Physician Assistant/ RN Nurse Practitioner, Renal Transplant

DHR Health - US:TX:Edinburg - Days

Summary:

FLSA STATUS: ☒ Exempt ☐ Non-Exempt

MISSION STATEMENT:

Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time.

VISION:

Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.

POSITION SUMMARY:

Primarily responsible to assess, evaluate and treat patients in the medical office setting, under the supervision and collaboration of a physician, by using advanced knowledge and skill to identify abnormal conditions, diagnose health problems, develop and implement treatment plans, evaluate patient outcomes, and collaborate with the physician in the medical practice for further care management.

POSITION EDUCATION/QUALIFICATIONS:

• Graduate of an accredited school for professional nursing with BSN degree required, MSN preferred. Successful completion of practitioner program. National certification preferred

• Registered Nurse (RN) Texas license and Nurse Practitioner license

• Minimum Two (2) years experience as nurse practitioner with medical office practice preferred

• Excellent customer service skills

• Computer skills required with knowledge of Microsoft Office suite

• Good written and verbal communication skills required

• Bilingual - English/Spanish

JOB KNOWLEDGE/EXPERIENCE:

• Minimum of two (2) years experience in a healthcare setting as a Nurse Practitioner

• Experience in a supervisory position is strongly preferred

• Requires reasoning ability and good independent judgment

• Excellent interpersonal skills and must be able to be sensitive to cultural and bilingual issues

• Organizational skills are necessary

• Good written and verbal communication skills required

• Requires working with frequent interruptions

• Must project a professional image

Responsibilities:

POSITION RESPONSIBILITIES:

Routine Patient Management by PA/NP: The APP will handle follow-ups, routine lab reviews, physical exams, and patient education for stable transplant patients. Clear Scope of PA Practice: Establish clear boundaries on what the APP can manage independently versus cases that require nephrologist involvement. Medical evaluation of patients with advanced chronic kidney disease or end stage kidney disease who apply for kidney transplant at DHR transplant institute. Setting of work DHR Transplant Institute office and/or inpatient at DHR Health Edinburg Hospital

Direct Communication Protocols with Nephrologist:

Daily Check-ins: Schedule structured check-ins between the APP and nephrologist at the start or end of each day to review cases, discuss patient updates, and plan follow-ups. Immediate Communication for Escalation: Ensure the APP has a reliable and immediate means to contact the nephrologist for any changes in patient condition or questions about critical care decisions. Standardized Documentation: Develop a standard documentation procedure to track communications and consultations between the APP and nephrologist, ensuring clear records of all actions and decisions.

PA Coverage for Routine and Non-Urgent Tasks:

Routine Follow-Ups and Lab Reviews: Delegate stable patient follow-ups, routine labs, and non-critical case management to the APP, freeing the nephrologist to focus on high-complexity cases. Patient Education and Support: Assign patient education and any questions about routine post-transplant care to the APP, creating consistent patient communication.

Emergency Escalation Plan:

Backup Nephrologist Access: In the event the primary nephrologist is unavailable, ensure there is another qualified and credentialed transplant physician available to consult and step in as needed. Escalation Protocols: Define specific criteria that warrant escalation to a nephrologist (e.g., significant lab abnormalities, patient instability, unexpected symptoms). The APP should be trained to recognize these indicators for immediate action.

Compliance with UNOS Guidelines:

Document Physician Accessibility: Regularly verify and document that a credentialed transplant physician is available to the APP. This includes updating coverage schedules if the primary nephrologist is out of town. Regular UNOS Compliance Checks: Periodically review UNOS guidelines to ensure the APP-nephrologist setup meets evolving compliance requirements. Adjust protocols as needed to align with any new UNOS requirements or institutional policies.

Monitor and Evaluate Plan Effectiveness:

Monthly Review Meetings: Conduct monthly team meetings to review patient outcomes, address any challenges, and refine the APP-nephrologist collaboration model. Feedback Loop: Gather feedback from both the APP and nephrologist on workload, communication, and patient care effectiveness to identify areas for improvement.

• Primarily responsible to assess, evaluate and treat patients in the medical office setting, under the supervision and collaboration of a physician, by using advanced knowledge and skill to identify abnormal conditions, diagnose health problems, develop and implement treatment plans, evaluate patient outcomes, and collaborate with or refer to a physician in the medical practice for further care management

• Actively demonstrates the organization's mission and core values, and conducts oneself at all times in a manner consistent with these values

• Knows and adheres to all laws and regulations pertaining to patient health, safety and medical information

• Performs complete, accurate history and physical assessment/examination as appropriate for patient setting/type of visit and closes notes on a daily basis for all patients

• Orders, performs and interprets diagnostic tests and accurately, communicates results to patient, completes all documentation, adhering to compliance standards for documentation, coding/billing and collaborative supervision. Reports abnormal findings to collaborative/supervising physician

• Prescribes appropriate treatment, pharmacological agents and/or other non-pharmacological interventions

• Completes simple and complex procedures independently. Reports adverse patient responses to collaborative/supervising physician

• Provides direct patient and family education regarding patient medical condition/disease process, treatment methodologies, outcomes management, wellness and prognosis

• Determines the effectiveness of patient care plans, treatment and interventions through reassessment and modifies as necessary to achieve patient health status goals. Reports significant plan changes to collaborative/supervising physician

• Responsible for communication with physician regarding variations from normal and evaluation of patient outcomes. Collaborates with physician and other members of health care team to provide individualized plan of care

• Participates in medical record, patient care, quality assurance, process improvement and compliance audits, evaluations and follow-up

• Demonstrates flexibility and responsiveness in handling schedule coverage and service excellence

• Performs other duties consistent with purpose of job, effective operation of medical practice and access/delivery of care to patients as directed

• Other duties as required

Other information:

LINES OF REPSONSIBILITY:

(Chain-of-command)

1. Practice Manager → 2. Director of DHR Health Clinics → 3. Chief Ambulatory Officer

CUSTOMER SERVICE:

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC:

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA):

A. Essential Duties: Indicated by bold print within performance standards, preceding individual numbered criteria.

The following table provides physical requirements that will be associated with, but not limited to, this position:

Light/moderate lifting up to 20 lbs, from the floor to shoulder height.

Yes

Kneeling

Yes

Must be able to assist other employees with lifting more than 20 lbs.

Yes

Walking

Yes

Light/moderate carrying up to 20 lbs.

Yes

Standing/Squatting

Yes

Straight pulling

Yes

Sitting

Yes

Pulling hand over hand

Yes

Pushing

Yes

Repeated bending

Yes

Stooping/Bending

Yes

Reaching above shoulder

Yes

Climbing Stairs

Yes

Simple grasping

Yes

Climbing Ladders

No

Dual simultaneous grasping

Yes

Depth Perceptions needed

Yes

Ability to see

Yes

Identify Colors

Yes

Operating office equipment

Yes

Twisting

Yes

Operating mechanical equipment

Yes

Crawling

No

Ability to read and write

Yes

Ability to Count

Yes

Ability to hear verbal communication without aid

Yes

Operating Personal Vehicle

Yes

Ability to comprehend written/verbal communication

Yes

Other: Ability to deal with stress

Yes

OSHA Category

III

B. Working Conditions: The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.

C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

D. Aptitudes: HIGH 1 2 3 4 5 6 LOW

Intelligence: General learning ability: The ability to "catch on" or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical: Ability to perform arithmetic operations quickly and accurately. 2

Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to "visualize" objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2

Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3

Finger Dexterity: Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3

Manual Dexterity: Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3

Eye-Hand-Foot Coordination: Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3

Color Discrimination: Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3

I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.

If applicable ____________ certification will be completed within _________ time frame of hire/transfer date.

Employee Signature: ________________________________ Date: ____________________

Transfer/Hire Date Effective: ________________________.