Markeeta Sansbury
Virginia Beach,VA
Summary
Detail-oriented utilization management representative with strong expertise in healthcare compliance and authorization review. Proven ability to assess medical necessity and ensure adherence to clinical guidelines. Facilitates timely access to essential services, enhancing patient care outcomes.
Overview
11
11
years of professional experience
Work History
Utilization Management Representative III
Elevance Health
Virginia Beach, Virginia
06.2015 - 05.2026
- Reviewed medical necessity for healthcare services and procedures, ensuring compliance with clinical guidelines.
- Collaborated with healthcare providers to ensure compliance with utilization guidelines.
- Ensured that all authorizations were documented accurately in the patient's medical record.
- Notified members, providers, and facilities of authorization requests, facilitating timely access to necessary services.
- Created peer-to-peer cases and assigned to appropriate Medical directors.
- Generated volume reports detailing findings for Medical Director authorizations and Expedite reports, supporting data-driven decision making.
Education
MBA - Health Services Administration
Strayer University
Virginia Beach, VA05-2011
Bachelor of Science - Integrated Science & Technology
James Madison University
Harrisonburg, VA05-1999
Skills
- Utilization management
- Authorization review
- Medical necessity review
- Healthcare compliance
- Data analysis
- Peer-to-peer communication
Affiliations
- Volunteer with Alpha Kappa Alpha Sorority, Inc. in the community through various activities such as food banks, working with teens and at senior centers. Conducting financial awareness and mental health seminars. Participate and raise funds for national awareness walks.
- Norfolk Pearls Foundation of VA - actively serves the Hampton Roads area by awarding scholarships to local students, both high school and college students. Host community programming focused on education, health, and family empowerment. Recently voted as the Assistant Treasurer 2026
Timeline
Utilization Management Representative III
Elevance Health
06.2015 - 05.2026
MBA - Health Services Administration
Strayer University
Bachelor of Science - Integrated Science & Technology
James Madison University