Joy Sterrett

Medical Management Nurse Senior

• Facilitated central region local group commercial utilization management as Medical Management Nurse Senior, ensuring effective utilization processes.
• Coordinated member care plans using Elevance Health clinical guidelines and documentation standards.
• Reviewed clinical records for medical necessity, coverage, and prior authorization requests.
• Escalated complex cases to clinical leadership and interdisciplinary care management teams.
• Applied AI assistance via IntelliAuth ICA for reviews.
• Completed reviews across all demographics, including NICU, Individual ACA, SNF/LTAC/IPR, and HealthLink.
• Answered questions, reviewed MCG criteria, and provided process education as resource and mentor for nurses.
• Managed AllMed referral processes.
• Supported onboarding for multiple new nurses to the team.

Medical Management Team Lead

• Managed daily queue case inventory, staffing, and assignments.
• Developed and implemented innovative strategies to improve team efficiency and outcomes.
• Collaborated with physicians, care teams, and members to support coverage decisions.
• Provided support and guidance to colleagues to maintain a collaborative work environment.
• Generated detailed reports for management review.
• Conducted root cause analysis to identify issues.
• Facilitated continuous education to enhance team knowledge.
• Coached team members to enhance skills and address performance gaps through targeted educational support.

• Facilitated home RN visits for neonatal and adult patients by providing education, performing physical assessments, checking vital signs, tracking weights, and administering medication pours.
• Recorded patient documentation accurately in the electronic health record system. and care coordination details accurately in Kantime documentation system.
• Streamlined communication by collecting physician orders and updating care providers on patient needs.
• Promoted to supervisor and preceptor, offering guidance and support to field nurses.

• Opened school health clinic for pre-k through 8th grade students.
• Developed comprehensive health management and safety policies to enhance student well-being and ensure compliance with state regulations.
• Applied nursing assessment process to assess, diagnose, plan, implement, and evaluate student care during clinic day.
• Created individualized health plans for students with IEPs, health concerns, or 504 needs to support their educational success and promote health equity.
• Delivered monthly student health education through bulletin boards, classroom instruction, and weekly newsletter.
• Updated Indiana Department of Education and Indiana State Department of Health immunization databases and maintained current records.
• Conducted training sessions for staff on essential student health protocols, including seizure management, anaphylaxis, and asthma care, while coordinating CPR training to enhance campus safety.
• Worked independently as only medically trained staff member on campus and served as key daily team member.

• July 2008–June 2012 and September 2016–September 2018 (bedside nurse).
• Provided direct care to critically ill infants in level IV neonatal intensive care unit.
• Oversaw management of high frequency and conventional ventilators, ensuring optimal respiratory support for critically ill infants.
• Enhanced expertise in ventilator management, intravenous therapy, enteral feeding, patient assessment, and equipment management to improve patient care.
• Achieved Level III Clinical Advancement Program recognition for exceptional nursing performance in 2009, 2010, and 2011.
• Received Level III Clinical Advancement Program recognition in 2009, 2010, and 2011.

• Demonstrated expertise in identifying adverse events related to pharmaceuticals.
• Monitored medical documents to identify and report potential adverse events from pharmaceuticals, enhancing safety protocols.
• Reviewed records and documented adverse event findings using Genentech medical documents and case management portal, ensuring compliance and accuracy.
• Utilized Quickbase application for efficient document tracking and streamlined case workflows.

• Coordinated NICU case management for 40–50 patients through comprehensive utilization review for commercial plans and Medicaid policies, enhancing discharge planning for infants.
• Established collaborative relationships with companies, physicians, and staff to effectively address and fulfill infant care needs.
• Created comprehensive discharge education for NICU families on home oxygen, cardiac apnea monitors, tracheostomies, ventilator management, nasogastric and gastrostomy enteral feedings, and urinary catheterization.
• Used Allscripts Care Management with ECIN to manage case data and support discharge workflow.
• Prepared referrals for durable medical equipment and related post-discharge services.
• Strengthened organization and communication skills through case management and family education responsibilities.
• Developed excellent organization and communication skills

• Administered direct patient care to critically ill infants in Level 3 Neonatal Intensive Care Unit, supporting health stabilization.
• Delivered bedside care to critically ill infants in Neonatal Intensive Care Unit, ensuring safety and comfort.
• Delivered bedside care at Miami Valley Hospital using patient assessment and clinical judgment.
• Monitored vital signs and responded to changes in patient condition.
• Administered medications and maintained safe medication administration practices.

• 2005-2006
• Completed 3-month summer training program for nursing students, gaining hands-on experience in NICU and surgical advanced care units.
• Assisted Miami Valley Hospital nurses with bedside patient care and comfort measures.
• Monitored vital signs and reported changes to Miami Valley Hospital nursing staff.
• Supported patient hygiene, mobility, and repositioning across Miami Valley Hospital units.