Advanced Practice Provider (45339)

Under general supervision of the Chief Medical Officer, the Advanced Practice Provider (APP), Nurse Practitioner (NP) or Physician Assistant (PA) provides comprehensive medical care for ambulatory patients, including chronic disease management, continuity and acute care for individuals of all ages at the Winslow Indian Health Care Center (WIHCC) and/or Dilkon Medical Center (DMC), including the Leupp satellite clinic. The APP works under supervision, but is expected to function autonomously in a variety of clinical settings. Uphold the principles of WIHCC’s Vision, Mission, and Value Statements. Maintains confidentiality of all privileged information at all times.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive.

Essential Duties & Responsibilities:

• Maintains regular attendance and punctuality.
• Provides diagnostic, preventative, and therapeutic health services to patients of all ages in a primary care setting, with the ability to function as an independent practitioner at isolated field clinics on Navajo Reservation. 
• Secures a medical and developmental history from the patient or parent and performs a detailed physical exam, records findings, and makes critical evaluations. 
• Orders diagnostic tests and procedures and interprets the results.  
• Discriminates between normal and abnormal findings to recognize early stages of physical, physiological, emotional, or mental problems.
• Makes decisions concerning medical care needs of patients which may involve various treatment modalities, medication prescription, and consultant/referral, and follow-up services when appropriate. 
• Provides direct and independent medical care in the presence of illness or injury in order to maintain life, provide comfort, reduce distress, and enhance coping ability. Notifies supervisor of all emergencies or unusual situations, as appropriate.
• Educates and counsels patients and families on topics to promote positive health outcomes, emphasizing responsibilities of medical care, diagnosis, treatment, and preventative care.
• Works collaboratively with physicians in management of selected complex medical problems. 
• Provides guidance to field clinic personnel in emergent situations regarding triage and disposition of patients. 
• Serves as a consultant and works collaboratively with other WIHCC staff, including clinic nursing, community health nursing, social work and other disciplines regarding clinical issues and policies.
• Documents medical care appropriately in the electronic health record, and in keeping with national standards as mandated by CMS and AAAHC. Documentation for completed patient encounters shall be sufficient to support appropriate billing for services by WIHCC. 
• Ensures clinical care is consistent with standards of practice, guidelines, and specific department policies and procedures.
• Attends department meetings and in-services of the medical staff or as specified by the Chief Medical Officer.
• Maintains professional knowledge, skills, and refines expertise by attending continuing education programs; maintains certification in compliance with Arizona state laws, and participates in professional affiliations.
• Maintains regular attendance and punctuality.
• Dependable in attendance and job performance.
• Ability to meet attendance, overtime, and other reliability requirements of the job.
• Uphold all principles of confidentiality and patient care to the fullest extent.
• Adhere to all professional and ethical behavior standards of the healthcare industry.
• Interact in an honest, trustworthy and dependable manner with patients, employees and vendors.
• Possess cultural awareness and sensitivity.
• Performs other duties as assigned.

Minimum Qualifications:

Family Nurse Practitioner requires completion of an accredited nursing program, valid unrestricted Registered Nurse license and license as a Nurse Practitioner, along with prescribing privileges. Physician Assistant requires completion of an accredited training program for Physician Assistants, certification from the national qualifying exam, and an Arizona license as a PA. Candidate must have demonstrated experience with electronic medical record systems. Advanced FNP/PA experience is required: minimum of two years demonstrated clinical experience as a licensed FNP/PA in a family practice or general practice setting including pediatrics, preferably with at least eighteen months in one location highly encouraged. For Urgent Care/ER, minimum of two years of Emergency Room/Urgent Care experience and current training in ACLS and PALS preferred. Must maintain a valid unrestricted and insurable driver’s license. Must successfully pass a background investigation and maintain suitable requirements for a Child Care position. This position is considered as a Child Care position, which requires a satisfactory background check investigation and is subject to the requirements of the Indian Child Protection and Family Violence Prevention Act, as amended (henceforth referred as the ICPFVP Act).

Knowledge, Skills, Ability:

• Knowledge of advanced practice provider principles, practices and procedures in providing comprehensive health programs in clinics, home, and community environments.
• Knowledge and skills necessary to assist in providing care appropriate to the age of the patients served.
• Knowledge and applied skills in utilizing concepts of adult education including motivational interviewing to promote behavioral changes.
• Knowledge of moral and customs of the ethnic group within the area and the ability to generate an appreciation of cultural differences.
• Knowledge of drugs and biological effects, and the desired effect on treatment of disease.
• Knowledge of strong work ethics in the workplace.
• Knowledge of basic application of confidentiality.
• Knowledge of basic computer skills, e.g. Outlook, Word, Excel, PowerPoint.
• Possess excellent interpersonal skills in handling interactions with hospital staff, other agencies, groups, and patients and families.
• Ability to maintain and renew required licensure for position.
• Ability to work as a team member and develop productive and cooperative working relationships with health care providers within the facility as well as healthcare providers in hospitals and nursing homes, private practitioners and law enforcement agencies throughout the community.
• Ability to take medical histories, conduct physical examinations and communicate results of laboratory tests
• Ability to be dependable in attendance and job performance.
• Ability to meet attendance, overtime (if necessary), and other reliability requirements of the job.
• Ability to accept and learn from feedback.
• Ability to communicate effectively both verbally and in writing.
• Ability to provide exemplary customer service at all times.
• Ability to interact positively with others and possess great interpersonal skills.
• Ability to multitask and perform well under pressure.
• Ability to have self-confidence.
• Ability to be a great team player.
• Ability to accept and learn from supervisor/peer critique.
• Ability to be flexible and adaptable to the changing needs of the organization.

Physical Demands:

While performing the duties of this job, the employee regularly is required to walk; sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to stand; climb or balance; and stoop, kneel, crouch, or crawl. The employee frequently is required to taste or smell. The employee must occasionally lift and/or move up to 50 pounds.    

Work Environment:

Work is performed in a clinical and office setting with a moderate noise and distraction level and exposure to various dusts and mists; and occasionally an outdoor setting with exposure to natural weather conditions. Work environment may involve exposure to physical risks, such as blood-borne pathogens and patients with infectious disease, and may involve operating potentially dangerous equipment or working with chemicals. Evening and/or weekend work may be required. Extended hours and irregular shifts may be required.

As required by P.L. 93-638, absolute preference will be given to qualified Navajo applicants.  If there is no qualified Navajo applicant, preference will be given to qualified American Indian applicants.