Advanced Practice Provider II

Department:

Public Health 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 Provide comprehensive, patient-centered clinical services across 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. 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. Child & Adolescent Health (Birth-20 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 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. Knowledge, 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. 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. 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

• 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. 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). Licensure/Certification (Must Maintain)
• 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.