Nurse Practitioner / Physician Assistant - Part-Time

Valley Vista is seeking a Nurse Practitioner (NP) or Physician Assistant (PA) to provide medical services primarily within its outpatient substance use disorder treatment program. This part-time position focuses on evaluating and treating patients with medical complaints, completing medical evaluations for admission and ongoing treatment, and providing Medication-Assisted Treatment (MAT). You will work collaboratively with nursing, counseling, case management, and other interdisciplinary team members to deliver coordinated, patient-centered care for individuals with substance use disorders and co-occurring medical and behavioral health needs.

While the primary assignment is outpatient services, you will also support Valley Vista's inpatient and residential programs as operational and patient-care needs arise. You will participate in medical on-call coverage as assigned and may provide clinical consultation for patient-care issues occurring outside regularly scheduled hours.

Clinical Setting

Valley Vista operates a continuum of care including outpatient, inpatient, and residential substance use disorder treatment programs. The outpatient program identifies medical stability and the absence of a need for withdrawal management as considerations for outpatient placement.

Responsibilities

Outpatient Medical Evaluation and Treatment

• Conduct comprehensive and focused medical evaluations
• Evaluate patients presenting with acute and chronic medical complaints within your authorized scope of practice
• Obtain and review relevant medical histories, medications, allergies, laboratory findings, and other clinical information
• Perform appropriate physical examinations and clinical assessments
• Establish diagnoses and develop appropriate treatment plans
• Order and review laboratory testing and other diagnostic services as clinically indicated
• Prescribe and manage medications within your authorized scope of practice
• Monitor medication effectiveness, adverse effects, contraindications, and potential drug interactions
• Provide patient education regarding medical conditions, medications, treatment recommendations, and follow-up care
• Determine when a patient's medical needs require referral to primary care, specialty care, urgent care, emergency services, or another appropriate level of care

Admissions

• Complete medical evaluations for patients being considered for or entering Valley Vista programs when required
• Review medical history, medications, allergies, substance use history, laboratory findings, and other available clinical information
• Identify medical conditions that may affect a patient's ability to safely participate in the proposed level of care
• Collaborate with admissions, nursing, medical, and clinical staff regarding medical appropriateness and treatment needs
• Assist with coordination of care when patients require additional evaluation or services outside Valley Vista

Medication-Assisted Treatment (MAT)

• Evaluate patients for medication treatment of substance use disorders
• Initiate, prescribe, manage, and monitor evidence-based MAT/MOUD within your authorized scope of practice
• Prescribe and manage buprenorphine and other clinically appropriate medications used in the treatment of opioid and other substance use disorders
• Conduct initial and ongoing MAT appointments
• Adjust medications and treatment recommendations based on patient needs and clinical response
• Monitor medication adherence, effectiveness, side effects, safety, and potential diversion
• Review laboratory results, toxicology testing, medication history, and prescription-monitoring information when clinically indicated
• Coordinate MAT with counseling and other substance use disorder treatment services
• Provide overdose-prevention education and prescribe or facilitate access to naloxone when clinically appropriate
• Maintain compliance with applicable federal and Vermont requirements governing controlled substances and MOUD

Inpatient and Residential Clinical Support

• Provide medical coverage for inpatient and residential treatment programs as needed
• Evaluate patients experiencing acute or chronic medical complaints
• Assist with admission-related medical evaluations
• Review medical histories, medications, laboratory findings, vital signs, and relevant clinical information
• Provide medication evaluation, reconciliation, prescribing, and management within your authorized scope of practice
• Collaborate with nursing and clinical staff regarding changes in a patient's medical condition
• Provide medical consultation and guidance to nursing staff
• Determine when a patient's condition requires evaluation or treatment outside Valley Vista
• Facilitate referrals or transfers to primary care, specialty care, urgent care, emergency services, or other appropriate healthcare resources when clinically indicated
• Assist with continuity of medical and MAT services when patients transition between Valley Vista's inpatient/residential and outpatient programs

Medical On-Call Responsibilities

• Provide telephone or secure electronic consultation to nursing and clinical staff regarding patient medical concerns
• Review available clinical information and provide medically appropriate recommendations within your authorized scope of practice
• Address medication-related questions and clinically appropriate medication orders
• Assist staff in determining whether a patient requires additional medical evaluation or transfer to a higher level of medical care
• Coordinate with physicians or other Valley Vista medical providers when additional consultation is appropriate
• Support continuity and safety of patient care during assigned on-call periods

Care Coordination and Collaboration

• Work collaboratively with physicians, advanced practice providers, nurses, counselors, case managers, recovery support staff, admissions staff, and other members of the interdisciplinary treatment team
• Participate in treatment planning, case consultation, and interdisciplinary clinical review as appropriate
• Coordinate medical and MAT services with outside healthcare providers when clinically indicated
• Facilitate referrals for primary care, specialty treatment, emergency services, behavioral health treatment, and higher levels of care
• Promote continuity of care across Valley Vista's inpatient, residential, outpatient, and community-based services

Documentation, Quality, and Compliance

• Complete clinical documentation accurately and within established timeframes
• Document assessments, diagnoses, treatment plans, medication orders, MAT encounters, follow-up visits, and care coordination
• Maintain patient confidentiality and comply with applicable federal and Vermont requirements, professional standards, payer requirements, and Valley Vista policies and procedures
• Maintain all professional licenses, registrations, certifications, and credentials required for assigned duties
• Participate in clinical quality improvement, utilization review, compliance activities, and program development as appropriate

Required Qualifications

Nurse Practitioner Candidates

• Current, unrestricted Vermont authorization/licensure to practice as an Advanced Practice Registered Nurse/Nurse Practitioner, or eligibility to obtain appropriate Vermont authorization before beginning clinical practice
• Graduate-level nursing education appropriate to your APRN role and population focus
• Applicable national board certification
• Appropriate prescriptive authority for assigned duties
• Current DEA registration, or ability to obtain and maintain DEA registration, when controlled-substance prescribing is required
• Must satisfy Vermont requirements applicable to your APRN role, scope of practice, and prescribing authority

Physician Assistant Candidates

• Current, unrestricted Vermont Physician Assistant license through the Vermont Board of Medical Practice, or eligibility to obtain licensure prior to beginning clinical practice
• Graduation from an accredited Physician Assistant educational program
• Appropriate professional certification required for Vermont PA practice
• Ability to practice in accordance with applicable Vermont PA scope-of-practice requirements and required practice arrangements
• Current DEA registration, or ability to obtain and maintain DEA registration, when controlled-substance prescribing is required

Additional Required Qualifications

• Demonstrated ability to assess and manage common acute and chronic medical conditions within your legally authorized scope of practice
• Knowledge of safe medication prescribing and monitoring practices
• Ability and willingness to provide treatment to individuals with substance use disorders
• Ability to work effectively in an interdisciplinary treatment environment
• Strong clinical judgment, assessment, communication, and documentation skills
• Ability to provide both in-person and telehealth services when assigned and legally permitted
• Willingness and ability to support outpatient, inpatient, and residential services based upon organizational and patient-care needs
• Willingness to participate in medical on-call coverage as assigned
• Ability to meet Valley Vista credentialing, training, background screening, and employment requirements

Preferred Qualifications

• Previous experience treating individuals with substance use disorders
• Experience prescribing and managing buprenorphine or other medications used in MAT/MOUD
• Experience in addiction medicine, primary care, behavioral health, community health, or outpatient medicine
• Experience evaluating patients with complex medical, behavioral health, and substance use treatment needs
• Familiarity with Vermont's substance use disorder treatment system and MAT/MOUD requirements
• For NP candidates, Family Nurse Practitioner (FNP) preparation or another population certification appropriate to the medical services being provided
• Dual FNP/PMHNP certification or significant behavioral health/psychiatric experience is highly desirable but not required

Schedule

This position requires flexibility to support Valley Vista's continuum of care. Although outpatient medical and MAT services are your primary responsibility, clinical assignments may vary based upon patient census, clinical needs, provider availability, staffing, and operational requirements. You may be assigned clinical responsibilities within Valley Vista's inpatient or residential programs and are expected to participate in the medical on-call rotation as assigned.