MAT Physician Assistant Nurse Practitioner

Job Title: Medication-Assisted Treatment (MAT) Physician Assistant or Nurse Practitioner

Job Code: MATPAFNP

Department: Analenisgi Outpatient

Division: Medical

Salary Level: Professional 1

Reports to: Behavioral Health Medical Director/Behavioral Health Assistant Medical Director

Last Revised: September 2024

Primary Function

Provides treatment for patients with addiction and behavioral health treatment needs, as well as direct care/services to pediatric, adolescent, adult and geriatric patients. Responsible for providing the full range of care to patients by examining, diagnosing, and treating patients and their families. The purpose of the work is to treat a wide range of medical problems, which affect the health, and well-being of patient and families served, and to provide medical leadership for the department in providing the best possible quality, safety, service, and stewardship of resources.

Job Description

• Provide medical care in the addiction and behavioral health settings, which may include, but is not limited to A Na Le Ni Sgi, Outpatient Based Opioid Treatment Program (Buprenorphine Clinic), Opioid Treatment Program (OTP), Pain Support Group, Pain Management Evaluations, Direct care extender physician coverage for behavioral health and related programs in both the outpatient and inpatient settings.
• Supervise and evaluate students or residents assigned to behavioral health program settings as directed by the Medical Director and Assistant Medical Director for Behavioral Health.
• Provide reports regarding patient care in regards to evaluation, diagnosis, and treatment options to supervising psychiatrist.
• Refers only the very difficult cases to another specialist.
• Provides for medical aspects of behavioral health care needs of patients. Instructs patients on specific treatment. Transfers patients to Cherokee Indian Hospital inpatient or elsewhere for admission as needed. Refers patients to contract hospitals for medical care and surgery not provided at Cherokee Indian Hospital.
• Works collaboratively with other health care professionals, such as primary care providers, to improve systems of patient care.
• Care and treatment of patients within MAT and OTP (buprenorphine and methadone) per policy and federal requirements.
• Works directly with clinical staff including close communication and collaboration with the OTP Manager and MAT clinicians.
• Provides medical guidance to MAT nursing staff.
• Fills in when needed on Analenisgi inpatient unit including one weekend per month.
• Participates in Cherokee Indian Hospital meetings and committees to develop new, and modify existing, medical policies and procedures relative to patient care with the objective of improving the quality of patient care.
• Participates in community activities and community health planning as necessary. Assists communities in planning community health services projects as needed.
• Maintains patient records in a consistent and organized format utilizing the patient care component of the resource and patient management systems (IHS-RPMS/EHR). Promptly completes forms directly related to patient care, which must be completed by a physician extender. This includes inpatient, outpatient, and emergency room records. Completes patient notes, admissions, discharge summaries and other required documentation within allotted time frames.
• Provides appropriate documentation to substantiate third party billing efforts. Follows Cherokee Indian Hospital procedures for third party billing. Abides by facility compliance plan.
• Observes and abides by the bylaws of the Cherokee Indian Hospital and the rules and regulations of the medical staff.
• Maintains professional certification through participation in appropriate programs of continuing medical education.
• Ensures holistic view of patient through a harm reduction lens.
• The Cherokee Indian Hospital provides services 24/7. Some early morning, evening and weekend work is required.
• Call coverage by phone will be required to be shared with other staff psychiatrists and physician extenders.
• May be necessary to work when Administrative Leave is granted to others if patient care would otherwise be compromised.
• May be necessary to fill in for other providers if patient care would otherwise be compromised.
• Must complete additional SAMSHA and Hospital Privileging for Opioid Treatment program.
• Performs other related duties as assigned.

Education/Experience

• Successful completion of an approved physician assistant or nurse practitioner program.
• Master's degree in Physician Assistant or Nurse Practitioner program from accredited college or university.
• At least two years of experience working as a medical provider treating chronic and acute medical conditions in settings such as, primary care, emergency medicine, urgent care or equivalent.
• Current medical license in State of North Carolina
• Valid driver’s license is required.
• Must have training and experience in behavioral health and the treatment of addiction.
• Must have or apply for SAMHSA exemption to complete OTP admissions within six months.
• Achieve non-core privilege for OTP program prescribing within six months.
• BLS required.
• ACLS certification required
• Will be proficient within 6 months.

Job Knowledge

· Professional knowledge of a wide range of concepts, principles, and practices in the fields of Addiction, Psychiatry and general medicine with the skill to apply this knowledge to difficult work assignments.

· Knowledge of the culture and medical health profile of the patient population.

· Professional knowledge of wide range of health principles, practices and processes including physical and mental health diagnosis, establishment of care goals, development and implementation of the care program and evaluation of the results.

· Ability to collect, organize, record an communicate in a concise method, data pertinent or primary health assessments including detailed family and medical history, physical examinations and selected laboratory tests.

· Ensure knowledge of all SAMHSA guidelines and requirements for OTP.

· Ability to work within a harm reduction setting.

· Ability to order and interpret special screening and diagnostic tests including EKGs, urine drug screens and other labs.

· Skills in making appropriate diagnoses, choosing, initiating and modifying current therapies. Ability to provide preventive service to healthy individuals including guidance in mental health and addictions and ability to teach individuals and families. Skill in working with groups for example guiding families in the development of general problem-solving ability regarding addiction, mental health, medical health problems, assisting with training health workers, and health counseling. Skill in making diagnoses and in choosing, initiating and modifying selected therapies; and ability to provide emergency treatment as appropriate such as management of suicidal or homicidal behaviors.

Complexity of Duties

The work consists of broad processes and functions in Addiction Medicine, Psychiatry, Family Medicine or Internal Medicine involving diagnosis and treatment of patients with an extremely wide variety of physical and emotional problems. The work is characterized by its intensity of effort and involves both episodic and preventive care carried on concurrently in inpatient, outpatient, and emergency room settings. The work is often difficult to perform because of fear and skepticism by patients, undefined problems presenting in advanced stages and often-conflicting data. The work requires continued efforts to establish programs and to resolve chronic medical problems among the population served. The work may require originating new techniques and concepts.

Supervision Received

The Medical Director and Assistant Medical Director of Behavioral Health provides administrative directions with assignments in terms of broadly defined missions and functions. The physician extender has responsibility for planning and carrying out the work independently with regular supervision by supervising psychiatrist. Results of the work are considered as technically authoritative. Work is reviewed through a peer process for quality of services provided. The physician extender keeps the supervisor informed on controversial matters or far-reaching implications.

Responsibility for Accuracy

A high degree of accuracy is required in the proper care of patients. Undetected errors could have minimal to life threatening results. Work is reviewed retrospectively through quality audits.

Guidelines include IHS manuals, Cherokee Hospital policies and procedures, medical journals and textbooks, and Cherokee Indian Hospital Medical Staff bylaws, rules, and regulations, SAMHSA, and DEA. Guidelines are broadly stated. Professional judgment must be exercised to determine the proper course to be taken in the care of patients. In nearly all cases, the medical provider’s judgment is the key factor in determining whether guidelines are to be adhered to or deviated from or whether new guidelines need to be developed.

Contact with Others

Personal contacts are with patients and their families, other staff at the Cherokee Indian Hospital and satellite clinics, outside providers and administrative staff of referral hospital, and tribal representatives. Personal contacts are to elicit pertinent medical information from patients and to treat patients. Other contacts are to encourage and promote health regimens in an effort to improve health, to plan, coordinate or advise on work efforts, and to resolve operating problems. Contacts with patients’ families are to provide information on patient’s condition and to counsel family on care required. A significant amount of contacts involve resolution of problems in treatment of patients through discussion with consulting specialists, federal and state health officials, and patients’ families, each with their own set of beliefs, objectives and goals.

Confidential Data

The provision of medical care requires that the incumbent shall maintain strict appropriate confidentiality regarding all patient information. Will have access to patient records and highly confidential information. Must function with utmost integrity to safe guard this information. Complies with EBCI policy on confidentiality of patient records, Cherokee Indian Hospital Authority Confidentiality policy and HIPAA requirements and CFR 42. Violations of confidentiality regulations may result in disciplinary action.

Mental/Visual/Physical

Job duties can be mentally/emotionally stressful at times. Close mental concentration and attention to detail are required. Physical activities require the ability to walk, sit, reach, bend, and lift while assisting patients to walk, transfer, or turn. Some physical exertion and stamina is required. Must have visual acuity, manual dexterity, and the ability to speak and hear. Must be able to lift 30 lbs.

Environment

Works in an outpatient and inpatient care environment. The work environment involves moderate risks of exposure to infectious disease, radiation, electrical hazards, and irritant chemical and explosive gases. Employee must strictly adhere to OSHA guidelines and protocol for maintaining sterile conditions.

Customer Service

Consistently demonstrates superior customer service skills to patients/customers by demonstrating characteristics that align with CIHA’s guiding principles and core values. Ensure excellent customer service is provided to all patients/customers by seeking out opportunities to be of service.