Nurse Practitioner - Dually Licensed (PMHNP and FNP/AGNP)

Nurse Practitioner - Dually Licensed (PMHNP and FNP/AGNP)

Mainspring Recovery is seeking a Nurse Practitioner to join our interdisciplinary clinical team supporting individuals in recovery from substance use disorders (SUD) and co-occurring mental health conditions. This position may be filled by a Psychiatric Nurse Practitioner (PMHNP) or a Medical Nurse Practitioner (FNP/AGNP) depending on the candidate's licensure and area of expertise. The NP will provide specialty-focused care psychiatric or medical while maintaining a whole-person approach aligned with Mainspring's mission.

Key Responsibilities:

• Upon admission, conduct a comprehensive specialty-specific intake evaluation:
• For Psychiatric NPs (PMHNP):
• Complete psychiatric intake evaluation including mental status exam (MSE), trauma history, and psychiatric review of systems
• Diagnose and document DSM-5 psychiatric conditions (e.g., mood disorders, anxiety, PTSD, psychosis) co-occurring with SUD
• Assess suicide/homicide risk and establish a safety plan
• Review current psychotropic medication history and identify medication-assisted treatment (MAT) need
• Establish an individualized psychiatric treatment plan with short- and long-term goals
• Routinely approve continuation of medications upon intake until full assessment can be completed.
• For Medical NPs (FNP/AGNP ):
• Perform a full history and physical examination (H&P) upon admission
• Identify and document acute and chronic medical conditions impacting SUD/MH treatment
• Complete a medical review of systems, addressing concerns common in SUD populations
• Order and interpret admission labs, toxicology screens, and diagnostic imaging/tests as indicated
• Establish an individualized medical treatment plan addressing the patient's needs during Mainspring care
• Routinely approve continuation of medications upon intake until full assessment can be completed
• SUD & Mental Health Focus During Mainspring Care:
• Identify and address SUD-specific clinical needs including withdrawal management, detox monitoring, and MAT initiation or continuation (buprenorphine, naltrexone, etc.)
• Collaborate with counselors, case managers, and behavioral health staff to ensure psychiatric and medical needs are integrated into the patient's individualized treatment plan
• Participate in interdisciplinary treatment team meetings and case conferences
• Provide clinical consultation to staff regarding the intersection of medical/psychiatric conditions and SUD recovery
• Screen for co-occurring disorders and refer internally or externally as appropriate
• Routine Follow-Up & Ongoing Care:
• Conduct scheduled follow-up appointments throughout the patient's stay to monitor treatment response, medication efficacy, and overall health status
• Reassess and update the care plan based on patient progress, emerging concerns, or changes in clinical status
• Document all clinical encounters, assessments, and care plan updates accurately and in a timely manner in the EHR
• Monitor vital signs, labs, and diagnostic results; communicate critical values and initiate appropriate follow-up
• Provide patient education regarding diagnosis, medications, side effects, and self-management strategies relevant to SUD recovery
• Medication Ordering & Prescribing:
• Prescribe and manage medications within scope of practice, including MAT medications, psychiatric medications, and medications for co-occurring medical conditions
• Conduct medication reconciliation upon admission, during treatment, and at discharge
• Monitor for medication interactions, contraindications, and adverse effects with attention to substances common in SUD populations
• Utilize the Virginia Prescription Monitoring Program (PMP) as required prior to prescribing controlled substances
• Collaborate with the Medical Director on complex or high-risk medication regimens
• Peer-to-Peer Reviews & Utilization Management:
• Complete peer-to-peer (P2P) reviews with insurance medical directors as required to advocate for medically necessary levels of care, continued stays, or treatment services
• Document clinical justification for level-of-care determinations in alignment with ASAM criteria
• Communicate with payers and utilization management teams to support authorization of clinical services
• Partner with the clinical and administrative team to ensure timely completion of P2P requests to avoid disruptions in patient care
• Additional Responsibilities:
• Refer patients to outside healthcare resources and specialists when clinical needs exceed on-site scope of care
• Maintain up-to-date knowledge of SUD treatment guidelines, MAT protocols, and psychiatric best practices
• Perform all other duties as assigned by the Executive Director or Medical Director

Minimum Qualifications:

Education / Credentials

• Active Nurse Practitioner licensure in the Commonwealth of Virginia (required)
• Board certification as a PMHNP-BC, FNP-C/FNP-BC, or AGNP-C/AGPCNP-BC
• Active DEA registration in Virginia (required)
• Current BLS/CPR certification (required)

Experience

• Minimum of one (1) year of clinical experience in a psychiatric, SUD, behavioral health, or related healthcare setting preferred
• Experience with medication-assisted treatment (MAT) preferred
• Experience completing peer-to-peer reviews with insurance companies preferred

Knowledge / Skills

• Strong clinical assessment skills with ability to identify and manage acute and chronic conditions in SUD/MH populations
• Familiarity with ASAM criteria and levels of care for SUD treatment
• Proficiency with electronic health records (EHR)
• Excellent written and verbal communication skills
• Commitment to trauma-informed, culturally responsive, and patient-centered care

Working Conditions:

• Direct Care Position
• Full-time, 40 hours per week, Monday-Friday 9:00am-5:30pm, on-call
• On-site

Why This Role Matters

• At Mainspring Recovery, we believe that healing from substance use disorder requires addressing the full picture of a person's health mind and body. Our Nurse Practitioners are essential to that mission. Whether your expertise is psychiatric or medical, your work directly supports patients in one of the most vulnerable and transformative periods of their lives. You will be part of a compassionate, collaborative team dedicated to meeting patients where they are and guiding them toward lasting recovery.

Pre-Employment Requirements

Mainspring conducts, as required, job-related background checks, drug testing, TB testing, verification of employment history, and/or reference checks prior to employment.

Equal Employment Opportunity Statement

Mainspring is an Equal Opportunity Employer. Employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, veteran status, or any other protected status in accordance with applicable federal, state, and local laws.

EEO is the Law: