JONES COUNTY

Advanced Practice Provider II

Hiring Range: $98,844 - $111,834

Note: If we are unable to recruit a fully qualified candidate for the Advanced Practice Provider II position, we are open to considering applicants for a related role with growth potential.

I.A. Primary Purpose of Organizational Unit: The Jones County Health Department staff serves around 9,500 citizens with the primary mission devoted to promoting sound health policies within the community, to preventing and controlling the spread of disease, to facilitating rehabilitation of the disabled and to safeguarding the integrity of the environment. Employees and contracted staff provide a myriad of health and environmental services to the residents of Jones County.

B. Primary Purpose of Position: The purpose of this position involves performing advanced level of professional medical acts to include making medical diagnoses and dispensing medical treatment. Position serves as an extension of a physician providing services in all health department personal care programs. Position is also accountable for assisting staff nurses when decisions are beyond their scope of practice. Employee supervises medical acts of the public health nurses and assists with the formulation of policies and/or procedures.

C. Work Schedule Normal working hours are Monday through Thursday, 8:00 am to 5:00 pm and Fridays 8:00 am to Noon. On occasion, circumstances may require the employee to work extended hours or to participate in services offered after 5:00 pm or weekend work, as needed. Scheduled hours may be amended to accommodate special or additional services. All nurses and physician extenders are required to staff emergency shelters during disasters which require working extended hours. Employee is required to work in any public health emergency including, but not limited to natural disasters, man-made disasters, influenza pandemics (e.g. COVID-19) or other outbreaks of communicable diseases.

D. Change in Responsibilities or Organizational Relationship: To reflect a change in classification title from Physician Extender II to Advance Practice Provider II by the NC Office of State Human Resources (NC OSHR), effective 10/31/2022.

II. A. DESCRIPTION OF RESPONSIBILITIES AND DUTIES: Employee performs complete physical examinations, monitors chronic illnesses, prescribes appropriate medications, obtains complete medical histories, collects laboratory data, performs appropriate diagnostic and therapeutic procedures such as laboratory specimens and assists with management of simple and common illnesses such as urinary tract infections and upper respiratory infections.

Employee performs these duties in a variety of health department clinics and programs to include Child Health, Family Planning, Maternity, Communicable Disease, Adult Health and Primary Care offered to citizens of all ages. Employee must be knowledgeable of all services and is assigned tasks in all health department personal care services.

Responsible for diagnosing and treating through administering and prescribing drugs under approved drug formulary by the Board of Medical Examiners and clinic physician. Day-to-day responsibilities are carried out with considerable independence and when problem situations occur, employee would typically consult physician. Duties require appropriate follow-up on patient status with physician. Establish follow-up appointments and makes home visits when necessary to ensure a continuity of care for patients. May from time to time refer cases of neglect/abuse to the local Department of Social Services, particularly when treating high-risk infants.

Employee in this position is accountable for the appropriate and accurate documentation of medical records by recording all patient contacts, obtaining a complete medical history and obtaining patient’s consent for having medical records in the health department. In addition, employee is responsible for documenting symptoms and methods of treatment including drugs prescribed whereby information could be easily reviewed by another staff member who may also provide treatment at a later date.

Considerable work is done in consultation with physician, pharmacists, social workers, health educators, nutritionist and other staff to establish a complete patient care plan that well serves the patient. Efforts will be made to coordinate services and to establish goals to improve the well-being of the patient.

Assist with flu vaccine program, making vaccine available to chronic disease patients, all those over 65 years of age and high risk for influenza. Responsible for reviewing histories, explanation for possible side effects and the value of the vaccination. Monitor any complications and prescribe medications or take the appropriate medical steps to assist patients in overcoming complications. Responsible for communicable disease program activities such as physical examinations, diagnosis and treatments, getting appropriate specimens, collecting histories, initiating follow-up patient care and patient education.

May also participate in health department services administered to school-age children to include examinations and medical histories for students playing sports. Serve as an expert and resource to other medical staff in addressing problem situations, providing alternative methods, appropriate procedure implementation, and training in new procedures and medications. Remain aware of agency medical services and address problem situations as they are identified and recommend corrective action. Maintain the necessary emergency equipment and remain knowledgeable of its operations and impact on patients. Overall, will serve as a trainer for in-service educational seminars and may participate in the evaluation, development and implementation of agency policies, procedures, goals and objectives and other administrative functions.

Employee must possess a complete understanding of patient care protocols and medical guidelines. Difficult situations and issues/problems which are beyond employee’s scope of practice are referred to physician and other specialists. Participates in various seminars, workshops and in-service sessions to remain knowledgeable of the most current and accurate treatment methods. Also, must maintain updated knowledge and skill in life support measures.

Employee in this position is accountable for the completion of medical records on all patients in compliance with required standards and ensure appropriate signatures are obtained including that of physician. Records are reviewed as required by regulations and evaluation of those records is ongoing. Necessary changes are implemented as to ensure required services. Responsible for conducting clinical audits on patient charts, performing research, and assisting with insurance credentialing. The position also includes significant involvement in community outreach events, providing direct interaction with the public and delivering educational sessions to community members outside of a health department setting.

II. B. OTHER POSITION CHARACTERISTICS:

1. Accuracy Required in Work: Accuracy is extremely important in all aspects of this position but particularly in direct patient care areas. Employee’s work and decision-making responsibility have a direct effect on the client population served. Independent decision-making in this position requires 100% accuracy.

2. Consequence of Error: Employee must understand all clinic functions for the purpose of providing accurate information when educating, treating and counseling patients and staff. Employee’s work and decision-making could have a substantial impact on the client population served. Employee will work closely with nursing staff, regional nursing consultant, and Health Director. Errors in work and judgment can cause sickness and even death to patients as well as potential possibilities of litigation against the county and state.

3. Guides, Regulations, Policies and References Used by Employee: Jones County Policies, Procedures and Standing Orders; Program manuals provided by the Department of Health and Human Services; North Carolina Nurse Practice Act; North Carolina Pharmacy Laws; North Carolina Public Health Laws; State and Federal Laws as they apply to medical treatment; Public Health Nursing Standards; Regional and state updates regarding medical treatment.

4. Supervision Received by Employee: Work is reviewed for adherence to established Public Health Nursing Standards. Daily work is self-planned and performed with considerable independence. Short range plans and changes can usually be implemented; other longer range planning may be completed and in conjunction with health director, lead nurse and physician. The supervising physician reviews work upon completion.

5. Physical Effort: Intense physical effort is not required for this position. It will, however, require some effort and stressful conditions when experiencing busy clinic services.

6. Work Environment and Conditions: Work environment is primarily in a small health department but may also include other locations and facilities when disease prevention or outbreak control is needed. Must participate in emergency shelter duty during emergency and/or disaster situations. Work requires some exposure to patients who may be difficult to work with and a mildly disagreeable work environment. Also, may be periodically exposed to patients who may be contagious with illnesses.

7. Machines, Tools, Instruments, Equipment, and Materials Used: Telephone, automobile, computer, medical equipment, gloves, masks, audiometers, accu-chek-centrifuge, autoclave, scales, titmus machine, speculums, opthalmascope and otoscope and injectable antibiotics.

8. Visual Attention, Mental Concentration, and Manipulative Skills: Physical assessment requires close visual attention. Mental concentration is required with all client contacts and intense mental concentration is required when counseling patients, administering immunizations and medications, and when participating in an epidemiological investigation.

9. Safety for Others: Follow department policy for OSHA regulations; follow Universal Precautions for Blood and Body Fluids and maintain confidentiality in all medical circumstances.

10. Dynamics of Work: Factors that may impact on this position are: Changes in Public Health Laws, DHHS Rules and Regulations, increases in morbidity or disease outbreaks, changes in policies and procedures, CDC recommendations, public demands and interests and numerous other factors as they relate to medical releases.

III. A. KNOWLEDGES, SKILLS, & ABILITIES:

Knowledge of and skill in the application of nursing techniques and the routine care and treatment of all types of clients and the ability to apply it to the area of work. Skill in preparing and administering medications and knowledge of proper dosage, effect and contradictions. Ability to make astute observations of patients’ conditions and to report conditions accurately. Ability to remain calm and function efficiently in emergency and stressed situations. Ability to understand, interpret and relate oral and written instructions. Ability to establish and maintain effective working relationships with patients and families and other employees.

B. 1. Minimum Training and Experience: Licensed as a Physician Assistant by the North Carolina Medical Board or approved to practice as a Nurse Practitioner or Certified Nurse Midwife by the North Carolina Board of Nursing and the North Carolina Medical Board and one year of experience as an APP.

2. Additional Training/Experience: Supervise all medical acts of the department including students and staff.

IV. License or Certification Required by Statute or Regulation: Licensed to practice as a Registered Nurse in North Carolina by the North Carolina Board of Nursing.

To apply, visit jonescountync.gov and navigate to the Human Resources or Careers section to view current vacancies. Select Advanced Practice Provider II from the list of openings, and complete your application. For further assistance, feel free to contact the Human Resources Director at ahall@jonescountync.gov.