Adult Nurse Practitioner

Medical training for family practice, general practice or other primary care practice orientation, with understanding and interest in preventive and community health.

II. RESPONSIBILITIES:

A. Examine and treat patients in the office. B. Admit and treat patients in the hospital (OB/GYN, if applicable). C. Refer patients for specialist services, as required. D. Occasionally rotate on call for emergencies, evenings and weekends, or travel to another site. E. Examine and treat patients in emergency settings when appropriate. F. Maintain accurate and complete electronic and/or paper documentation of patient care services. G. Review lab, x-ray, and emergency reports daily. H. Coordinate and communicate with medical support personnel. I. Provide back-up and development of standing orders for clinical standardized care. J. Participate in special screening, training, and community outreach activities as determined. K. Participate in cooperative arrangements with other health providers in the area. L. Participate in the drafting of medical policies in conjunction with GMC Chief Medical Officer and the Chief Executive Officer. M. Perform all other medically-related assigned duties. N. Regularly review all communications from Goshen managers and other staff that are sent through inter-office “regular” mail and e-mail systems, and respond as requested.

III. JOB FACTORS:

Physical Requirements: Requires considerable physical effort most of the day. Requires squatting, kneeling, reaching, twisting, walking, lifting supplies and sitting for long periods of time. Mental Requirements: Must be able to make sound judgment based on assessment and data available and act accordingly. Must be able to be flexible, innovative, and work independently. Must possess skills for computer usage and written and oral communication. Must possess good interpersonal skills and ability to prioritize multiple functions or tasks; and must have tolerance for unpredictable circumstances and usual stress of coping with the human nature of staff and patients. Hours: Must be able to work a flexible work schedule including all week days, and on the rare occasion, some weekends, evenings, and holidays if needed.

IV. SUPERVISORY RELATIONSHIPS:

Responsible for all medical support personnel regarding patient care. Responsible to the Chief Medical Officer for clinical concerns and to the Executive Director for administrative issues. Provider Responsibilities

1. The Provider shall devote his/her best professional skill and services in practicing medicine in accordance with the customary rules of ethics and conduct of the general practice of medicine, and specifically, as set forth by the North Carolina Board of Medical Examiners.
2. The Provider will comply with GMC’s requirements for: pre-employment drug and alcohol screening, criminal background check, and national databank search, with the understanding that any incriminating results are grounds for dismissal.
3. The Provider will complete all required Federal and State onboarding processes, forms, applications, etc., whether through paper form or electronic submission.
4. The Provider employed on a full time basis agrees to be on site a minimum of 40 hours per week, less Goshen Approved Holidays and Paid Time Off (PTO) and Continuing Medical Education (CME).
5. The Provider employed on a part time basis agrees to be on site a minimum of 32 hours per week, less Goshen Approved Holidays and Paid Time Off (PTO) and Continuing Medical Education (CME.
6. GMC awards the Provider with 21 PTO days for full-time and 16 PTO days for part-time per year, which are cumulative and may be used in subsequent years if not the current year.
7. GMC awards the Provider 4 CME days off (32 hours) for full-time and 3 CME days off (24 hours) for part-time per year (non-carryover, “use-them-or-lose-them”), and GMC encourages the Provider to use these CME days to stay current on education and skill.
8. Lunch hours” are mandatory daily, and can’t be “worked through” to shorten days. Extended hours (early starts or long days) are permissible as long as they are productive. With prior approval, extended hours may be worked to create a short day, or a 4 day work week (as for working four 10-hour days). The only exception to the “lunch hours” rule above, is when extended hours have been worked to enable to provider and staff to work a Friday (for example) from 8:00 until 1:00 to complete the 40 hours that work week.
9. The Provider agrees to arrive at work on-time and to productively work during all hours scheduled.
10. The provider agrees to appropriately use the 30 minutes per day allocated for administrative time (to do paperwork), as scheduled by the site leader, and will not abuse the allocated time, such as by leaving work 30 minutes early or by taking extended lunches beyond the allotted hour.
11. The Provider is required to obtain and retain a state medical license and DEA number.
12. The Provider may choose to work extended hours (Saturdays or evenings), as mutually agreed, for compensation at either the provider’s encounter rate or a pre-approved rate.
13. The Provider agrees to occasionally volunteer for community service and outreach activities, such as a health fair, health screening, or educational activity for a local church, school, civic club or community center. Such time is voluntary and should help the Provider to achieve patient encounters as well as marketing, community relations and community service. The Provider agrees that no comparable compensation given for such volunteer “extra” hours of service. FTCA will provide malpractice coverage for all such outreach done on behalf of Goshen Medical Center, Inc.
14. The Provider agrees to provide direct medical care to all patients accepted for services at GMC, and will follow proper protocol and the leadership of the Chief Medical Officer when it seems necessary to dismiss any patients who prove to be too difficult, disruptive or dangerous to serve.
15. The Provider agrees to provide all information needed to complete all Licensure Credentialing process, procedure, and paperwork as directed by GMC to obtain Federal Tort Claims Act coverage for the provider s work with GMC and to obtain payment for services .
16. The Provider also acknowledges that all fees collected as a result of professional services rendered shall be the property of the Corporation.
17. The Provider agrees to complete all required documentation of medical records (electronically and in some situation using paper) in a timely manner (48 hours, unless otherwise notified) to completeness of documentation and to support billing activities to be done by other GMC staff.
18. The Provider agrees that GMC has the right to discuss all such issues with any officials, including such authorities as the hospital administration, the Chief Medical Officer, physician-led committees, state medical boards, or any other licensing or credentialing authority, etc. The Provider has no “right to privacy” regarding any issue that has implications for quality of care or qualifications or skills or job-relevant behaviors of the Provider.
19. The Provider agrees to fully disclose any and all such information, sanctions, reprimands or performance feedback to GMC within two weeks of its reception.
20. The Provider shall perform such administrative and managerial duties as may be assigned to him/her by GMC (CEO/CMO) from time to time, including but not limited to, regular health center management, Quality Improvement meetings, and clinical policy and procedure development, review and/or revision, training sessions, which may occasionally be held at Lunch or rarely After-Hours dinner meetings.
21. The Provider will devote full time attention to rendering quality professional services on behalf of the Corporation. “Moonlighting” is permitted as long as it does not interfere with work at Goshen. The Provider will provide the CMO with a written plan for moonlighting, which demonstrates no negative results for Goshen, doesn’t divert Goshen patients to another practice, and does not lead to burnout and fatigue which could diminish the Provider’s ability to render full effort during normal working hours.
22. The Provider agrees to cooperate with operational initiatives for improvement of the business.
23. The Provider agrees with GMC’s mission of improving access to care and agrees to work a schedule of patients that roughly corresponds to 15 minutes per patient, with 30 minutes for new patients and physicals.
24. The Provider agrees to see “walk-ins” on short notice, as needed and as possible, such as to fill empty time slots on the schedule created by “no-shows” and to promote patient access to care.
25. The Provider agrees that the site leader controls the schedule and holds the authority to schedule patients in accordance with GMC policy and standard operating procedures. GMC acknowledges that the Site Leader will work with the Provider to optimize use of time in providing access to quality care for our patients.
26. The Provider agrees not to arbitrarily refuse to see patients, except with approval by the Chief Medical Officer, such as when a patient is a potential danger, a disruptive influence on operations, or a drug-seeker. See Discharge Policy for more detail.
27. If the Provider decides to terminate employment with Goshen Medical Center, Inc., the Provider agrees to provide a written notice of resignation 90 days in advance of the last day of work. (If the Provider quits work and fails to give at least 90 days advance notice, the Provider forfeits all PTO and will be required to repay any monetary advances, costs of recruitment or costs of processing visas, work permits, etc.).
28. The Provider agrees that his/her employment may be immediately terminated by Goshen Medical Center, Inc. if he/she willfully breeches, repeatedly fails to perform; or habitually neglects the duties which he/she is required to perform under the terms of this agreement; or if the Provider endangers the health and wellbeing of patients; or if the Provider repeatedly engages in behaviors that are emotionally disruptive, abusive, or disrespectful toward co-workers or patients. In particular, refusal to see patients, repeated failures to complete documentation, to attend work, or to fulfill the hours of productive work, will not be tolerated.
29. The Provider agrees to refrain from practicing primary care medicine within 20 miles of the assigned practice site of GMC for a period of two (2) years after the date of termination of employment. At all times thereafter, irrespective of the time, manner or cause of termination, Employee shall hold in strictest confidence, and not disclose directly or indirectly to any person outside of the employ of the Corporation, without the express authorization of the Corporation, any information including, but not limited to, patient lists, relating to the services, income, or business of the Corporation. For a period of two (2) years from the date of termination, Provider shall not engage or participate in any effort or act to induce any of the patients, associates, or employees of the Corporation to take any action or refrain from taking any action which action or inaction might be disadvantageous to the Corporation, including but not limited to removal of patients lists from the premises of the Health Center and the solicitation of such patients, associates, or employees to cease doing business, association, or employment with the Corporation. This prohibition includes all actions to solicit patients through any form of advertisement or public promotion or private conversation (including, but not limited to handing out business cards, brochures, posters, newspaper ads, etc.).

Provider represents and warrants to Employer that:

1. Provider is not subject to any other restraints which would impair or encumber Provider’s ability or authority to perform the duties described in this Agreement;
2. Provider is not currently a party to any claim or lawsuit involving Provider’s prior medical practice and knows of no facts which would cause Provider to believe any claim or lawsuit would be filed; and
3. Provider has not been excluded from participation in any federal health care program, as defined under 42 U.S.C. §1320a-7b(f), for the provision of items or services for which payment may be made under such federal health care programs. No final adverse action, as such term is defined under 42 U.S.C. §1320a-7e(g), has occurred or is pending or threatened against Provider.
4. Provider agrees to complete: Provider Disclosure and Attestation Regarding Compliance with Federal Statues Relating to the “Stark Act” and “Anti-Kickback Law” as a condition of employment with GMC.

PROBATIONARY PERIOD

The Provider agrees that his/her permanent employment is subject to a 90 day probation period, as with all other employees. The new employee will be evaluated at 45 days of employment regarding the progress and skills in performing role and responsibilities of the position. If the Provider fails to meet the requirements of the job duties and responsibilities, Goshen Medical Center, Inc. will not retain the Provider as a permanent employee entitled to all due benefits of the position. The following factors will be evaluated at 45 days (as will be done in subsequent annual reviews): a. Teamwork (with colleagues, staff, supervisors, the executive team) b. Productivity (measured in completed and signed encounters) c. Quality (based upon review of outcome measures: UDS, PCMH, MU, etc.) d. Accuracy (based on performance on the documentation and coding audit) e. Peer review (as performed by Clinical peer) f. Review of credentialing (see Credentialing and Privileging policy and procedure) g. Patient Satisfaction (as recorded from via paper and/or electronic surveys) #J-18808-Ljbffr Goshen Medical Center