| LCA CASE NUMBER | I-200-21173-418928 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-06-22 |
| DECISION DATE | 2021-06-29 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Senior Informatics Analyst |
| SOC CODE | 15-1199.01 |
| SOC TITLE | Software Quality Assurance Engineers and Testers |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-06-24 |
| END DATE | 2024-06-23 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Aetna Medicaid Administrators LLC |
| EMPLOYER ADDRESS1 | c/o CVS Health, 1 CVS Drive |
| EMPLOYER ADDRESS2 | Mail Code HR695 |
| EMPLOYER CITY | Woonsocket |
| EMPLOYER STATE | RI |
| EMPLOYER POSTAL CODE | 2895 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | RI |
| EMPLOYER PHONE | 14017701621 |
| NAICS CODE | 524114 |
| EMPLOYER POC LAST NAME | Messenger |
| EMPLOYER POC FIRST NAME | Paul |
| EMPLOYER POC MIDDLE NAME | R |
| EMPLOYER POC JOB TITLE | Immigration Program Lead |
| EMPLOYER POC ADDRESS 1 | 1 CVS Drive |
| EMPLOYER POC CITY | Woonsocket |
| EMPLOYER POC STATE | RI |
| EMPLOYER POC POSTAL CODE | 02895 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14017701621 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Tang |
| AGENT ATTORNEY FIRST NAME | Caroline |
| AGENT ATTORNEY ADDRESS1 | 301 Congress Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 1150 |
| AGENT ATTORNEY CITY | Austin |
| AGENT ATTORNEY STATE | TX |
| AGENT ATTORNEY POSTAL CODE | 78701 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | TX |
| AGENT ATTORNEY PHONE | 15123444704 |
|
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Ogletree, Deakins, Nash, Smoak & Stewart, P.C. |
| STATE OF HIGHEST COURT | TX |
| NAME OF HIGHEST STATE COURT | Supreme Court of Texas |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 20401 N 19th Ave |
| WORKSITE ADDRESS2 | Apt. 1049 |
| LCA CASE WORKLOC1 CITY | Phoenix |
| WORKSITE COUNTY | MARICOPA |
| LCA CASE WORKLOC1 STATE | AZ |
| WORKSITE POSTAL CODE | 85027 |
| LCA CASE WAGE RATE FROM | 78000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 66768 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
