La’Cretia Sterling
Humble,TX
Summary
Seasoned RN with a robust background in pediatric nursing and health promotion, demonstrated through impactful roles at Texas Children's Health Plan and beyond. Excelled in clinical judgment and interdisciplinary collaboration, significantly enhancing patient care continuity. Expert in discharge planning and community health, consistently advocating for at-risk populations.
Overview
36
36
years of professional experience
Work History
RN Initial Reviewer
Texas Children's Health Plan
06.2018 - Current
- Maintained thorough, accurate and confidential documentation in electronic medical records.
- Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
- Collaborated with doctors to plan post-treatment home care and prevent return hospitalization.
- Managed complex cases involving multiple diagnoses or treatments.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
- Participated in continuing education programs related to nursing practice.
- Coordinated discharge planning to ensure continuity of care post-hospitalization.
- Interpreted and evaluated diagnostic tests to identify and assess patient's condition.
RN Service Coordinator
Texas Children’s Health Plan
10.2016 - 06.2018
- Service coordinator- help connect special needs members to community services
- Assess, develop, implement, and monitor a comprehensive plan of care through an interdisciplinary team process in conjunction with members/families.
- Collaborate with community health education/outreach organizations and providers for the overall health of members
Utilization Review Specialist
Memorial Herman
01.2016 - 09.2016
- Pre-certification nurse
- Review clinical information for medical necessary
- Complete and send those not meeting or without information to medical director for determination
Case Manager
Conroe Regional Medical Center
12.2015 - 01.2016
- Applies criteria for admission
- Communicates with payor and external case managers
- Assists and communicates with physicians
- Perform discharge planning appropriately considering safety of patients
Health Coach Consultant
Aetna
01.2014 - 12.2015
- Assigned to designated team
- Provide health education to members based on plan benefits
- Telephonic outreach to provide health alerts to members
- Contact providers for collaboration on members care
- Refer to RD, Case Management, or other teams as needed
Utilization Review Manager
Amerigroup Inc.
01.2001 - 12.2014
- Team Preceptor
- Leadership role in absence of direct supervisors
- Performed quarterly Audits
- Large Case Report
- Obtain reviews of hospitalized members
- Apply criteria (Interqual) to determine appropriateness of inpatient stay
- Facilitate transfers to alternate levels of care as appropriate
- Always available to staff
Case Manager
Department of Health & Human Services
01.1996 - 12.2001
- Pregnant women and children case management
- Assists clients to access services and makes appropriate referrals
- Medical record audits in preparation for state visits
Public Health Generalist
Harris County Health Department
01.1994 - 12.1996
- Physical examinations on Medicaid clients ages 2 weeks to 21 years
- Perform vision, hearing, and Denver II developmental testing
- Administer immunizations
- Participate in quality improvement activities
EPSDT Nurse
Harris County Hospital District
01.1989 - 12.1994
- Charge Nurse
- Provide direct nursing care
- Perform admission, discharge, and transfer duties
- Execute physician orders
- Assist with transition from JD Hospital to LBJ Hospital
Education
Bachelor of Science - Nursing
Prairie View A & M University
Skills
- Clinical judgment
- Quality improvement
- Community health
- Discharge planning
- Health promotion
- Vaccine administration
- Health screening
- Precepting
- Health care consultation
- Pediatric nursing
- IV drug therapy management
- Seizure management
- Gastroenteral nutrition education
- At-risk patient care
- Disease management programs
- Infant vitals monitoring
Timeline
RN Initial Reviewer
Texas Children's Health Plan
06.2018 - Current
RN Service Coordinator
Texas Children’s Health Plan
10.2016 - 06.2018
Utilization Review Specialist
Memorial Herman
01.2016 - 09.2016
Case Manager
Conroe Regional Medical Center
12.2015 - 01.2016
Health Coach Consultant
Aetna
01.2014 - 12.2015
Utilization Review Manager
Amerigroup Inc.
01.2001 - 12.2014
Case Manager
Department of Health & Human Services
01.1996 - 12.2001
Public Health Generalist
Harris County Health Department
01.1994 - 12.1996
EPSDT Nurse
Harris County Hospital District
01.1989 - 12.1994
Bachelor of Science - Nursing
Prairie View A & M University
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