Maile Bradford, RN
Orlando,FL
Summary
Experienced and proficient healthcare professional specializing in interdisciplinary collaboration and clinical review, delivering significant improvements in patient care quality and operational efficiency, while maintaining regulatory standards.
Overview
8
8
years of professional experience
1
1
Certification
Work History
PICU RN Case Manager
Nemour's Children's Hospital
Orlando, FL
12.2024 - Current
- Developed streamlined care plans with outpatient complex care clinic, reducing inpatient length of stay by 52% in 2025.
- Implemented hospital-wide discharge planning assessment, resulting in 43% reduction in ED admissions and 68% decrease in readmissions.
- Process insurance claims by adhering to payor guidelines and direct providers in the appeal process.
Oncology RN Case Manager
St. Joseph's Hospital
Tampa, Florida
01.2024 - 12.2024
- Ensured compliance with CMS guidelines, MDS regulations, HIPAA, and hospital policies for inpatient services.
- Negotiated coverage agreements with insurance companies and providers for treatment and transitional care services.
- Directed interdisciplinary meetings to escalate patient care issues and facilitate collaboration.
WellCare Care Coordinator
Centene
Tampa, Florida
06.2021 - 01.2024
- Conducting thorough insurance verification to confirm coverage eligibility for services.
- Assisting patients with barriers to care, navigating referrals, and providing telephonic nursing advice support, while successfully managing a caseload of 85+ patients.
- Preparing monthly reports for senior management, highlighting key performance indicators for department.
Registered Nurse Clinical Manager
Tampa Family Health Centers
Tampa, FL
05.2020 - 01.2021
- Oversaw center-wide daily operations, patient flow, budget planning, payroll, medication inventory management, and conflict resolution.
- Spearheaded first federally funded COVID vaccine administration drive-thru for Hillsborough County in 2021.
- Ensured compliance with federal, state, and company regulations through comprehensive review audits and meticulous documentation.
Registered Nurse - Short Stay
Tampa General Hospital
Tampa, Florida
03.2019 - 06.2020
- Provided patient care per physician orders for transplant, ENT, urology, and ophthalmology surgical procedures.
- Supported professional advancement through mentorship and training opportunities as a nurse preceptor.
- Directed unit staff and promoted quality care as Charge Nurse.
Infusion Center and Radiation RN
Orlando Health at UF Health Cancer Center
Orlando, Florida
04.2018 - 03.2019
- Administered chemotherapy agents and provided supportive care through radiation therapy while monitoring patients for adverse effects.
- Provided direct patient care and education with empathetic communication and thorough knowledge of treatment protocols.
Education
Bachelor of Science - Nursing
Chamberlain College of Nursing
Chicago, IL03-2026
Associate of Science - Nursing
Cambridge Institute of Health And Technology
Altamonte Springs, FL12-2017
Skills
- Healthcare leadership
- Communication
- Interdisciplinary collaboration
- Utilization management
- Magnet Accreditation
- Quality improvement
- InterQual criteria expertise
- CMS Guidelines
- Prior authorization, claims, and appeals processes
- Medical billing and coding
- Insurance verification
Certification
RN License Number: 9482337
Accomplishments
Daisy Award 2021
Timeline
PICU RN Case Manager
Nemour's Children's Hospital
12.2024 - Current
Oncology RN Case Manager
St. Joseph's Hospital
01.2024 - 12.2024
WellCare Care Coordinator
Centene
06.2021 - 01.2024
Registered Nurse Clinical Manager
Tampa Family Health Centers
05.2020 - 01.2021
Registered Nurse - Short Stay
Tampa General Hospital
03.2019 - 06.2020
Infusion Center and Radiation RN
Orlando Health at UF Health Cancer Center
04.2018 - 03.2019
Bachelor of Science - Nursing
Chamberlain College of Nursing
Associate of Science - Nursing
Cambridge Institute of Health And Technology