Utilization Review Agent Sample Clauses
Utilization Review Agent. The term "Utilization Review Agent" means the entity appointed by the Plan Administrator to perform the functions of the Utilization Review Agent as set forth herein.
Related to Utilization Review Agent
Utilization Review NOTE: The Utilization Review process does not apply to Services that are not covered by Blue Shield because of a coverage determination made by Medicare. State law requires that health plans disclose to Sub- scribers and health plan providers the process used to authorize or deny health care services under the plan. Blue Shield has completed documentation of this process ("Utilization Review"), as required un- der Section 1363.5 of the California Health and Safety Code. To request a copy of the document describing this Utilization Review process, call the Customer Service Department at the telephone number indicated on your Identification Card.
Project Review A. Programmatic Allowances 1. If FEMA determines that the entire scope of an Undertaking conforms to one or more allowances in Appendix B of this Agreement, with determinations for Tier II Allowances being made by SOI-qualified staff, FEMA shall complete the Section 106 review process by documenting this determination in the project file, without SHPO review or notification. 2. If the Undertaking involves a National Historic Landmark (NHL), FEMA shall notify the SHPO, participating Tribe(s), and the NPS NHL Program Manager of the NPS Midwest Regional Office that the Undertaking conforms to one or more allowances. FEMA shall provide information about the proposed scope of work for the Undertaking and the allowance(s) enabling FEMA’s determination. 3. If FEMA determines any portion of an Undertaking’s scope of work does not conform to one or more allowances listed in Appendix B, FEMA shall conduct expedited or standard Section 106 review, as appropriate, for the entire Undertaking in accordance with Stipulation II.B, Expedited Review for Emergency Undertakings, or Stipulation II.C, Standard Project Review. 4. Allowances may be revised and new allowances may be added to this Agreement in accordance with Stipulation IV.A.3, Amendments. B. Expedited Review for Emergency Undertakings
Position Review 18.3.1 Either an employee or the University may request an audit of the duties and responsibilities of a position he/she/it believes is not allocated to the proper class. Employees requesting such an audit are expected to notify the Union at the time of their request. 18.3.2 Job audits will be performed and reclassification decisions will be made by the University’s Human Resources Services staff according to the University’s Classification Process. The affected employee(s) and the Union will be notified of the outcome of a job audit in writing. In the event of a reallocation that results in removal of a position from the bargaining unit, the written notice will describe the manner in which the bargaining unit work is being distributed, including the classification and position(s) of any employee(s) absorbing work from the reallocated position. 18.3.3 If an employee disagrees with a classification decision made by the Human Resources staff, the employee may request review of that decision through the Director of OFM/State Human Resources within 30 (thirty) calendar days of receiving the final allocation decision from the University. Should the employee disagree with the Director’s decision, the employee may further appeal the matter to the Washington Personnel Resources Board within 30 (thirty) calendar days of being provided the written decision of the Director. The Board will render a decision, which will be final and binding. Decisions regarding appropriate classification will be reviewed in accordance with this Section and will not be subject to the grievance procedure specified in Article 40 of this Agreement.
Log Reviews All systems processing and/or storing PHI COUNTY discloses to 11 CONTRACTOR or CONTRACTOR creates, receives, maintains, or transmits on behalf of COUNTY 12 must have a routine procedure in place to review system logs for unauthorized access.
Transition Review Period In accordance with Article 35, Layoff and Recall, the Employer may require an employee to complete a transition review period.