Smarter Prior Authorization: Improving Outcomes Without Adding Burden
- Tuesday, March 31, 2026
- 1:00 PM (ET)
Join us for an engaging panel featuring experts from BCBS of Alabama, Itiliti Health and NCQA as they discuss what “better prior authorization” could look like for patients and clinicians.
Key Discussion Points:
- Prior authorization is not an operational activity only; it has a significant impact on quality of care, patient experience and provider experience
- There are ways to do prior authorization better
- Technology is an enabler and organizations can leverage efficiencies to improve patient and provider experience within an organization’s prior authorization process
- How NCQA’s programs provide a glidepath to accountability, data analysis and continuous improvement
- The clearest way prior authorization modernization can translate into improved care quality (not just faster paperwork)
- Best practices for success and implementation
Tracy Welsh
Tracy Welsh
Tracy Welsh is a Department Manager in Clinical Services at Blue Cross and Blue Shield of Alabama, bringing more than 30 years of experience across the healthcare continuum. A registered nurse and certified case manager, Tracy offers a seasoned leadership perspective shaped by extensive clinical experience and progressive leadership at Blue Cross. In her current and prior leadership roles, Tracy has provided strategic and operational oversight for key clinical functions, including case management, utilization management, appeals, medical review, clinical audits, and multiple lines of business. She is known for building and leading high-performing teams, navigating complex clinical and regulatory environments, and translating strategy into sustainable operational outcomes.
Michael Lunzer
Michael Lunzer
Michael Lunzer is the Founder and CEO of Itiliti Health, Inc., where he drives innovation in healthcare by streamlining and automating prior authorization. A seasoned entrepreneur, Michael co-founded the first-ever technology-based vendor management system for the staffing industry, which processed $2 billion annually by 2005. He also co-founded Warm Health, a virtual care manager platform for payers, later acquired by Change Healthcare. With a career focused on solving inefficiencies through technology, Michael continues to lead transformative change in healthcare, making him a sought-after speaker on industry innovation and optimization.
Tsveta Polhemus
Tsveta Polhemus
As Assistant Vice President, Product Management, Tsveta Polhemus steers NCQA’s product management efforts with a focus on Accreditation and Recognition Evaluation Programs. Her role involves executing strategy and fostering cross-functional collaboration, aligning product roadmaps with the evolving needs of the healthcare market and ensuring high-value solutions for stakeholders. NCQA’s portfolio of Evaluation programs programs include Health Plan Accreditation, Credentialing, Utilization Management, Population Health Management and Health Equity among others. These programs enable healthcare quality improvement and help organizations align with state, federal, employer and other stakeholder needs. Tsveta is responsible for leading teams that develop new products and enhancements to existing NCQA programs. Tsveta has over 15 years of industry experience, including private sector consulting for the Centers for Medicare & Medicaid Services (CMS), congressional internships, and her work at NCQA.
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