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Position Summary

Performs paralegal tasks specific to Medicaid and Medicare administrative state fair hearings.

• Conduct basic legal and investigative research and analysis for member appeals and provider claim disputes.

• Research and apply knowledge of legal, regulatory and procedural developments that relate to area of practice, as well as clients’ business goals, plans and priorities to all member appeals and provider claim disputes.

• Participate in due diligence; conduct fact finding, document gathering and document creation (such as, motions, communications, etc.).

• Ensure that all state fair hearing requests and related documentation are uploaded to the appropriate government agency in timely manner.

• Ensure all state fair hearing request information, hearing notices, orders, minute entries, and hearing decisions are entered into appropriate databases and calendars, as required, accurately and in a timely manner.

• Hearing Files: Create a state fair hearing file using the designated format. Research and route state fair hearing files for appropriate reviews by the relevant department or subject matter expert.

• Staffings and Meetings: Schedule staffings and meetings as required by the assigned hearing attorney.

• Other miscellaneous projects as needed by the legal department.

Required Qualifications

3+ years of demonstrated paralegal experience in a law firm or in-house legal department.

Preferred Qualifications

• Experience in litigation or administrative hearings.

• Managed care experience, especially Medicaid or Medicare.

• Experience in administrative law.

Education

Associate’s Degree and Paralegal Certificate (from an accredited ABA program preferred). Bachelor’s Degree a plus.

Pay Range

The typical pay range for this role is:

$29.72 – $59.42

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.  
 
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 03/21/2024

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. 

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.