Advanced Practice Provider III (Nurse Practitioner or Physician Assistant)

Advanced Practice Provider III

The Advanced Practice Provider III serves as the lead clinical provider for the Nash County Health Department, responsible for advanced-level medical care, oversight of other clinical extenders, and coordination of multidisciplinary services. This position provides independent, comprehensive, patient assessment, diagnosis, treatment, and follow-up care within a broad scope of public health settings and specialized clinical environments involving child and adolescent health (birth to 20 years), women's and reproductive health, maternal health, sexually transmitted infection (STI) services, and adult preventive health in a local health department setting.

Practice under approved standing orders, agency protocols, and a current Collaborative Practice (NP) or Supervisory Agreement (PA) consistent with North Carolina Board of Nursing and North Carolina Medical Board requirements. The APP III exercises significant clinical judgment with reduced direct supervision. This role ensures high-quality care delivery by leading other clinical providers, supporting adherence to clinical protocols, coordinating training, and driving continuous improvement in clinical operations. Core functions include advanced assessment, ordering and interpreting diagnostics, prescribing treatment, immunization management, meticulous EHR documentation, care coordination and referrals, and participation in quality improvement and population health goals using trauma-informed, culturally responsive, and health equity principles.

Essential Duties and Tasks

Clinical Leadership, Supervision, Oversight and Performance Management

• Function as the lead clinician, offering guidance, mentorship, and functional supervision to clinical providers, nursing personnel, and other clinical service providers in conjunction with the Lead Clinic Nurse and Clinical Nurse Supervisor.
• Provide direct supervision and oversight of all assigned clinical providers.
• Reviews performance indicators which may include access (show rates, cycle times), documentation timeliness/accuracy, guideline adherence, immunization coverage, EPSDT compliance, and patient experience.
• Coordinate all activities related to precepting students, including scheduling, oversight, evaluation, and ensuring adherence to departmental training standards.
• Participate in quality improvement, chart reviews, staff meetings, continuing education, and public health emergency/disaster response.
• Conducts regular reviews of standing orders for all programs and works in collaboration with the medical doctor to maintain and update clinical directives.

Child & Adolescent Health (Birth20 Years)

• 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

Additional Duties

• Support general clinic services (e.g., pregnancy testing, TB medication administration, vaccine visits, BP checks, injections).

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.

Knowledges, Skills and Abilities

• 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.

Desirable Education and Experience

Minimum Qualifications (Required)

• 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
• Two years of experience as an Advanced Practice Provider or an equivalent combination of education and experience.
• Current BLS/CPR.

Preferred Qualifications

• 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).

Benefits

Nash County offers cafeteria-style benefits including:

• Health Insurance
• Dental Insurance
• Life Insurance
• Vision Insurance
• Supplemental Health Benefits (Accident, Critical Illness, and Hospital Indemnity Insurances)
• Disability Insurance (Long-Term and Short-Term Disability)
• Retirement Membership in the North Carolina Local Government Employees Retirement System is a requirement for all regular full-time and regular part-time employees. Employees contribute 6% of their annual compensation before it is taxed. If you leave County service before retirement, you may withdraw your retirement contributions or elect to freeze your contributions in anticipation of future local