Division Review of Contractor Grievance Decisions Sample Clauses

Division Review of Contractor Grievance Decisions. A final grievance decision by the Plan may be appealed by the Enrollee to the Division. The Division's appointed Hearing Officer will review the grievance record, gather additional information if necessary, and provide the Enrollee and his or her representative or the representative of a deceased Enrollee’s estate and the Plan an opportunity to be heard. The Hearing Officer will recommend a resolution of the grievance to the Executive Director of the Division. The Executive Director will render a final decision. The Division review of Plan grievances decisions will not exceed 90 days minus the number of days taken by the Plan to resolve the appeal internally. The decision by the Division shall be final, subject to appropriate judicial review. For appeals that meet the criteria for expedited resolution, as expeditiously as the Enrollee’s health condition requires, but no later than 72 hours after receipt of the request for appeal from the Enrollee or receipt of the file from the Contractor the Division will take final administrative action.
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Related to Division Review of Contractor Grievance Decisions

  • ADB’s Review of Procurement Decisions 9. All contracts procured under international competitive bidding procedures and contracts for consulting services shall be subject to prior review by ADB, unless otherwise agreed between the Borrower and ADB and set forth in the Procurement Plan. SCHEDULE 5

  • Claims Review Population A description of the Population subject to the Claims Review.

  • Office of Inspector General Investigative Findings Expert Review In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government Code, Section 531.102(m-1)(2) is applicable to this Contract, Contractor affirms that it possesses the necessary occupational licenses and experience.

  • Claims Review Findings a. Narrative Results.‌‌

  • Union Grievance Committee (a) The Employer shall recognize a Union Grievance Committee which consists of:

  • Claims Review Methodology a. C laims Review Population. A description of the Population subject to the Quarterly Claims Review.‌

  • Claims Review The IRO shall perform the Claims Review annually to cover each of the five Reporting Periods. The IRO shall perform all components of each Claims Review.

  • Classification Review (a) An Employee who has reason to believe that they are improperly classified due to a substantial change in job duties, may apply to the Department Director, or designate, to have the Employee’s classification reviewed. The Director, or designate, will review the Employee’s application and advise the Employee of the Employer’s decision.

  • Grievance Committee The Hospital will recognize a Grievance Committee composed of the Chief Xxxxxxx and not more than (as set out in Local Provisions Appendix) employees selected by the Union who have completed their probationary period. A general representative of the Union may be present at any meeting of the Committee. The purpose of the Committee is to deal with complaints or grievances as set out in this Collective Agreement. The Union shall keep the Hospital notified in writing of the names of the members of the Grievance Committee appointed or selected under this Article as well as the effective date of their respective appointments. A Committee member shall suffer no loss of earnings for time spent during their regular scheduled working hours in attending grievance meetings with the Hospital up to, but not including arbitration. The number of employees on the Grievance Committee shall be determined locally.

  • Claims Review Objective A clear statement of the objective intended to be achieved by the Claims Review.

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