What are the responsibilities and job description for the Advanced Practice Provider II position at Nash County?
Reports to: Director of Nursing; practices under a physician Collaborative Practice (NP) or Supervisory Agreement (PA) per NC rules
Schedule: Monday–Friday, 8:00 a.m.–5:00 p.m.; flexibility for occasional evening clinics and rare weekends based on program needs
Work Locations: Two clinic sites
• Deliver EPSDT/Health Check well-child care and problem-focused visits, including Kindergarten assessments and school/sports physicals.
• Obtain comprehensive medical/surgical/family/social and behavioral/mental health histories; conduct age-appropriate physical and developmental assessments.
• Order/interpret labs and screenings (e.g., lead, hemoglobin, sickle cell, urinalysis; BP, hearing, vision; dental and developmental screening).
• Update immunizations under standing orders and document in NCIR.
• Provide anticipatory guidance and coordinate referrals (PCP, WIC, CDSA, behavioral health, dental).
• Manage common pediatric conditions per protocol; consult or refer for issues outside scope.
Women’s & Reproductive Health
• Perform comprehensive and problem-focused reproductive health visits; provide contraceptive counseling and methods (condoms, oral contraceptives, diaphragm, Depo-Provera).
• Perform LARC insertion and removal per competency and protocol; manage post-procedure care.
• Conduct pelvic/breast exams as indicated; order/interpret labs (urinalysis, hematocrit, pregnancy tests, wet mounts).
• Diagnose and treat vaginitis and STIs per CDC/NC guidelines; order HPV, Hep B, and other indicated vaccines.
• Initiate consultation/referral for abnormal findings beyond protocol; dispense medications per agency pharmacy policy and standing orders.
Maternal Health (Prenatal/Perinatal)
• Complete initial and return prenatal visits per protocol, including comprehensive histories, targeted physicals, fundal height, fetal heart tones, and indicated specimens (e.g., GC/CT, GBS) and Pap per guidelines.
• Order/interpret prenatal labs; treat infections and pregnancy-related conditions within scope; prescribe prenatal vitamins/iron and other medications per standing orders.
• Provide education (warning signs, nutrition, lactation, substance use risk reduction, family planning); coordinate referrals for high-risk pregnancies; ensure continuity with obstetric providers.
STI Services
• Obtain sexual health histories; perform focused exams and collect appropriate specimens.
• Diagnose and treat STIs and conditions such as condyloma per guidelines and standing orders.
• Provide counseling, partner services coordination, and risk-reduction education; offer linkage to HIV care/PrEP/PEP where available; update immunizations under standing orders.
Adult Preventive Health
• Conduct preventive and problem-focused visits, including age- and risk-appropriate screenings (e.g., BP, diabetes/lipids, cervical cancer).
• Diagnose and treat common conditions within protocol; provide education and immunizations; coordinate referrals.
Additional Duties
• Support general clinic services (e.g., pregnancy testing, TB medication administration, vaccine visits, BP checks, injections).
• Precept nurses for adult/child physical assessment as assigned.
• Participate in quality improvement, chart reviews, staff meetings, continuing education, and public health emergency/disaster response.
Cross-Cutting Responsibilities
• Maintain current Collaborative Practice/Supervisory Agreement; participate in required chart reviews and QA per NC rules and agency policy.
• Document thoroughly and promptly in Patagonia Health EHR; ensure accurate coding (ICD-10-CM/CPT), EPSDT/Health Check documentation, and billing compliance.
• Utilize NCIR for immunizations; ensure timely lab follow-up, abnormal result management, care coordination, and referrals.
• Apply health-equity, plain-language, and trauma-informed approaches; use interpreter services appropriately.
• Serve as a clinical resource to multidisciplinary staff; liaise with local physicians, hospitals, schools, and community partners to ensure continuity of care.
• Advanced clinical assessment, diagnostic reasoning, and therapeutic management across assigned programs and age groups.
• Proficiency in interviewing, history-taking, and age-appropriate physical/developmental assessments.
• Knowledge of laboratory testing, screening tools, immunization schedules, health education, and community resources/referral pathways.
• Ability to develop individualized care plans; provide preventive counseling; and communicate clearly with diverse populations.
• Accurate, complete documentation; effective collaboration with supervising/collaborating physicians and multidisciplinary teams.
• Commitment to quality improvement, patient safety, confidentiality (HIPAA; 42 CFR Part 2 as applicable), and health equity.
Work Environment and Physical Requirements
• Primarily clinic-based at two sites and/or mobile unit with frequent intra-county travel; occasional travel to hospitals or community partner sites.
• Possible exposure to blood/body fluids; adheres to BBP and infection control policies; PPE provided.
• May provide services to persons in custody in the agency setting with appropriate security present.
• Requires prolonged standing/sitting, use of exam equipment (stethoscope, BP cuff, otoscope, Doppler), computer/EHR use, and occasional lifting up to 25 lbs.
• Reliable attendance; flexibility to support occasional evening clinics and rare weekend events.
Supervision and Performance Management
• Receives clinical supervision and performance evaluations per agency policy; participates in scheduled chart reviews and QA audits for Child Health, Women’s/Reproductive Health, Maternal Health, Adult Health, and STI/HIV programs.
• Performance indicators may include access (show rates, cycle times), documentation timeliness/accuracy, guideline adherence, immunization coverage, EPSDT compliance, and patient experience.
• Nurse Practitioner: Approved to practice by the North Carolina Board of Nursing and North Carolina Medical Board with a current Collaborative Practice Agreement; or
• Physician Assistant: Licensed by the North Carolina Medical Board with a current Supervisory Agreement; and
• Active, unencumbered North Carolina license (NP or PA); national certification as applicable (e.g., PA-C); valid NC driver’s license; ability to travel between clinic sites.
• Current BLS/CPR.
• Experience in pediatrics/adolescent health, women’s/reproductive health (including IUD insertion and removal), prenatal care, and STI/HIV services.
• Local public health experience; EPSDT/Health Check and immunization/NCIR proficiency.
• Patagonia Health EHR proficiency; mobile health experience.
• HIV counseling/testing certification; Spanish or other language proficiency.
• NIMS/ICS training (IS-100/200/700/800) within 6 months of hire.
• DEA registration preferred (or ability to obtain if required by agency scope).
• Active NC license (NP or PA) and national certification as applicable.
• Current Collaborative Practice/Supervisory Agreement on file.
• BLS/CPR; agency-required vaccinations; valid NC driver’s license.
• DEA registration preferred.