing, planning, directing and coordinating of the daily operations, which 
include, billing, budgeting and planning, and patient flow in the facility utilizing 
Eclinical Works - 5% 
• Preparing financial reports and analysis to optimize the efficiency of healthcare 
provided - 5% 
• Performing public relations functions - 5% 
• Maintaining documentation ahd reports of audit activity and auditing medical 
records as needed to ensure Corporate Compliance - 5% 
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Matter ofC-S-1-, LLC 
• Performing and overseeing the functions of coding, DRG assignment, collection 
of predefined indicators, and abstracting medical records- 5% 
• Providing timely and accurate ICD-9-CM and CPT codes for reimbursement 
and specific information for statistical purposes - 5% 
• Assembling patient charts and analyzing medical records utilizing JACHO 
standards, Medicare and Medical Staff regulations - 5% 
• Analyzing, testing and implementing clinical applications and Information 
Technology in support of core business functions and processes - 5% 
• Running financial and management reports on client accounts using Electronic 
Medical Records systems- 5% 
• Coordinating the accurate collection of data associated with the registration of 
patients- 5% 
• Providing a wide variety of services (record assembly, retrieval, filing) for the 
Medical Records Department, physicians, patients and insurance companies -
5% 
• Overseeing insurance account receivable reports and contacting carriers 
regarding outstanding claims, denials or discrepancies- 5% 
• Assisting physicians in determining the appropriate use of codes in order to 
maximize reimbursement of physicians' services - 5% 
• The position will involve the supervision of administrative staff and physicians 
assistants as well as coordination of physicians schedules - 1 0% 
The Petitioner states that the minimum entry requirement for the proffered position is a bachelor's 
degree in business administration, finance, health sciences, or a related field. 
III. ANALYSIS 
Upon review of the record in its totality and for the reasons set out below, we determine that the 
Petitioner has not demonstrated that the proffered position qualifies as a specialty occupation. 1 
Specifically, the record does not establish that the job duties require an educational background, or 
its equivalent, commensurate with a specialty occupation.
2 
As a preliminary matter, we observe that the Petitioner has never effectively claimed that the 
proffered position requires a minimum of a bachelor's degree in a specific specialty or its equivalent. 
To the contrary, the Petitioner stated that it would find acceptable a degree in business 
administration, finance, any of the health sciences, or a related field. 
1 Although some aspects of the regulatory criteria may overlap, we will address each of the criteria individually. 
2 The Petitioner submitted documentation to support the H-1 B petition, including evidence regarding the proffered 
position and its business operations. While we may not discuss every document submitted, we have reviewed and 
considered each one. 
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Matter of C-S-1-, LLC 
First, we note that a petitioner must demonstrate that the proffered position requires a precise and 
specific course of study that relates directly and closely to the position in question. Since there must 
be a close correlation between the required specialized studies and the position, the requirement of a 
degree with a generalized title, such as business administration, without further specification, does 
not establish the position as a specialty occupation. C.f Matter of Michael Hertz Assocs., 19 I&N 
Dec. 558, 560 (Comm'r 1988). To prove that a job requires the theoretical and practical application 
of a body of highly specialized knowledge as required by section 214(i)(l) of the Act, a petitioner 
must establish that the position requires the attainment of a bachelor's or higher degree in a 
specialized field of study or its equivalent. 
USCIS interprets the degree requirement at 8 C.F.R. § 214.2(h)(4)(iii)(A) to require a degree in a 
specific specialty that is directly related to the proposed position. Although a general-purpose 
bachelor's degree, such as a degree in business administration, may be a legitimate prerequisite for a 
particular position, requiring such a degree, without more, will not justify a finding that a particular 
position qualifies for classification as a specialty occupation. Royal Siam, 484 F.3d at 147.3 The 
Petitioner in this matter claims that the duties of the proffered position can be performed by an 
individual with only a general-purpose bachelor's degree, i.e., a bachelor's degree in business 
administration. Without more, this assertion alone indicates that the proffered position is not in fact 
a specialty occupation. 
Second, while we do not claim to provide an exhaustive list of all of the health sciences, we note that 
the list would include, for instance, the diverse fields of anesthesiology, audiology, dentistry, genetic 
counseling, medical physics, medical technology, midwifery, nursing, dietetics, occupational 
therapy, optometry, pharmacology, physical therapy, psychiatry, and speech-language pathology. In 
general, provided the specialties are closely related, e.g., chemistry and biochemistry, a minimum of 
a bachelor's or higher degree in more than one specialty is recognized as satisfying the "degree in 
the specific specialty (or its equivalent)" requirement of section 214(i)(l )(B) of the Act. In such a 
case, the required '-'body of highly specialized knowledge" would essentially be the same. Since 
there must be a close correlation between the required "body of highly specialized knowledge" and 
the position, however, a minimum entry requirement of a degree in two disparate fields, such as 
philosophy and engipeering, would not meet the statutory requirement that the degree be "in the 
specific specialty (or its equivalent)," unless the Petitioner establishes how each field is directly 
3 Specifically, the judge explained in Royal Siam, 484 F.3d at 147, that: 
The courts and the agency consistently have stated that, although a general-purpose bachelor's degree, 
such as a business administration degree, may be a legitimate prerequisite for a particular position, 
requiring such a degree, without more, will not justify the granting of a petition for an H-1 8 specialty 
occupation visa. See, e.g., Tapis lnt 'I v. INS, 94 F.Supp.2d 172, 175-76 (D. Mass. 2000); Shanti, 36 F. 
Supp. 2d at 1164-66; cf Matter of Michael Hertz Assocs., 191 & &N Dec. 558,560 ([Comm'r] 1988) 
(providing frequently cited analysis in connection with a conceptually similar provision). This is as it 
should be: elsewise, an employer could ensure the granting of a specialty occupation visa petition by 
the simple expedient of creating a generic (and essentially artificial) degree requirement. 
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Matter ofC-S-1-, LLC 
related to the duties and responsibilities of the particular position such that the required "body of 
highly specialized knowledge" is essentially an amalgamation of these differ~nt- specialties. Section 
214(i)(l)(B) ofthe Act (emphasis added). 
In other words, while the statutory "the" and the regulatory "a" both denote a singular "specialty," 
we do not so narrowly interpret these provisions to exclude positions from qualifying as specialty 
occupations if they permit, as a minimum entry requirement, degrees in more than one closely 
related specialty. See section 214(i)(l)(B) of the Act; 8 C.P.R. § 214.2(h)(4)(ii). This also includes 
even seemingly disparate specialties providing, again, the evidence of record establishes how each 
acceptable, specific field of study is directly related to the duties and responsibilities of the particular 
position. 
Again, the Petitioner claims that the duties of the proffered positiOn can be performed by an 
individual with a bachelor's degree in, among other subjects, any health science, a general category 
which would include, for example, dentistry, genetic counseling, midwifery, and speech-language 
pathology. Those subjects do not delineate a single specific specialty. The educational requirement 
placed on the proffered position by the Petitioner demonstrates that the proffered position in the 
instant case is not a specialty occupation position. The Director's decision must therefore be 
affirmed and the appeal dismissed on this basis alone. 
Nevertheless, we will continue our analysis of whether the proffered position qualifies as a specialty 
occupation for the purpose of performing a comprehensive analysis. We will next discuss the record 
of proceedings in relation to the four criteria at 8 C.P.R. § 214.2(h)(4)(iii)(A). We will conduct this 
analysis pursuant to the assumption, made arguendo, that the wide variety of degrees the Petitioner 
indicates would be a sufficient educational qualification for the proffered position does not 
disqualify it from being found to be a specialty occupation position. 
A. First Criterion 
We tum first to the criterion at 8 C.P.R. § 214.2(h)(4)(iii)(A)(l), which requires that a baccalaureate 
or higher degree in a specific specialty, or its equivalent, is normally the minimum requirement for 
entry into the particular position. To inform this inquiry, we recognize the U.S. Department of Labor's 
(DOL) Occupational Outlook Handbook (Handbook) as an authoritative source on the duties and 
educational requirements of the wide variety of occupations that it addresses.4 
4 All of our references are to the 2016-2017 edition of the Handbook, which may be accessed at the Internet site 
http://www.bls.gbv/ooh/. We do not, however, maintain that the Handbook is the exclusive source of relevant 
information. That is, the occupational category designated by the Petitioner is considered as an aspect in establishing the 
general tasks and responsibilities of a proffered position, and USCIS regularly reviews the Handbook on the duties and 
educational requirements of the wide variety of occupations that it addresses. To satisfy the first criterion, however, the 
burden of proof remains on the Petitioner to submit sufficient evidence to support a finding that its particular position 
would normally have a minimum, specialty degree requirement, or its equivalent, for entry. 
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Matter ojC-S-1-, LLC 
On the labor condition application (LCA) submitted in support of the H-1B petition, the Petitioner 
designated the proffered position under the occupational category "Medical and Health Services 
Managers" corresponding to the Standard Occupational Classification code 11-9111.5 
The Handbook states the following with regard to the educational qualifications necessary for 
entrance into positions located within this occupational category: 
Education 
Medical and health services managers typically need at least a bachelor's degree to 
enter the occupation. However, master's degrees are common and sometimes 
preferred by employers. Graduate programs often last between 2 and 3 years and 
may include up to 1 year of supervised administrative experience in a hospital or 
healthcare consulting setting. 
Prospective medical and health services managers typically have a degree in health 
administration, health management, nursing, public health administration, or business 
administration. Degrees that focus on both management and healthcare combine 
business-related courses with courses in medical terminology, hospital organization, 
and health information systems. For example, a degree in health administration or 
health information management often includes courses in health services 
management, accounting and budgeting, human resources administration, strategic 
planning, law and ethics, health economics, and health information systems. 
Work Experience in a Related Occupation 
Many employers require prospective medical and health services managers to have 
some work experience in either an administrative or a clinical role in a hospital or 
other healthcare facility. For example, nursing home administrators usually have 
years of experience working as a registered nurse. 
Others may begin their careers as medical records and health information technicians, 
administrative assistants, or financial clerks within a healthcare office. 
5 The Petitioner classified the proffered position at a Level I wage (the lowest of four assignable wage levels). We will 
consider this selection in our analysis of the position. The "Prevailing Wage Determination Policy Guidance" issued by 
the DOL provides a description of the wage levels. A Level I wage rate is generally appropriate for positions for which 
the Petitioner expects the Beneficiary to have a basic understanding of the occupation. This wage rate indicates: ( 1) that 
the Beneficiary will be expected to perform routine tasks that require limited, if any, exercise of judgment; (2) that he 
will be closely supervised and his work closely monitored and reviewed for accuracy; and (3) that he will receive 
specific instructions on required tasks and expected results. U.S. Dep't of Labor, Emp't & Training Admin., Prevailing 
Wage Determination Policy Guidance, Nonagric. Immigration Programs (rev. Nov. 2009), available, at 
http://tlcdatacenter.com/download/NPWHC_Guidance_Revised_11_2009.pdf A prevailing wage determination starts 
with an entry level wage and progresses to a higher wage level after considering the experience, education, and skill 
requirements of the Petitioner's job opportunity. !d. 
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Matter ofC-S-1-, LLC 
Licenses, Certifications, and Registrations 
All states require licensure for nursing home administrators; requirements vary by 
state. In most states, these administrators must have a bachelor's degree, complete a 
state-approved training program, and pass a national licensing exam. Some states 
also require applicants to pass a state-specific exam; others may require applicants to 
have previous work experience in a healthcare facility. Some states also require 
licensure for administrators in assisted-living facilities. For information on specific 
state-by-state licensure requirements, visit the National Association of Long Term 
Care Administrator Boards. 
A license is typically not required in other areas of medical and health services 
management. However, some positions may require applicants to have a registered 
nurse or social worker license. 
Although certification is not required, some managers choose to become certified. 
Certification is available in many areas of practice. For example, the Professional 
Association of Health Care Office Management offers certification in medical 
management, the American Health Information Management Association offers 
health information management certification, and the American College of Health 
Care Administrators offers the Certified Nursing Home Administrator and Certified 
Assisted Living Administrator distinctions. · 
Advancement 
Medical and health services managers advance by moving into higher paying 
positions with more responsibility. Some health information managers, for example, 
can advance to become responsible for the entire hospital's information systems. 
Other managers may advance to top executive positions within the organization. 
U.S. Dep't of Labor, Bureau of Labor Statistics, Occupational Outlook Handbook, 2016-17 ed., 
Medical and Health Services Managers, http://www.bls.gov/OOH/management/medical-and-health-
services-managers.htm#tab-4 (last visited Nov. '16, 2016). · 
When reviewing the Handbook, we must note that the Petitioner designated the proffered position 
under this occupational category at a Level I on the LCA. Based upon the Petitioner's designation of 
the proffered position as a Level I position (relative to others with the occupation) it does not appear 
that the Beneficiary will serve in a senior or leadership role or in a position that performs more 
technical research that requires a master's degree. 
The Handbook reports that the requirements for medical and health services managers vary by 
facility. The Handbook also states that medical and health services' managers typically need an 
advanced degree to enter the occupation, but it further clarifies that the degrees are in various fields 
Matter ofC-S-1-, LLC 
of study (health administration, health management, nursing, public health administration, or 
business administration). In addition, the Handbook reports that degrees that focus on both 
management and healthcare combine business-related courses with courses in medical terminology, 
hospital organization, and health information systems. For example, the Handbook states that a 
degree in health administration or health information management often includes courses in health 
services management, accounting and budgeting, human resources 'administration, strategic 
planning, law and ethics, health economics, and health information systems. Therefore, although the 
Handbook states that medical and health services managers typically need an advanced degree, it 
also specifies that the requirements for these positions vary by facility and that degrees in various 
fields are acceptable for jobs in this occupation (e.g., health administration, health management, 
nursing, public health administration, and business administration). 
Again, provided the specialties are closely related, e.g., chemistry and biochemistry, a minimum of a 
bachelor's or higher degree in more than one specialty is recognized as satisfying the "degree in the 
specific specialty (or its equivalent)" requirement of section 214(i)(l )(B) of the Act. In such a case, 
the required "body of highly specialized knowledge" would essentially be the same. Since there 
must be a close correlation between the required "body of highly specialized knowledge" and the 
position, however, a minimum entry requirement of a degree in two disparate fields, such as 
philosophy and engineering, would not meet the statutory requirement that the degree be "in the 
specific specialty (or its equivalent)," unless the Petitioner establishes how each field is directly 
related to the duties and responsibilities of the particular position such that the required body of 
highly specialized knowledge is essentially an amalgamation of these different specialties. Section 
214(i)(l)(B) ofthe Act (emphasis added). 
The Handbook also states that a degree in business administration is sufficient for medical and 
health services manager jobs. Although a general-purpose bachelor's degree, such as a degree in 
business administration, may be a legitimate prerequisite for a particular position, requiring such a 
degree, without more, will not justify a finding that a particular position qualifies for classification as 
a specialty occupation. Royal Siam, 484 F.3d at 147. 
Again, USCIS interprets the degree requirement at 8 C.F.R. § 214.2(h)(4)(iii)(A) to require a degree 
in a specific specialty that is directly related to the proposed position. Since there must be a close 
correlation between the required specialized studies and the position, the requirement of a degree 
with a generalized title, such as business administration,. without further specification, does not 
establish the position as a specialty occupation. C.f Matter of Michael Hertz Assocs., 19 I&N Dec. 
558, 560 (Comm'r 1988). Therefore, the Handbook's recognition that a general, non-specialty 
degree in business administration is sufficient for entry into the occupation strongly suggests that a 
bachelor's degree in a spec(fic specialty is not normally the minimum entry requirement for this 
occupation. 
The narrative of the Handbook further indicates that nursing care facility administrators and 
administrators in assisted-living facilities may be subject to state licensure requirements. The 
Handbook reports that a license is not required in other areas of medical and health services 
8 
Matter ofC-S-1-, LLC 
managem~nt; however, certification is available in many areas of practice and that some employees 
obtain professional certification. The Handbook notes that the Professional Association of Health 
Care Office Management (PAHCOM) provides certification in medical management, that the 
American Health Information Management Association (AHIMA) offers health information 
management certification, and that the American College of Health Care Administrators (ACHCA) 
provides the Certified Assisted Living Administrator and Certified Nursing Home Administrator 
distinctions. 
We reviewed the P AHCOM website regarding its requirements for professional certification. "6 The 
PAHCOM website states that its Certified Medical Manager (CMM) and its Health Information 
Technology Certified Manager for Physician Practice (HITCM-PP) certifications are nationally 
recognized as the standards of excellence in physician office management. It further indicates that 
the programs provide recognition to office managers having the knowledge, skills, and experience 
necessary to successf~lly manage today's medical practices. The requirements for certification 
include: 
• A minimum of two years of experience in the health care field (must be in support of patient 
care, as in a medical practice or other clinical environment); and 
• Twelve college credit hours in courses (1) pertinent to healthcare or business management 
for the CMM credential; or (2) pertinent to healthcare, business management, or information 
technology for the HITCM-PP credential. The educational credit requirement is reduced by 
one hour for each year experience above the two year minimum. 
The P AHCOM website states that its credentialing program recognizes the qualifications and 
expertise of medical managers of physician practices. It Bpecifically notes that the credential is not 
an entry level certification; but, rather, that the CMM designation is the most senior in the industry, 
requiring both experience and education. 
However, the P AHCOM website does not indicate that medical manager positions have any 
particular degree requirements for entry, nor does it indicate that these positions require a degree to 
be identified as qualified and possessing a level of expertise/competence. Instead, PAHCOM 
stresses the importance of professional experience, along with a few courses in healthcare, business 
management and/or information technology. 
We also reviewed the AHIMA website regarding its health information management certification.
7 
The AHIMA website states that it is ,the premier association of health information management 
(HIM) professionals worldwide. The website also states that AHIMA credentials are earned through 
6 For additional information regarding PAHCOM and its credentialing programs, see the Professional Association of 
Health Care Office Management website at https://www.pahcom.com (last visited Nov. 16, 20 16). 
7 For additional information regarding AHIMA and its certification program, see the American Health Information 
Management Association website at http://www.ahima.org/ (last visited Nov. 16, 20 16) 
9 
Matter of C-S-1-, LLC 
a challenging program of examinations, education, and expenence, and maintained through 
continuous review and education. 
The AHIMA website indicates that there are two types of HIM certifications: (1) Registered Health 
Information Administrator (RHIA) certification; and (2) Registered Health Information Technician 
(RHIT) certification. According to the website, RHIA applicants must meet one of the following 
eligibility requirements: 
• Successfully complete the academic requirements, at the baccalaureate level, of an HIM 
program accredited by the Commission on Accreditation for Health Informatics and 
Information Management Education (CAHIIM); or 
• Successfully complete the academic requirements, at the master's level, of an HIM program 
accredited by CAHIM and following <! specific set of criteria; or 
• Graduate from an HIM program approved by a foreign association with which AHIMA has a 
reciprocity agreement. 
In addition, RHIT applicants must meet one of the following requirements: 
• Successfully complete the academic requirements, at an associate's degree level, of an HIM 
program accredited by the [CAHIIM]; or 
• Graduate from an HIM program approved by a foreign association with which AHIMA has a 
reciprocity agreement. 
However, the AHIMA website does not indicate that at least a bachelor's degree in a specific 
specialty (or its equivalent) is required to work as a health information management professional 
and/or be HIM certified. 
Finally, we reviewed the ACHCA website regarding the Certified Assisted Living Administrator and 
Certified Nursing Home Administrator distinctions. 8 According to ACHCA, its professional 
certification program identifies and honors administrators and managers'who are performing at an 
advanced level of skill and knowledge. The website states that its professional certification program 
promotes quality in the profession and improves the public image of administrators, as well as 
allows experienced and practicing administrators to validate their knowledge, skill, and abilities. 
The ACHCA website indicates that there are a number of paths available to candidates seeking to 
fulfill the education and experience requirements for the Certified Assisted Living Administrator 
(CALA) distinction. These include possessing: (1) a high school diploma or General Education 
8 For additional information regarding ACHCA and its certification programs, see the American College of Health Care 
Administrators website at http://www.achca.org/ (last visited Nov. 16, 2016). 
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Matter ofC-S-1-, LLC 
Diploma (G.E.D.) along with six years of full-time experience as. an assisted living 
administrator/manager in an assisted living environment; (2) an associate's degree along with four 
years of full-time experience as an assisted living administrator/manager in an assisted living 
environment; or (3) a baccalaureate degree along with two years of full-time experience as an 
assisted living administrator/manager in an assisted living environment. Thus, the ACHCA website 
does not indicate that at least a bachelor's degree in a specific specialty (or its equivalent) is required 
to work as an assisted living administrator/manager- or for certification. 
The requirements for the Certified Nursing Home Administrator (CNHA) distinction include the 
following: (1) two year licensure as a nursing home administrator; (2) two years of experience as a 
nursing home administrator; and (3) a baccalaureate degree if licensed after January 1, 1996. We 
note that a candidate is not required to have a degree in a specific specialty, but rather a degree in 
any field or a general-purpose degree is sufficient. · 
Thus, the Handbook, P AHCOM, AHIMA, and ACHCA do not support the claim that the "Medical 
and Health Services Managers" occupational category is one for which normally the minimum 
requirement for entry is a baccalaureate degree (or higher) in a specific specialty, or its 
equivalent. Even if it did (which it does not), to satisfy the first criterion, the Petitioner would still 
need to provide evidence to support a finding that the particular position proffered would normally 
have such a minimum, specialty degree requirement, or its equivalent. 
In response to the RFE, the Petitioner stated that it was submitting a copy of the Occupational 
Information Network (O*NET) OnLine Summary Report for the "Medical and Health Services 
. Managers" occupational category. Although not submitted, we will briefly address the report. In 
this matter, O*NET does not establish that the proffered position qualifies as a specialty occupation. 
In general, O*NET is not particularly useful in determining whether a baccalaureate degree in a 
specific specialty, or its equivalent, is a standard entry requirement for a given position, as O*NET 
Job Zone designations make no mention of the specific field of study from which a degree must 
come. Furthermore, the Specific Vocational Preparation (SVP) .ratings, which are cited within 
O*NET's Job Zone designations, are meant to indicate only the total number of years of vocational 
preparation required for a particular position. The SVP ratings do not describe how those years are 
to be divided among training, formal education, and experience and it does not specify the particular 
type of degree, if any, that a position would require. Therefore, O*NET does not establish that the 
proffered position qualifies as a specialty occupation. 
Further, we find that, to the extent that they are described in the record of proceedings, the numerous 
duties that the Petitioner ascribes to the proffered position indicate a need for a range of knowledge 
and abilities, such as overseeing business affairs, maintain documentation, collecting data, 
assembling patient charts, and similar duties, but do not establish any particular level of formal, 
postsecondary education leading to a bachelor's or higher degree in a specific specialty as minimally 
necessary to attain such knowledge. 
In the instant case, the duties and requirements of the position as described in the record of 
proceeding do not indicate that this particular position proffered by the Petitioner is one for which a 
II 
Matter ofC-S-1-, LLC 
baccalaureate or higher degree in a specific specialty, or its equivalent, is normally the minimum 
requirement for entry, 
Thus, the Petitioner has not satisfied the criterion at 8 C.F.R. § 214.2(h)(4)(iii)(A)(l). 
B. Second Criterion 
The second criterion presents two, alternative prongs: "The degree requirement is common to the 
industry in parallel positions among similar organizations or, in the alternative, an employer may 
show that its particular position is so complex or unique that it can be performed only by an 
individual with a degree[.]" 8 C.F.R. § 214.2(h)(4)(iii)(A)(2) (emphasis added). The first prong 
casts its gaze upon the common industry practice, while the alternative prong narrows its focus to the 
Petitioner's specific position. 
j 
1. First Prong 
To satisfy this first prong of the second criterion, the Petitioner must establish that the "degree 
requirement" (i.e., a requirement of a bachelor's or higher degree in a specific specialty, or its 
equivalent) is common to the industry in parallel positions among similar organizations. 
In determining whether there is such a common degree requirement, factors often considered by 
USCIS include: whether the Handbook reports that the industry requires a degree; whether the 
industry's professional association has made a degree a minimum entry requirement; and whether 
letters or affidavits from firms or individuals in the industry attest that such firms "routinely employ 
and recruit only degreed individuals." See Shanti, Inc. v. Reno, 36 F. Supp. 2d 1151, 1165 (D. Minn. 
1999)(quoting Hird/Blaker Corp. v. Sava, 712 F. Supp. 1095, 1102 (S.D.N.Y. 1989)). 
Here and as already discussed, the Petitioner has not established that its proffered position is one for 
which the Handbook (or other independent, authoritative source) reports an industry-wide requirement 
for at least a bachelor's degree in a specific specialty or its equivalent. Thus, we incorporate by 
reference the previous discussion on the matter. Also, there are no submissions from the industry's 
professional association indicating that it has made a degree a minimum entry requirement. 
In support of its assertion that the degree requirement is common to the Petitioner's industry in 
parallel positions among similar organizations, the Petitioner submitted copies of advertisements for 
positions entitled Spine Practice Administrative Manager, Practice Administrator, Manager of 
Practice Access Services, Client Manager, and Medical Practice Manager/ Administrator. None! of 
the advertisements submitted provide sufficient information regarding the advertising organizations 
to establish that the advertising organizations are similar to the Petitioner. That is, the record does 
not demonstrate that the advertising organizations are similar in type, scope, and size to this 
Petitioner. Further, some of the advertisements list a requirement for a bachelor's degree, but not for 
a degree in any specific specialty. One of the advertisements requires a bachelor's degree in 
business or public administration, or a related field, and at least five years of experience; another 
12 
Matter ofC-S-1-, LLC 
advertisement requires a bachelor's degree in a related field and four years of experience; another 
advertisement requires a bachelor's degree in business administration, healthcare administration, or a 
related field and at least three years of experience; another advertisement requires a bachelor's 
degree in health care administration or a similar field and at least three years of experience; and 
another advertisement does not require any degree but states it prefers a bachelor's degree in 
business administration, fin~pce, accounting, or a related field and at least five years of experience. 
Here, while some of the advertisements generally require a bachelor's degree in business 
administration, healthcare administration, public administration, or a related field, they also require 
experience of at least three to five years in addition to the bachelor's degree. The Petitioner here has 
designated the proffered position as a wage Level I on the LCA (the lowest of four assignable wage 
levels), a wage level that only requires a basic understanding of the occupation, which is in contrast 
to some of the advertised positions that are for more senior positions. One of the advertised 
positions does not even require any bachelor's degree; therefore, it, too, does not demonstrate that a 
requirement of a bachelor's or higher degree in a specific specialty, or its equivalent, is common to 
parallel positions with organizations that are in the Petitioner's industry and otherwise similar to the 
Petitioner. 
For these reasons, the Petitioner has not satisfied the criterion of the first alternative prong of 
8 C.P.R.§ 214.2(h)(4)(iii)(A)(2). 
2. Second Prong 
We will next consider the second alternative prong of 8 C.F.R. § 214.2(h)(4)(iii)(A)(2), which is 
satisfied if the Petitioner shows that its particular position is so complex or unique that it can be 
performed only by an individual with at least a bachelor's degree in a specific specialty, or its 
equivalent. 
In this matter, the evidence of record does not distinguish the proffered position as unique from or 
more complex than other health operations manager positions that can be performed by persons 
without at least a bachelor's degree in a specific specialty, or its equivalent. 
It does not credibly demonstrate relative complexity or uniqueness as aspects of the proffered position. 
Specifically, it is unclear how the proffered position, as described, necessitates the theoretical and 
practical application of a body of highly specialized knowledge such that a person who has attained a 
bachelor's or higher degree in a specific specialty or its equivalent is required to perform them. Rather, 
we find, that, as reflected in this decision's earlier quotation of duty descriptions from the record of 
proceeding, the evidence of record does not distinguish the proffered position from other positions 
falling within the "Medical and Health Services Managers" occupational category, which, the 
Handbook indicates, do not necessarily require a person with at least a bachelor's degree m a 
specific specialty or its equivalent to enter those positions. 
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Matter ojC-S-1-, LLC 
To begin with, the record does not credibly demonstrate exactly what the Beneficiary will do on a 
day-to-day basis such that complexity or uniqueness can even be determined. That is, while the 
Petitioner claims that the position involves focusing on "manag[ing] general operations of the 
facility, relations with employees and patients, performing marketing and outreach, and setting 
policies for the facility," the Petitioner does not demonstrate how the health operations manager's 
duties described require the theoretical and practical application of a body of highly specialized 
knowledge such that a bachelor's or higher degree in a specific specialty, or its equivalent, is 
required to perform them. 
For instance, here, the Petitioner stated that the proffered position requires a bachelor's degree in 
business administration, finance, health sciences, or a related field. As previously discussed, a 
general-purpose bachelor's degree, such as a degree in business administration, finance, or health 
sciences, without more, will not justify a finding that a particular position qualifies for classification 
as a specialty occupation. 
This is further evidenced by the LCA submitted by the Petitioner in support of the instant petition. 
Again, the LCA indicates that, relative to other positions located within the "Medical and Health 
Services Managers" occupational category, the Beneficiary would perform only routine tasks that 
require limited, if any, exercise of judgment; close supervision of work, monitored and reviewed for 
accuracy; and the receipt of specific instructions on required tasks and expected results. Without 
further evidence, the evidence does not demonstrate that the proffered position is complex or unique 
as such a position falling under this occupational category would likely be classified at a higher­
level, such as a Level III (experienced) or Level IV (fully competent) position, requiring a 
significantly higher prevailing wage.9 For example, a Level IV (fully competent) position is 
designated by DOL for employees who "use advanced skills and diversified knowledge to solve 
unusual and complex problems." The evidence of record does not establish that this position is 
significantly different from other positions in the occupational category such that it refutes the 
Handbook's information that a bachelor's degree in a specific specialty, or its equivalent, is not 
required for the proffered position. 
The Petitioner claims that the Beneficiary is well-qualified for the pos1t10n, and references his 
qualifications. However, the test to establish a position as a specialty occupation is not the education 
or experience of a proposed beneficiary, but whether the position itself requires at least a bachelor's 
degree in a specific specialty, or its equivalent. The Petitioner did not sufficiently develop relative 
9 The issue here is that the Petitioner.'s designation of this position as a Level I position undermines its claim that the 
position is particularly complex, specialized, or unique compared to other positions within the same 
occupation. Nevertheless, it is important to note that a Level I wage-designation does not preclude a proffered position 
from classification as a specialty occupation. In certain occupations (doctors or lawyers, for example), such a position 
would still require a minimum of a bachelor's degree in a specific specialty, or its equivalent, for entry. Similarly, 
however, a Level IV wage-designation would not reflect that an occupation qualifies as a specialty occupation if that 
higher-level position does not have an entry requirement of at least a bachelor's degree in a specific specialty or its 
equivalent. That is, a position's wage level designation may be a consideration but is not a substitute for a determination 
of whether a proffered position meets the requirements of section 214(i)( I) of the Act. 
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Matter ofC-S-1-, LLC-
complexity or uniqueness as an aspect of the duties of the position, and it did not identify any tasks 
that are so complex or unique that only a specifically degreed individual could perform them. 
Accordingly, the Petitioner has not satisfied the second alternative prong of 8 C.P.R. 
§ 214.2(h)(4)(iii)(A)(2). 
C. Third Criterion 
The third criterion of 8 C.P.R. § 214.2(h)(4)(iii)(A) entails an empioyer demonstrating that it 
normally requires a bachelor's degree in a specific specialty, or its equivalent, for the position. 
Here, the Petitioner submitted a resume for a claiming that he was previously 
employed as its health operations manager. The Petitioner also submitted an employment offer letter 
addressed to dated October 17, 2014. The letter, however, welcomes to 
the Petitioner's company as a "consultant and administrator." As such, the title offered to 
and the briefly listed duties do not appear to be parallel to the proffered position. For 
example, the offer letter states that would "not be involved in any financial aspects 
associated with the practice" while the proffered position's duties include "[d) eve loping, planning, 
directing and coordinating of the daily operations, which include billing, budgeting, and planning" 
and "[p]reparing financial reports." Further, although resume states that he received a 
bachelor's degree in Psychology and a master's degree in health administration from 
the Petitioner did not submit any evidence of degrees. Furthermore, the 
Petitioner also did not submit any evidence that it actually employed at any time. 
As the Petitioner does not submit probative evidence that demonstrates the academic qualifications 
of individuals previously or currently employed in a similar health operations manager position, the 
Petitioner has not satisfied the criterion at 8 C.P.R. § 214.2(h)( 4)(iii)(A)(3) .10 
D. Fourth Criterion 
The fourth criterion at 8 C.P.R. § 214.2(h)(4)(iii)(A) requires a petitioner to establish that the nature 
of the specific duties is so specialized and complex that the knowledge required to perform them is 
usually associated with the attainment of a baccalaureate or higher degree in a specific specialty , or 
its equivalent. 
10 While a petitioner may believe or otherwise assert that a proffered position requires a degree in a specific specialty , 
that opinion alone without corroborating evidence cannot establish the position as a specialty occupation. Were USCIS 
limited solely to reviewing a petitioner's claimed self-imposed requirements, then any individual with a bachelor 's 
degree could be brought to the United States to perform any occupation as long as the employer artificially created a 
token degree 
requirement, whereby all individuals employed in a particular position possessed a baccalaureate or higher 
degree in the specific specialty , or its equivalent. See Def ensor v. Meissner, 20 I F. 3d at 387. In other words, if a 
petitioner's degree requirement is only symbolic and the proffered position does not in fact require such a specialty 
degree , or its equivalent, to perform its duties, the occupation would not meet the statutory or regulatory definition of a 
specialty occupation . See section 214(i)(l) of the Act; 8 C.F .R. § 214.2(h)(4)(ii) (defining the term "specialty 
occupation "). 
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Matter ojC-S-1-, LLC 
The Petitioner asserts that the job duties of the proffered position are specialized and complex. We refer 
to our earlier comments and findings with regard to the implication of the Petitioner's designation of the 
proffered position in the LCA as a Level I wage, and hence one not likely distinguishable by relatively 
specialized and complex duties. We have also reviewed the Petitioner's description of duties for the 
proffered position, including the Petitioner's expanded version of the description submitted in response 
to the Director's RFE and again on appeal. While we understand that the Beneficiary must have 
technical knowledge in order to perform some of these duties, the Petitioner has not sufficiently 
explained how these duties require the theoretical and practical application of a body of highly 
specialized knowledge, and the attainment of a bachelor's or higher degree in the specific specialty (or 
its equivalent) as a minimum for entry into the occupation in the United States. Upon review of the 
totality of the record, the record does not include probative evidence that the duties require more than 
technical proficiency in the medical and health services field. The Petitioner has not demonstrated in 
the record that its proffered position is one with duties sufficiently specialized and complex to satisfY 8 
C.F.R. § 214.2(h)(4)(iii)(A)(4). 
IV. CONCLUSION 
As discussed above, the Petitioner has not demonstrated that the proffered position qualifies as a 
specialty occupation. 
The burden is on the Petitioner to show eligibility for the immigration benefit sought. Section 291 of 
the Act, 8 U.S.C. § 1361; Matter. ofOtiende, 26 I&N Dec. 127, 128 (BIA 2013). Here,. that burden 
has not been met. 
ORDER: The appeal is dismissed. 
Cite as Matter ofC-S-1-, LLC, ID# 124421 (AAO Nov. 29, 2016) 
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