JORGE L. BRAO
Miami,FL
Summary
Highly experienced and dedicated Registered Nurse Case Manager with 39+ years of expertise in pediatric acute care. Adept at coordinating comprehensive patient care plans, collaborating with multidisciplinary teams, and advocating for optimal patient outcomes. Skilled in assessing patient needs, discharge planning, and resource management to ensure seamless transitions of care. Known for compassionate patient advocacy, strong leadership, and a commitment to quality improvement. Dedicated to providing exceptional care while streamlining healthcare processes to enhance patient experiences and outcomes.
Overview
42
42
years of professional experience
1
1
Certification
Work History
RN Case Manager | Utilization Review Nurse
Nicholas Children’s Hospital
01.2001 - 01.2025
- Conduct comprehensive clinical assessments to determine medical necessity and appropriate level of care for patients
- Perform utilization review by evaluating hospital admissions, continued stays, and discharge plans using evidence-based criteria (e.g., MCG, InterQual)
- Collaborate with physicians, nursing staff, social workers, and insurance providers to ensure cost-effective, high-quality patient care
- Develop and implement discharge plans, coordinating with post-acute care providers, home health agencies, and community resources to ensure seamless patient transitions
- Advocate for patients and families, ensuring they receive appropriate care while navigating insurance requirements and prior authorization processes
- Monitor patient progress and identify barriers to discharge, intervening to resolve delays and improve care efficiency
- Ensure compliance with Medicare, Medicaid, and private insurance regulations, reducing denials and improving reimbursement outcomes
- Educate staff and patients on care pathways, utilization management policies, and resource optimization
- Successfully reduced hospital length of stay by implementing efficient care coordination strategies
- Decreased insurance denials and appeals by maintaining strict adherence to medical necessity criteria
- Improved interdisciplinary communication leading to better patient outcomes and workflow efficiency
- Extensive experience providing Case Management in ICU, Med-Surg, and Emergency Department settings, managing critical and acute cases efficiently
Supervisor Respiratory Department | CRTT /RN
Nicholas Children’s Hospital
01.1986 - 01.2001
- Supervised and coordinated daily operations of the respiratory therapy department, ensuring high-quality patient care and adherence to hospital protocols
- Specialized in ECMO (Extracorporeal Membrane Oxygenation) services, providing advanced life support to critically ill pediatric and neonatal patients with severe respiratory and cardiac failure
- Managed and operated ECMO circuits, including VA and VV ECMO, ensuring optimal patient outcomes
- Led and trained a multidisciplinary team on ECMO initiation, management, and troubleshooting
- Collaborated with physicians, nurses, and perfusionists to develop individualized care plans for ECMO patients
- Assisted in bedside procedures such as cannulation, decannulation, and circuit changeouts
- Monitored and adjusted ECMO parameters based on patient condition, lab results, and hemodynamic status
- Provided crisis intervention and decision-making support during emergencies, including ECMO failure or complications
- Developed and implemented ECMO training programs for new staff and ongoing education for the respiratory therapy team
- Ensured compliance with ECMO program protocols, ELSO (Extracorporeal Life Support Organization) guidelines, and hospital policies
- Conducted performance evaluations, staff scheduling, and quality assurance initiatives to enhance respiratory therapy services
Respiratory Therapist
Abbey Hospital
01.1983 - 01.1986
- Administer oxygen therapy, aerosol medications, and other respiratory treatments as prescribed
- Perform patient assessments and monitor respiratory status, including breath sounds, oxygen levels, and ventilator settings
- Manage and operate ventilators, BiPAP/CPAP machines, and other respiratory support equipment
- Conduct arterial blood gas (ABG) analysis and interpret results to guide treatment
- Collaborate with physicians and nurses to develop and adjust patient care plans
- Provide airway management, including suctioning, intubation assistance, and tracheostomy care
- Educate patients and families on respiratory conditions, treatments, and equipment usage
- Respond to respiratory emergencies, including code blue situations, and provide lifesaving interventions
- Ensure compliance with hospital protocols, infection control measures, and safety standards
- Document patient progress and respiratory interventions in electronic medical records (EMR)
Education
Associate of Science - Nursing
Miami Dade Community College
Miami, FL12-1995
Certified Respiratory Therapy Technician - RT
Respiratory Therapy Institute
Miami, FL05-1983
Skills
- Electronic Health Records (EHR)
- Utilization Review Software
- Insurance & Reimbursement Systems
- Microsoft Office Suite
- RN/CRTT
- ECMO specialist
- BLS Certified
- HIPAA compliance
- Chronic disease management
- Utilization review
- Quality improvement
- Case management
- Patient care assessment
Certification
- CPR/AED Certification
- Basic Life Support Certification (BLS)
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
RN Case Manager | Utilization Review Nurse
Nicholas Children’s Hospital
01.2001 - 01.2025
Supervisor Respiratory Department | CRTT /RN
Nicholas Children’s Hospital
01.1986 - 01.2001
Respiratory Therapist
Abbey Hospital
01.1983 - 01.1986
Associate of Science - Nursing
Miami Dade Community College
Certified Respiratory Therapy Technician - RT
Respiratory Therapy Institute
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