Telehealth Advanced Practice Provider - Temporary

Bargaining Unit: EAP

Rate of Pay: $84.91/hour + DOE (Base pay of $80.87 includes 5% temporary rate)

Summary The Clinics Nurse Practitioner/Physician Assistant is responsible for the primary care of those individuals directed to the clinics via hospital based programs.   Essential Duties and Responsibilities

• Demonstrates clinical competence to provide adult or family primary care through telehealth modalities, with or without sub-specialty expertise, within the APP's scope of practice, clinical privileges, and applicable laws and regulations.
• Provides primary care medical services for assigned patients through telehealth, including preventive care, evaluation and treatment of acute illnesses and injuries when clinically appropriate for virtual management, chronic disease management, health maintenance, and referrals to appropriate in-person services, specialties, or facilities.
• Conducts comprehensive and focused patient assessments through video and other approved telehealth modalities, including obtaining an appropriate medical history and performing an appropriate virtual examination.
• Recognizes the clinical limitations of telehealth and appropriately determines when an in-person physical examination, diagnostic testing, laboratory services, imaging, urgent care, emergency care, or other in-person evaluation is necessary to safely assess and manage the patient.
• Verifies patient identity and location and follows applicable telehealth consent, privacy, security, documentation, and regulatory requirements.
• Orders, performs, and interprets diagnostic tests as appropriate, recognizing when testing or diagnostic evaluation requires coordination with an in-person healthcare location.
• Prescribes medications, therapy, and other specialized medical care consistent with the standard of care, scope of practice, clinical privileges, organizational policies, and applicable laws and regulations.
• Performs appropriate medical procedures within scope of practice as defined by licensing requirements and the health system's credentialing and privileging processes and appropriately identifies procedures or interventions that cannot be safely performed through telehealth.
• Considers a thorough range of treatment and preventive options and arrives at a recommended course of action that is age appropriate, culturally appropriate, realistic, attainable, and appropriate to the patient's ability to access necessary in-person services.
• Appropriately manages patient care and health status following initiation of a treatment or preventive plan through virtual follow-up, monitoring, and reassessment, and adjusts the plan of care as warranted.
• Communicates effectively with patients and families in a virtual environment so that they understand their diagnosis, treatment plan, medications, follow-up requirements, and circumstances that require escalation to in-person or emergency care.
• Educates and encourages patients to become active participants in their healthcare and provides appropriate patient education materials, digital resources, and self-management tools.
• Documents telehealth encounters accurately and in a timely manner within the electronic medical record to facilitate continuity, coordination, and quality of care.  Demonstrates the ability to distinguish between normal and abnormal findings based on available patient history, virtual examination, diagnostic information, and other clinical data, and recognizes when the limitations of virtual assessment require additional in-person evaluation.
• Makes appropriate referrals to physicians, specialists, community agencies, and in-person healthcare services based on the patient's clinical needs.
• Collaborates with and consults supervising physician(s) and other members of the healthcare team when appropriate and required by policy. Completes chart review as required by health system policies and escalates care appropriately when a patient's condition exceeds the APP's training, expertise, scope of practice, or the capabilities of telehealth.
• Coordinates patient care across primary care clinics, specialty services, laboratory, imaging, emergency services, urgent care, and other healthcare resources to ensure appropriate follow-up and continuity of care.
• Assists with EHR inbox coverage and patient triage, including evaluation of telephone calls, electronic messages, test results, medication requests, and other patient communications within scope of practice.
• Provides additional virtual clinical support for patients whose primary provider is out of the office, including appropriate assessment, treatment, follow-up, and coordination of care.
• Provides same-day and urgent telehealth visits when clinically appropriate and directs patients to appropriate in-person urgent care or emergency services when the patient's condition cannot be safely managed virtually.
• Responds to telephone calls, electronic messages, and other patient communications in a timely manner and determines when a communication requires conversion to a telehealth visit or in person evaluation.
• Utilizes telehealth technology, the electronic medical record, and other approved digital health tools effectively to provide safe, efficient, and patient-centered care. Troubleshoots routine technology issues and appropriately transitions the encounter to another modality or in-person care when technology limitations affect safe patient care.
• Maintains a professional, patient-centered virtual environment and establishes effective therapeutic relationships with patients through video and other approved telehealth modalities.
• Adheres to all relevant policies, procedures, practice guidelines, telehealth requirements, professional standards, and applicable federal and state laws and regulations.
• Supports appropriate billing for professional services through timely, accurate documentation and maintains adequate knowledge of the health system's telehealth, coding, billing, and documentation requirements.
• Reviews and follows up on complaints, concerns, and patient feedback related to medical care and the telehealth experience.
• Regularly attends and actively participates in clinic staff meetings, physician/NP/PA meetings, Primary Care Committee meetings, and other meetings as requested.
• Participates in community education and other professional activities to promote access to care, practice growth, health education, and community wellness as requested.
• Maintains positive, caring, and supportive relationships with patients, families, care team members, and clinic staff while working effectively within a virtual care environment.
• Demonstrates System Values in performance and behavior.
• Complies with System policies and procedures.
• Performs other duties as assigned.

Qualifications 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, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.   Supervisory Responsibilities No supervisory responsibilities.   Education and Experience Nurse Practitioner Bachelor’s degree (B.S.) from four-year college or university; Graduation from a National League of Nursing (NLN), Commission on Collegiate Nursing Education (CCNE) or equivalent accredited school of nursing. The nurse shall have completed a nursing education program that included clinical experiences with actual patients under the supervision of qualified faculty. Must be certified by the American Academy of Nurse Practitioners (AANP) or the American Nurses credentialing Center (ANCC).   Physician Assistant Completion of a Physician Assistant program accredited by the Accreditation Review Commission on Education for the Physician Assistant.   Telehealth Competencies Demonstrates proficiency in providing patient-centered care through telehealth modalities; effectively utilizes telehealth technology and electronic health record systems; demonstrates sound clinical judgment regarding the limitations of virtual assessment; appropriately identifies patients requiring in-person or emergency evaluation; and effectively coordinates care across multiple healthcare locations and services.    Licenses, Certifications Required if working in departments 17092-MSC Urgent Care Truckee, 17093-MSC Urgent Care Tahoe City or 17094-MSC Urgent Care Squaw Valley and hired after 8/24/2020: Employee will be enrolled in the Resuscitation Quality Improvement (RQI) Advanced Cardiovascular Life Support (ACLS) Entry or Prep Curriculum (depending on their previous ACLS certification) which must be completed within three (3) months of hire. Anyone hired prior to 8/24/2020 will have three (3) months to obtain ACLS certificate.   Nurse Practitioner:

• Current Advance Practice RN (APRN) licensure to practice in California (and/or NV, depending upon the position being sought)
• Current ANCC (American Nurses Credentialing Center) or AANP (American Academy of Nurse Practitioners) certification required. Current PNCB (Pediatric Nursing Certification Board) or current ANCC is required if requesting to work in pediatrics.
• Current BLS (Basic Life Support) and must maintain certification at all times.
• Must have a Collaborative Service Agreement (CA) or evidence of Supervising Physician Agreement (NV State Medical Board), as applicable, with a designated supervising physician member of the Hospital’s medical staff (upon hiring, manager will initiate).
• Current, unrestricted DEA certificate in CA and/or NV, as applicable (Schedules II-V). Nevada Pharmacy Board certificate, if applying to work in NV.
• Ability to participate in a federally funded program (Medicare and Medicaid)

  Physician Assistant:

• Current CA and/or NV State license in good standing
• Current NCCPA (National Commission on Certification of Physician Assistants) certified
• Current BLS (Basic Life Support) and must maintain certification at all times
• Must have a Collaborative Agreement (CA) or evidence of Supervising Physician Agreement (NV State Medical Board), as applicable, with a designated supervising physician member of the Hospital’s medical staff (upon hiring, manager will initiate).
• Current, unrestricted DEA certificate in CA and/or NV, as applicable (Schedules II-V). Nevada Pharmacy Board certificate, if applying to work in NV
• Ability to participate in a federally funded program (Medicare and Medicaid)
• Physician Assistants must complete an educational course in controlled substances that meets the standards of practice by TFHD and the State of California

  Other Experience/Qualifications None