Tracy Sawatka

Secured timely pre-authorization for treatments and procedures to ensure compliance with insurance regulations. Documented patient interactions, treatment plans, and interventions to maintain accurate medical records and support continuity of care.

Formulated and presented recommendations for approval to ensure alignment with care standards. Collected clinical information to facilitate timely concurrent reviews and crafted recommendations for denial to medical director and plan liaison.

Prepared and presented recommendations for approval in home healthcare and DME, facilitating timely access to necessary services. Requested clinical information for concurrent review, ensuring compliance with URAQ guidelines.

Applied health plan criteria and Medicare guidelines to approve outpatient services and ancillary providers. Generated authorizations and precertifications, coordinated utilization review activities, and executed tasks independently to determine medical necessity.

Supported case management team by ensuring compliance with program policies and regulatory requirements. Conducted file audits, coordinated interdepartmental services, and collaborated with IT and clinical departments to uphold NCQA and URAC standards.

Provided nursing care as a Licensed Practical Nurse.

Provided nursing care as a Licensed Vocational Nurse.

Provided nursing care as a Licensed Vocational Nurse.

Provided nursing care as a Licensed Vocational Nurse.

Coordinated recruitment efforts, conducted employee interviews, developed application forms, and managed onboarding processes.

Managed all aspects of 4-star hotel operations in 7 departments with over 40 employees. Developed and implemented targeted hiring policies and outreach recruitment programs, diversifying the workplace by 20%.

Taught English as a second language full-time to elementary age children for 8 years.

Completed LVN Program at North Central Texas College in Corinth, Texas.

Attended Tarrant County Community College in Tampa, FL.

Attended Pearl River Community College.

Attended Pensacola Junior College and University of West Florida.

Attended University of West Florida.