| Title: Advanced Practice Provider | FLSA Status: Exempt | Shift: Work Schedules Vary | |
| Reports to: VP of Clinical Operations/APP Manager | Department: Clinical | Employment Status: FT | PT | PRN | |
| Supervisory Responsibilities: No | Location: Location varies | Date Created/Last Evaluated: 10/04/2023, 02/08/2024, 04/09/2024
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| Salary: Commensurate with Market and Experience |
Summary:
Nurse Practitioner or Physician’s Assistant to provide chronic and acute care for CKD and ESRD patients in hospital, dialysis, and outpatient office settings. They interact with a patient population that is highly diverse, and resource challenging. Practice includes but not limited to: assessment; ordering, performing, supervising, and interpreting diagnostic and laboratory tests; making diagnoses; initiating and managing treatment plans including prescribing medication and non-pharmacologic treatments in collaboration with MD Nephrologist. Management in partnership with individuals, families, communities to coordinate care, provide counseling and educate. Provide expertise and support to nursing and licensed medical staff caring for patients utilizing best practices and evidence-based care to achieve best possible patient outcomes.
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Qualification Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge base, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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Minimum Qualifications
- Nurse Practitioner: Successful completion of graduate education at the master’s, post-master’s or doctoral level from nationally accredited program, and obtain national board certification. Master of Science in Advance Practice Nursing (MSN) or Clinical Doctorate in Nursing Practice with preference for FNP, ANP, AGNP or ACNP certification, National Board-Certification Nurse Practitioner (ANCC or AANP) with a valid, unrestricted NC RN license, Initial Nurse Practitioner Approval to Practice and in good standing with the North Carolina Board of Nursing.
- Physician Assistant: Successful completion of an educational program for Physician Assistants accredited by the Committee on Allied Health Education and Accreditation, or by its successor agency, and pass the Physician Assistant National Certifying Examination administered by the National Commission on Certification of Physician Assistants.
- Basic Cardiac Life Support (BCLS) and ACLS are required and must be maintained.
- Clear criminal history
- Maintenance and engagement in continuing education to remain ahead of technological, methodological and other developments in the field.
- Completion of requirements to maintain a clear and unrestricted license to practice, prior to expiration.
- Valid driver license and reliable transportation to allow individual to provide support to multiple office, hospital and dialysis unit locations as necessary.
- Working knowledge of Microsoft Office Applications, and familiarization with Electronic Health Records.
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Knowledge, Skills and Abilities- Maintenance of patient confidentiality and medical records in accordance with HIPAA.
- Ability to practice autonomously and in coordination with healthcare professionals and other individuals.
- Ability to provide a wide range of health care services: diagnosis and management of acute, chronic and complex health problems.
- Comfort with health promotion, disease prevention, health education and counseling.
- General knowledge of health care research methodology and interdisciplinary consultation.
- Strong patient advocacy skills desired.
- Detailed oriented with the ability to speak and write effectively, including the preparation of clear and concise documentation of patient interactions, excellent records maintenance skills.
- Proactive individual with the ability to manage required workload, with strong independent decision-making skills and attention to detail.
- Recognize social determinants which affect health, access to care, and engagement in the healthcare contract between provider and patient.
- Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse resource challenged community.
- Ability to function well while involved in multiple task assignments. Ability to concentrate on details and deal with constant interruption. Skill in organizing resources and establishing priorities.
- Attendance and completion of in-service training as required.
- Flexibility in scheduling and assignments to meet the needs of the organization.
- Must be proficient in MS Word, Excel, and PowerPoint software programs.
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Supervisory Responsibilities
None – However each APP is accountable to patients, their professional organization, state boards and are expected to practice consistently with an ethical code of conduct, evidence-based principles and current practice standards.
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Essential Function
- This position is responsible for providing care to the following patient populations: adult and geriatric chronic kidney disease with variable etiologies and end stage renal disease.
- The patient-centered nature of the APP role requires a commitment to meet the evolving needs of society and advances in health care science. APPs are responsible to the public and combine the roles of provider, mentor, educator, researcher, advocate, and administrator.
- Direct clinical care: Order perform and interpret diagnostic tests to include lab work, radiologic exams, and renal biopsies. Initiate referrals to Interventional Nephrology and/or Vascular surgery, PCP and subspecialty care as needed with a goal of meeting value-based care quality indicators. Document Comprehensive and Limited dialysis rounding notes. Documentation and billing for hospital and office-based patient encounters.
- Leadership & Collaborative Practice: Work as an integral team member with Interventional Nephrology, Vascular surgery, hospital staff, outpatient dialysis staff, office staff, peer and consulting APP’s, and collaborative and consulting physicians.
- Quality Improvement: Awareness and adherence to all safety policies and procedures in all practice settings. Recommend changes or updates as needed to safety policies and procedures. Maintain working knowledge of current trends and concepts of professional practices, laws and regulations relating to the practice of medicine and APP practice.
- Personal Development: Encouraged to maintain appropriate levels of continued medical education credits, involvement in professional organizations and participation in health policy activities and local, state, national and international levels. Advanced Certification in Nephrology supported and encouraged.
- Travel to dialysis units to provide Medicare Capitated Payment rounding visits as assigned.
- Data collection and performance of Value Based Care activities (Annual Wellness Visits, Depression Screening, Patient Activation Measures) as assigned.
- Provide clinical support for ENA Research Division Clinical trials and Collaborative Quality Improvement.
- Provide Cross coverage of APPs in hospital/office/dialysis as assigned by Operations Management.
- Attendance of clinical and non-clinical staff meetings.
- Performs other work as required to accomplish the mission of the organization while providing patient care.
| Essential Tasks: % | % of Time | | Provide Clinical assessment, and case management including constructing and interpreting medical history, performing physical assessment, evaluating patient behavior, performing and interpreting selected laboratory tests, identifying problems and developing and implementing treatment plans for chronic kidney disease or end-stage renal disease patients. | 70% | | Order and schedule laboratory studies, diagnostic procedures, and services such as renal transplant recipient evaluations, changes in immunosuppression, renal biopsies, inpatient and outpatient dialysis, and home health care; explain necessity, preparation, nature and anticipated effects of scheduled diagnostic and therapeutic procedures to the patients. | 10% | | Seek Expert Opinion or advice of collaborating physician when case falls outside of protocol of agency; refer patients to outside physician for consultation and/or specialized health resources for treatment or clinical management. | 5% | | Documentation of Patient Encounters | 10% | | Other duties as assigned | 5% |
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Physical Demands- Required travel between sites.
- Hearing, visual acuity, talking.
- Reaching, grabbing, holding – fine motor skills.
- Extended periods in a stationary or standing position.
- Repetitive motion such as entering data into computer-based programs.
- May be required to assist in patient transfer and should use appropriate techniques and equipment to safely transfer patients.
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Work Environment
Work is normally performed in a typical interior office, hospital, and dialysis medical environment. The noise level is usually moderate. High risk of exposure to blood borne pathogens and OPIM. |