Advanced Practice Provider (APRN or PA)

Outpatient Clinic - Same Day Access/In-Basket Clinician

Dartmouth-Hitchcock Medical Center- Lebanon, NH

The General Internal Medicine (GIM) Section seeks an experienced Advanced Practice Provider (Nurse Practitioner or Physician Assistant) to serve as a Primary Care Access & Coverage APP within a large, academically affiliated primary care practice.

As an organized, clinically skilled APP who enjoys team collaboration, you will join our General Internal Medicine team in a unique role focused on in-basket management and same day/sick visits, improving clinical access for established patients and providing coverage for clinicians during planned and unplanned absences. Unlike a traditional primary care position, this role does not include responsibility for an independent continuity panel. Instead, the APP will serve as a dedicated member of the care team, bridging patient communication and acute clinical care to ensure that patients receive timely and seamless care. This APP will have a faculty academic appointment in the Geisel School of Medicine, as well as many opportunities for academic involvement and learning including teaching, mentorship and preceptorship, weekly conferences, monthly staff and team meetings, and hospital grand rounds.

The ideal candidate is a motivated, self-directed and highly collaborative team player who is enthusiastic, compassionate, and committed to evidence-based practice, lifelong learning and teaching/mentorship.

This position is intentionally structured to be sustainable, team-based, and professionally rewarding. This is an in-person position within the section of General Internal Medicine, providing direct patient care, supporting same-day access, collaborating with care teams, and contributing to the daily operations of the practice.

This position is intended for experienced primary care APPs who enjoy broad clinical practice and team-based care, and do not wish to maintain an independent continuity panel. New APP graduates will not be considered.

This position reports to the APRN Outpatient Clinic Lead and Section Chief in General Internal Medicine, and is a full-time weekday shift, salaried, benefited position with no call, and no weekend or holiday responsibility.

What Dartmouth Health has to offer you:

• Inclusive and collegial multidisciplinary team
• Excellent work-life balance in a highly desirable community
• Robust on-boarding program and mentorship
• APP representation in clinic and hospital leadership
• Independent practice for both APRNs and PAs in the State of NH
• Academic faculty appointment with the Geisel School of Medicine
• Teaching role with APP and medical students, and APP fellows
• Opportunities for preceptorship, mentorship, scholarly work, and teaching
• Retirement (up to 6% match)
• Dedicated CME funds and time off
• Comprehensive benefits package including health, dental, vision and malpractice insurance, life and disability, loan repayment, and relocation bonus

Dartmouth Health is an academic health system serving patients across northern New England, providing the only Level I trauma center in New Hampshire, as well as the Norris Cotton Cancer Center and the Children’s Hospital at Dartmouth-Hitchcock in Lebanon.

What New Hampshire has to offer you:

• Four seasons for both outdoor and indoor lifestyles
• Easy access to major cities and airports
• Proximity to mountains and hiking trails
• Easy driving distance to the seacoast
• No sales tax or income tax

Lebanon and the neighboring town of Hanover, which is home to Dartmouth College, are located in the “Upper Valley,” which straddles the Connecticut River and includes towns in western New Hampshire and eastern Vermont. This region boasts excellent local schools, a myriad of cultural opportunities (through Dartmouth College, the Lebanon Opera House, and the Northern Stage in White River Junction, Vermont), and an abundance of recreational activities. Amenities of urban areas in Boston, Burlington (Vermont), and Montreal (Quebec, Canada) are all within a few hours’ drive. This beautiful area has been consistently ranked as one of the best places in the US to live and work.

• APRN licensure in the States of New Hampshire (prior to hire) and Vermont (within 6 months of hire) with a Master’s of Nursing from an accredited program, or eligible for licensure

OR

• Current (or eligible) certification to practice as a Physician’s Assistant in the State of New Hampshire (prior to hire) and Vermont (within 6 months of hire) with a degree from an accredited PA program.
• National specialty certification as FNP, AGPCNP, or certification through the National Commission on Certification of Physicians Assistants (NCCPA)
• Eligible for Federal DEA Registration
• BLS certification
• Minimum 3 years primary care experience
• Excellent interpersonal skills with the ability to communicate effectively both verbally and in writing
• Strong clinical judgment and commitment to patient-centered care in a team environment

Preferred

• Doctorate degree
• Minimum 5 years primary care experience
• Experience managing primary care in-baskets, results review, and care coordination.
• Experience working in a robust ambulatory practice.

• Provide in-basket coverage for physicians and APPs during vacations, leave, and other absences, managing patient messages, laboratory and imaging results, medication refill requests, and care coordination needs.
• Collaborate closely with physicians, APPs, APP fellows, nurses, medical assistants, and administrative staff to ensure high-quality, efficient patient care.
• Provide same-day visits for established primary care patients, including history taking, physical examination, diagnosis and management of conditions.
• Obtain focused history and physical examination during same-day visits for established primary care patients, including history taking, physical examination, diagnosis and management of conditions.
• Determine, order and interpret appropriate diagnostic studies and tests.
• Obtain informed consent for treatment diagnostic and therapeutic procedures and studies.
• Develop and implement treatment plans based on relevant findings.
• Prescribe medications, treatments and medical devices in accordance within scope of practice and applicable rules and regulations.
• Initiate referrals to other providers as necessary.
• Initiate admission/discharge of patients (APPs do not have admitting privileges).
• Complete appropriate documentation.
• Be on-site and available to the clinical team to assist in addressing urgent patient needs
• Provide education and counseling regarding the management of acute and chronic illnesses and injuries. Encourage behavioral change and assist with self-management skills to improve overall health, within scope of practice.
• Demonstrate advocacy that insure the patient’s right to privacy, confidentiality and informed consent.
• Maintain current licensure and certification as an APRN or PA and DEA registration.
• Attend continuing education programs to ensure ongoing professional growth and development.
• Perform other duties as required or assigned.
• Abide by the Dartmouth-Hitchcock Bylaws for the Professional Staff and Code of Conduct.