Psychiatric Nurse Practitioner (PMHNP) or Psychiatric Physician Assistant

Psychiatric NP or PA — Pediatric Integrated Behavioral Health

The Children's Clinic of Billings is a physician-owned general pediatrics practice with two locations in Billings, Montana, serving patients from newborn to 21 years. We have had an embedded psychiatric provider since 2022 and know this model is amazing for our patients and our general pediatric providers. Our current psychiatric mental health nurse practitioner is moving out of town and we are looking for a new provider who is ready to be the embedded psychiatric resource for our pediatric patients and our PCP team.

What Makes This Role Unusual

Most psychiatric positions are built around long-term patient panels. This one is not.

Our Integrated Behavioral Health program runs on a consultation and stabilization model: our PCPs try first- and/or second-line treatment first. When a patient needs more than that — a more complex medication regimen, more frequent visits, or clinical expertise beyond what a general pediatrics schedule allows — they refer internally to you. You conduct a comprehensive intake, develop a plan, stabilize the patient over a defined episode of care, and hand them back to their PCP for ongoing management. Then you move to the next patient who needs what you uniquely offer.

If you find real satisfaction in the intensive phase of psychiatric care — the evaluation, the medication puzzle, the moment a regimen clicks for a kid who has been struggling — this program is built around exactly that.

This is a medication management role. We are not looking for a therapist or counselor currently.

What You'll Do

• See patients referred internally by our PCPs after first- and/or second-line treatment has been attempted. Patients range in age from approximately 4 to 21, though we treat as young as the provider is clinically comfortable and can adjust that age range as appropriate.
• Conduct comprehensive psychiatric intakes (currently 1.5 hours) and follow-up visits (currently 30 minutes) on a biweekly cadence (or a different frequency, as needed).
• Triage patients alongside PCPs to determine which are appropriate for an IBH psychiatric medication management program and which patients need long-term psychiatric support in the community, offering bridge care when appropriate until the patient can get in with an outside psychiatric provider.
• Manage a broad range of pediatric psychiatric conditions: ADHD, anxiety disorders, depression, bipolar disorder, DMDD, ODD, tic disorders, eating disorders, personality disorders, and more.
• Prescribe and manage psychiatric medications, including poly-pharmacy regimens, second-generation antipsychotics, and medications requiring careful titration in younger patients.
• Collaborate closely with PCPs to ensure every patient has a clear path back to primary care management once stable.
• Serve as a clinical resource for our PCP and nursing team on behavioral health medication management and triage.
• As the program grows, contribute to expanded IBH initiatives including Collaborative Care Management (CoCM), brief behavioral interventions, and psychology integration — though none of these are a current-day expectation.
• Document accurately and timely in Epic EHR.

Who We're Looking For

• PMHNP or PA with formal psychiatric training. Physician psychiatrists interested in IBH work may also apply, though we may need to make adjustments to our current model.
• Pediatric psychiatric experience is required. The medication titration work for younger patients is meaningfully different from adult psychiatric practice, and adult-only experience is, unfortunately, a disqualifier.
• Proficiency with poly-pharmacy, second-generation antipsychotics, and working with children, including young children.
• Someone drawn to consultation-style work and episodic care vs. managing a stable long-term panel.
• A warm, collaborative clinician who will integrate into a close-knit PCP team and be trusted as a resource by both providers and families.
• Current Montana licensure or eligibility to obtain it prior to start.

The Schedule

Full-time is preferred, but part-time will be considered. Full-time at Children’s Clinic is typically considered four, 10-hour shifts per week. However, we would also be interested in exploring three extended clinic days weighted toward after-school and early evening hours to better serve school-aged patients and their working families. This role will initially be 100% in person; however, some remote shifts doing telehealth may be considered after the probationary period.

Compensation & Benefits

• Base salary benchmarked to MGMA median for NP: Psychiatry, with a production bonus for wRVUs above the median threshold — no cap.
• Comprehensive benefits: medical, dental, vision, and more.
• Approximately 22 days PTO to start.
• 401(k) with employer match and generous profit sharing after one year.
• Continuing education allowance.

Apply

If you are a psychiatric NP or PA with real pediatric experience and you are looking for a distinctive practice model in a growing Montana city, we would like to talk!

The Children's Clinic of Billings is an equal opportunity employer.

Pay: From $145,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Relocation assistance
• Retirement plan
• Vision insurance

Experience:

• Pediatric psychiatry: 1 year (Preferred)

Work Location: In person

Salary : $145,000