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Completes daily formulary operational processes, including tracking, processing, and obtaining appropriate documentation for pharmacy medical exception requests, prior authorization requests, reconsiderations, and appeals.
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Represents the State or plaintiff at arraignments, trials, sentencing and all pre-trial and post-trial hearings, including appeals in Court of Appeals and State Supreme Court. This position performs civil or criminal legal work for the County Prosecutor or Public Defender.
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Acts as a brand ambassador and reflects the company values; partners with the store leadership team on the creation of an engaging experience that appeals to the FP customer. Collaborates with key partners to effectively execute shipment processing, restocking, and placement of product while maintaining FP’s visual and display standards; ensures omni-channel orders are processed timely and accurately.
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NOTE: This position has female gender as a Bona Fide Occupational Qualification (BFOQ) under the Title VII guidelines as approved by the United States Court of Appeals for the Ninth circuit. This is an exciting opportunity to be involved with an organization focused on lowering barriers to a successful reentry for returning citizens, racial justice, and diversity, equity and inclusion.
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Revenue agents, counsel attorneys, appeals officers, and/or specialists throughout IRS to leverage and expand. the team in conferences with appeals, including issue resolution meetings such as fast track.
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Description & Requirements Maximus is looking for an Admin II for Appeals. The candidate will responsible for providing support to the State Appeals contract. - Respond to incoming calls from clients, health plans, providers and enrollees regarding case status, questions about the program, and the appeals process.
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Ensures all program requirements imposed by Compensation Service and/or the Pension and Fiduciary Service and the Court of Appeals for Veterans Claims are met or implemented. Technical Competence - Knowledge of veteran-based state and federal laws (dependency status, social services programs, Medicaid, special income-based programs), to include legal opinions from (1) the court of Appeals for Veterans' Claims (CAVC) and (2) state and federal courts having a relationship to VA programs.
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Provide coverage recommendations for medications subject to prior authorization, appeals, retrospective claim reviews, and audits based on applicable medication coverage policies, member benefit contracts, and provider contracts.
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