dismissed H-1B Case: Medical Consulting

U.S. Citizenship 
and Immigration 
Services 
MATTER OF G-H-P-, INC. 
Non-Precedent Decision of the 
Administrative Appeals Office 
DATE: DEC. 21, 2016 
APPEAL OF CALIFORNIA SERVICE CENTER DECISION 
PETITION: FORM I-129, PETITION FOR A NONIMMIGRANT WORKER 
The Petitioner, a medical consulting firm providing services to companies based in China, seeks to 
temporarily employ the Beneficiary on a part-time basis as a "medical services manager" under the 
H-1B 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-1B 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, California 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. In its appeal, the Petitioner submits additional evidence and 
asserts that the Director erred in denying the petition. 
Upon de novo review, we will dismiss the appeal. 
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 that requires: 
(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 of G-H-P-, Inc. 
(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 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; 
(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. Chertoff, 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-lB petition, the Petitioner stated that the Beneficiary will serve as a "medical services 
manager." In response to the Director's request for evidence (RFE), the Petitioner provided the 
following job duties for the proffered position: 
55% of the time is devoted to the following duties: 
• Recruit, train, and supervise the patient services team; Develop goals and 
objectives, and create work schedules for the patient services team. The patient 
services team compiles, organizes and handles all medical records, contacts and 
makes appointments with physicians, accompanies patients to medical 
appointments and assists in communication and other needs, coordinates with 
the IT team to ensure high quality remote conference meeting delivery between 
patients in China and physicians in the U.S., etc. 
• Recruit, train, and supervise the medical translation team. The medical 
translation team (Chinese and English) translates medical records, medical 
procedures and instructions, legal documents and other pertinent documents as 
necessary, and performs medical interpretation/translation for patients and their J 
families. 
2 
(b)(6)
Matter of G-H-P-, Inc. 
• Coordinate the work and activities between the patient services team and the 
medical translation team to improve the efficiency and quality in delivering 
medical consultation services. 
• Ensure that [the Petitioner] is compliant with new health laws and regulations 
and keep all medical related documents under HIPP A [sic] [.] 
20% of the time is devoted to the following duties: 
• Communicate with hospital global services department, nurses, and physicians 
regarding [the Petitioner's] patients' medical needs; 
• Build and maintain good relationship between [the Petitioner] and cooperative 
physicians and hospitals, including 
and 
15% of the time is devoted to the following duties: 
• Keep and organize records of all medical and health services of [the Petitioner], 
including patient database and physician profile database. 
• Manage patients' fees and billing. 
10% of the time is devoted to the following duties: 
• Administer patient based surveys, such as breast cancer survey and patient 
satisfaction survey, to better understand patients' needs and improve the 
services; 
• Lead patient education projects and coordinate with other teams (translation 
team and IT team) to better demonstrate contents (e.g. breast cancer education 
project)[.] 
In its initial letter of support, the Petitioner stated that the minimum entry requirement for the 
proffered position is a bachelor's degree in health management, health administration, or a related 
field. In response .to the RFE, the Petitioner added public health administration as an acceptable 
field of study. 
3 
Matter ofG-H-P-, Inc. 
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 
A. First Criterion 
We turn first to the criterion at 8 C.F.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 recogriize 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? 
On the labor conditiop. application (LCA) submitted in support of the H-lB petition, the Petitioner 
designated the proffered position under the occupational category "Medical and Health Services 
Managers" corresponding to the Standard Occupational Classification code 11-9111.4 
The Handbook states the following with regard to the educational qualifications necessary for 
entrance into positions located within this occupational category: 
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-1B 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. \ 
3 All of our references are to the 2016-2017 edition of the Handbook, which may be accessed at the Internet site 
http://www.bls.gov/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. 
4 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 she 
will be closely supervised and her work closely monitored and, reviewed for accuracy; and (3) that she 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. ~009), available at 
http://flcdatacenter.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. 
4 
Matter ofG-H-P-, Inc. 
Most medical and health services managers have at least a bachelor's degree before 
entering the field. However, master's degrees are common and sometimes preferred 
by employers. Educational requirements vary by facility. 
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 
l 
administration, health managemept, 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. 
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. 
5 
Matter ofG-H-P-, Inc. 
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 Dec. 15, 2016). 
On appeal, the Petitioner contends that the Handbook "plainly states that a bachelor's degree in one of 
only a few interrelated fields is the normal requirement fm: entry into the occupation," which fulfills the 
requirement in the first of the four alternative criteria. The Petitioner also contends that the select few 
degree fields listed by the Handbook as acceptable for entry into the medical and health services 
manager occupation are all closely related fields in the health field, with the exception of business 
administration. The Petitioner states that business administration focuses on management, accounting, 
finance, strategic planning, and related subjects, which are relevant to business management positions 
and directly related to the duties of the proffered position. The Petitioner went on to list relevant 
coursework that are essential to the duties of the proffered position and reiterated that the position 
requires a minimum of a bachelor's degree in health management, health administration, or a related 
field. 
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 duties 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 
6 
Matter ofG-H-P-, Inc. 
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). 
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 betweet:t the required specialized studies and the position, the requirement of a degree 
with a generalized title, such <JS business administration, without further specification, does not 
establish the position as a specialty occupation. Cf Matter of Michael HertzAssocs., 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 specific 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 
management; 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 (P AHCOM) 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. 
7 
Matter of G-H-P-, Inc. 
We reviewed the PAHCOM website regarding its requirements for professional certification." 5 The 
P AHCOM 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 successfully 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 envi~onment); 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 specifically 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 PAHCOM 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, P AHCOM 
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.6 
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 
a challenging program of examinations, education, and experience, 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: 
5 For additional informati6ri regarding P AHCOM and its credentialing programs, see the Professional Association of 
Health Care Office Management website at https://www.pahcom.com (last visited Dec. 15, 2016). 
6 For additional information regarding AHIMA and its certification program, see the American Health Information 
Management Association website at http://www.ahima.org/ (last visited Dec. 15, 2016). 
8 
Matter ofG-H-P-, Inc. 
• 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 CAHIIM and following a. 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.7 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 
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 as_sisted living administrator/manager - or for certification. 
7 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 Dec. 15, 2016). 
9 
Matter ofG-H-P-, Inc. 
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, PAHCOM, 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, 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. 
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, coordinating between teams internally, 
coordinating patient care, providing patient services, maintaining documentation, collecting data, 
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 
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 secqnd 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. 
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. 
10 
Matter of G-H-P-, Inc. 
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 
f 
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. In addition, the Petitioner did not submit any letters or 
affidavits from similar firms or individuals in the Petitioner's industry attesting that such firms 
"routinely employ and recruit only degreed individuals." 
The Petitioner does not submit probative evidence that demonstrates the degree requirement is common 
to the industry in parallel positions among similar organizations. Therefore, the Petitioner has not 
satisfied the criterion of the first-alternative prong of 8 C.F.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 medical services 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 in a 
specific specialty or its equivalent to enter those positions. 
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 on appeal that the position involves "the application and understanding of 
numerous sophisticated business and health management concepts, theories and tools," the Petitioner 
11 
(b)(6)
Matter of G-H-P-, Inc. 
does not demonstrate how the medical services 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. 
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. 8 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. 
Furthermore, in response to the RFE, the Petitioner submitted an evaluation letter authored by 
Associate Professor of Clinical Health Policy and Management in 
~ s~~~t~ 
Beneficiary asked him to "write a letter explaining her coursework and the need for someone 
working as a Medical Services Manager to have the advanced skills that are taught in a Master of 
Public Health (MPH) program." 
one-page letter provides information about the health policy and management 
program and does not specifically address the proffered position or the duties provided by the 
Petitioner for the proffered position. only direct statement about the proffered 
position is that "the position described to me by [the Beneficiary] requires that someone have 
advanced training in public health." did not specifically opine that the proffered 
position, or its duties, requires 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. 
8 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 Levell 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 requireme,nt 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)(l) of the Act. 
12 
(b)(6)
Matter ofG-H-P-, Inc. 
In addition, letter does not discuss the Petitioner's designation of this position as 
requiring only a Level I wage and does not explain or distinguish the duties of the proffered position 
from the Handbook's report on medical and health services managers. For these reasons, we do not 
find the opinion sufficient to support the Petitioner's assertion that the proffered position requires a 
bachelor's degree in a specific specialty, or its equivalent, and thus qualifies as a specialty 
occupation. We may, in our discretion, use opinion statements submitted by the Petitioner as 
advisory. Matter of Caron Int'l, Inc., 19 I&N Dec. 791, 795 (Comm'r 1988). However, where an 
opinion is not in accord with other information or is in any way questionable, we are not required to 
accept or may give less weight to that evidence. Id. 
Here, the record does not include sufficient information relevant to a detailed course of study leading 
to a specialty degree and the Petitioner has not established how such a curriculum is necessary to 
perform the duties it claims are so complex. While a few related coUrses may be beneficial in 
performing certain duties of the position, the Petitioner has not . demonstrated how an established 
curriculum of such courses leading to a baccalaureate or higher degree in a specific specialty, or its 
equivalent, is required to perform the duties of the proffered position. 
Additionally, we again note that the Petitioner has designated the proffered position as requiring 
only a Level I wage, that requires only a basic understanding of the occupation. Given the 
Handbook's indication that medical and health services manager positions do not normally require at 
least a bachelor's degree in a specific specialty, or the equivalent, for entry, it is not credible that a 
position involving limited, if any, exercise of independent judgment, close supervision and 
monitoring, receipt of specific instructions on required tasks and expected results, and close review 
would contain such a requirement. Thus, the record lacks sufficiently detailed information to 
distinguish the proffered position as unique from or more complex than positions that can be 
performed by persons without at least a bachelor's degree in a specific specialty or its equivalent. 
Moreover, the Petitioner claims that the Beneficiary is well-qualified for the position, and references 
her 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 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.F.R. 
§ 214.2(h)(4)(iii)(A)(2). 
C. Third Criterion 
The third criterion of 8 C.F.R. § 214.2(h)(4)(iii)(A) entails an employer demonstrating that it 
normally requires a bachelor's degree in a specific specialty, or its equivalent, for the position. 
13 
Matter ofG-H-P-, Inc. 
Here, the Petitioner does not submit any evidence of previous or current employees in the same 
position as the Beneficiary's proffered position. As such, the Petitioner does not submit probative 
evidence that demonstrates the academic qualifications of individuals previously or currently 
employed in a similar medical services manager position. Therefore, the Petitioner has not satisfied 
the criterion at 8 C.F.R. § 214.2(h)(4)(iii)(A)(3). 
D. Fourth Criterion 
The fourth criterion at 8 C.F.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. 
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 
Because the Petitioner has not satisfied one of the criteria at 8 C.P.R.§ 214.2(h)(4)(iii)(A), it 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 of Otiende, 26 I&N Dec. 127, 128 (BIA 2013). Here, that burden 
has not been met. 
r 
ORDER: The appeal is dismissed. 
Cite as Matter ofG-H-P-, Inc., ID# 152392 (AAO Dec. 21, 2016) 
14