Kaylan D. Copeland
Houston
Summary
Registered nurse with extensive experience in patient care across diverse settings. Expertise in delivering comprehensive care and effectively delegating tasks based on patient needs and team capabilities. Committed to maintaining high standards of quality care within a collaborative multidisciplinary team.
Overview
6
6
years of professional experience
Work History
Autism Service Navigator
TriWest Healthcare Alliance
03.2025 - Current
- Collaborated with stakeholders to oversee assessment, planning, and care coordination for TRICARE beneficiaries enrolled in Autism Care Demonstration.
- Educated beneficiaries on Autism Care Demonstration and TRICARE benefits for enhanced understanding.
- Completed comprehensive case management assessments and developed individualized comprehensive care plans with beneficiaries and families.
- Identified high-risk beneficiaries with adverse health outcomes and significant clinical or psychological factors.
- Ensured compliance with HIPAA privacy regulations and accreditation standards in daily practice.
- Screened beneficiary needs against program criteria for appropriateness in Autism Care Demonstration enrollment.
- Promoted awareness of state licensure scope of practice among Autism Services Navigators.
- Facilitated timely enrollment decisions into Autism Care Demonstration, completing necessary notifications.
LTSS RN Case Manager
Molina Healthcare
11.2024 - 03.2025
- Completed comprehensive face-to-face assessments of members within regulated timelines.
- Developed and implemented case management plans in collaboration with members and healthcare professionals.
- Monitored care plans to evaluate effectiveness, document interventions, and suggest necessary adjustments.
- Promoted integration of behavioral health services and long-term support for continuity of care.
- Assessed medical necessity and authorized appropriate waiver services based on evaluations.
- Evaluated covered benefits and provided guidance on funding sources.
- Facilitated interdisciplinary care team meetings for service approval or denial decisions.
- Identified barriers to care and coordinated assistance for psycho-social, financial, and medical issues.
RN Service Coordinator STAR KIDS
Texas Children’s Health plan
10.2023 - 11.2024
- Assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs utilizing a collaborative approach.
- Ensure optimal patient outcomes that address quality, service, customer satisfaction and cost effectiveness.
- Assesses, develops, implements, and monitors a comprehensive plan of care through an interdisciplinary team process in conjunction with the patient/family in internal and external settings.
- Ensures quality, cost-effective use of resources and facilitates access to care.
- Collaborates with community health education/outreach organizations and providers to promote health for children with complex healthcare needs.
- Prepares and monitors outcome data to assist in identification of improvement opportunities.
- Demonstrates commitment to team, flexibility, professional interpersonal, communication, critical thinking, and customer service skills.
- Uses positive and effective interpersonal skills when dealing with patients/families, visitors, peers, and other healthcare team members.
- Serves as a patient/family advocate while caring for patients and collaborating with other healthcare team members.
- Assists in creating a positive work environment that promotes productivity, mentoring, teamwork, and cooperation.
- Participates in the orientation and training of new department members.
Complex RN Case Manager
Molina Healthcare
04.2022 - 10.2023
- Monitored member progress towards outcomes through continuous assessment and evaluation.
- Coordinated services with providers, UM staff, social workers, and community agencies.
- Developed care plans in alignment with Molina, state, and NCQA guidelines.
- Ensured prompt and efficient delivery of healthcare services.
- Utilized QNXT, UMK2, Clinical Care Advance, PRISM, Caremark, and Outlook for operational efficiency.
- Served as Clinical Review Nurse for Patient Review and Coordination Program.
RN Case Manager
HCA Conroe
Conroe
08.2021 - 04.2022
- Responsible for coordinating, monitoring, executing and evaluating Case Management Department activities.
- Accountable for assisting hospital utilization performance improvement in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services.
- Utilization Management supporting medical necessity and denial prevention.
- Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction.
- Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care.
- Compliance with state and federal regulatory requirements, TJC accreditation standards and HCA policy.
- Education provided to physicians, patients, families and caregivers.
- Assesses by interview and charts review discharge needs of all high-risk patients (and others referred). Identifies resources available to address the needs identified, coordinate referrals and document plan.
- Utilize community resources to support patient’s post hospital needs. Documents choice in available resources has been offered.
- Performs admission and continued stay reviews. Provides clinical information to payers upon request for certification and reimbursement of care. Discusses alternate level of care with physician. Refers cases not meeting acute care criteria to Physician Advisor as needed.
- Facilitates and or provides education of hospital staff, physicians, patients and caregivers for purposes of efficient resource utilization.
- Keeps current of requirements by JCAHO, HCFA and other state/federal agencies on provision of care, planning and documenting.
- Tracks resource statistics to identify improvement opportunities. Attends medical staff and other hospital committee meetings to report findings.
Acute Dialysis RN
DaVita Kidney Care
The Woodlands
05.2021 - 08.2021
- Provides supervision and direction of Patient Care Technicians and clerical staff; provides direction and education to ICU staff for Hemodialysis treatments.
- Provides and requests information from other team members as they receive and discharge patients from care according to policy.
- Initiates, documents, and completes ongoing QAI activities including monthly reports as directed by the relevant acute clinical coordinator.
- Collaborates with diverse healthcare team.
- Delivers safe and effective patient care in compliance with established company standards; hospital contracted policies and procedures, acute hospital services policies and procedures, as well as regulations set forth by the corporation, state, and federal agencies.
- Responsible for the compliance, support and delivery of all relevant company and contracted facility policies and procedure.
Registered Nurse
Angels of Care Pediatric Home Health
Houston
05.2019 - 05.2021
- Provide assessments and nursing care to pediatric patients in home environment.
- Conduct IV therapy, TPN treatment, Eternal Feedings.
- Provide activity therapy according to plan of care.
- Administer medications, Oxygen, and breathing treatments according to plan of care.
- Evaluate and document responses to interventions provided.
- Identify patient needs.
Telephonic RN/Nurse Advocate
Optum Health
Sugar Land
03.2020 - 04.2021
- Established trusting relationships with members, caregivers, clinic staff, and physicians.
- Proactively engaged members to coordinate care needs effectively.
- Provided patient education on various health conditions.
- Performed telephonic triage to assess member needs promptly.
- Maintained active engagement between members and primary care physicians, facilitating appointment scheduling and transportation.
- Collaborated with members’ care teams, serving as a liaison for health services and processes.
- Connected members facing healthcare barriers with appropriate care teams through telephonic outreach.
- Conducted Social Determinants of Health assessments to identify member needs and connect them with suitable care teams.
Registered Nurse- Pediatric Clinic
UT Physicians
Katy
01.2020 - 03.2020
- Prioritizes, synthesizes and documents assessments and nursing plan of care using critical thinking and judgment.
- Implements plan of care within scope of practice through assignment and monitoring of other nurses and delegation and monitoring of unlicensed staff. Initiates standing orders for prescription refills and labs as well as standing delegation orders where appropriate.
- Develops and implements teaching plans for patients concerning maintenance, promotion and restoration of health.
- Evaluates patients’ response and outcomes to education and therapeutic interventions.
- Communicates effectively with collaborative team while escalating critical results and issues in an appropriate and timely manner.
- Exercises judgment while coordinating care and referring patients to agencies or health care professionals for other services/transitions in care where indicated.
Registered Nurse Tele/IMU
HCA Houston Healthcare Kingwood
Kingwood
08.2019 - 12.2019
- Collaborated with physician and healthcare team to enhance patient care delivery.
- Utilized nursing process to assess and address patient needs effectively.
- Provided professional nursing care to patients, ensuring safety and comfort.
- Conducted thorough nursing assessments, assisting during exams and treatment procedures.
- Delivered patient education to promote understanding of health conditions and treatments.
- Maintained accurate medical records to support continuity of care.
Education
Bachelor of Science - Nursing
University of Texas at Arlington
Arlington, TX12.2021
Associates of Applied - Nursing
College of The Mainland
Texas City, TX12.2018
Master of Science - Health Care Management
University of New Orleans
New Orleans, LA12.2012
Bachelor of Science - Psychology
Prairie View A & M University
Prairie View, TX08.2010
Skills
- Case management
- Care coordination
- Health assessment
- Individualized care plans
- Stakeholder collaboration
Licensures And Certifications
- Registered Nurse, Texas State Board of Nursing, Compact License #966890
- Basic Life Support (BLS), American Heart Association
- Advanced Cardiac Life Support (ACLS)
<Enter your own>
Title: Registered Nurse
Timeline
Autism Service Navigator
TriWest Healthcare Alliance
03.2025 - Current
LTSS RN Case Manager
Molina Healthcare
11.2024 - 03.2025
RN Service Coordinator STAR KIDS
Texas Children’s Health plan
10.2023 - 11.2024
Complex RN Case Manager
Molina Healthcare
04.2022 - 10.2023
RN Case Manager
HCA Conroe
08.2021 - 04.2022
Acute Dialysis RN
DaVita Kidney Care
05.2021 - 08.2021
Telephonic RN/Nurse Advocate
Optum Health
03.2020 - 04.2021
Registered Nurse- Pediatric Clinic
UT Physicians
01.2020 - 03.2020
Registered Nurse Tele/IMU
HCA Houston Healthcare Kingwood
08.2019 - 12.2019
Registered Nurse
Angels of Care Pediatric Home Health
05.2019 - 05.2021
Bachelor of Science - Nursing
University of Texas at Arlington
Associates of Applied - Nursing
College of The Mainland
Master of Science - Health Care Management
University of New Orleans
Bachelor of Science - Psychology
Prairie View A & M University
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