Job Description​

This position is full time at our plaza location. It will be primarily focused on seeing patients in clinic Monday through Friday, but may also involve taking call, working a weekend once every 5 weeks, and rounding on inpatients.

Accountable for advanced nursing practice in the care of assigned patient populations. Responsible for collecting and analyzing client health data identifies appropriate expected outcomes development and implement plan of care provide comprehensive clinical coordination of care and case management provide consultation to influence plan of care for clients enhance the abilities of others and effect change in the system uses prescriptive authority procedures and treatments in accordance with state and federal laws and regulations evaluate clients progress in attaining expected outcomes conduct nursing research provide education to patient family and nursing staff and case manages high risk patients. See department policy regarding scheduling requirements.

Statement of Purpose: The purpose of this protocol is to describe and provide guidelines for the practice of the advanced practice provider (APP) at St. Luke’s in Hepatology.

Definition of APP: An APP is an advanced practice provider, which encompasses Nurse Practitioners and Physician Assistants. They will have all successfully completed a Master’s degree or higher and have met the requirements for both respective state boards (Missouri and Kansas). They also hold a national certification.

Supervision: The APP will report directly to the APP Manager. They will also collaborate with a physician and follow all state requirements for their Collaborative Practice Agreement (CPA) or Physician Assistant Supervision Agreement (PASA), including following chart review requirements. They are also able to collaborate with other physicians if necessary. Consultation with the collaborating physician in a timely manner is needed for:

Emergent situations, particularly if considering need for a transfer to the Emergency Department. Uncontrolled chronic medical conditions. Conditions that are not improving in the expected time frame. Any instance where the APP feels it is necessary.

Responsibilities of the APP:

Deliver comprehensive care to new and established patients, including (but not limited to): inquiring about the patient’s history, performing a physical examination, documenting, ordering diagnostic testing, treating, and charging appropriately. Prescribing drugs within the scope of practice. Performing or assisting in the performance of procedures that are documented on the CPA, and consistent with the education, training, and experience of both the APP and their collaborating physician. First assisting in surgery (if deemed necessary and if APRN has completed first assist certification) Rotate every 2 weeks between Clinic, inpatient hepatology, and surgical side Providing education to the patient and/or their caregivers. Referring patients to other specialties as needed. If prescriptive authority for controlled medications is determined necessary by the collaborating physician based on clinic needs, it is the responsibility of the APP to maintain all requirements for their DEA and BNDD. They are also responsible for maintaining the correct DEA information in the CPA and notifying their APP manager and collaborating physician of any concerns. All controlled medication prescriptions should be limited and appropriate for the diagnose(s). Participate in employer sponsored or affiliated activities and pursuing continuing education to maintain proficiency. Follow CME reimbursement guidelines and enter expense reports in Workday. Serve as a consultant to staff on clinical and technical matters, as well as managing difficult patient circumstances. Participate in the call schedule (if applicable) and ensure proper functioning of telephone devices. Stay informed for clinic initiatives and changes in billing. Meet the standards for quality measures and monitor their own reports through the EPIC dashboard. Consider functioning as a preceptor for students as able. Consider developing the APP fellowship program for this department if necessary for new hires. Follow the Attendance and Rules of Conduct Policies. Notify the clinic practice manager if unable to work, at least 2 hours prior to start of shift. Also notify the APP Manager to update Workday within 24 hours. Complete all patient encounters and charges within 48 hours of appointment time, per policy. Stay current with in-basket messages, results, and medication refills. Delegate a provider to cover their in-basket when out of the office. Meet or exceed the system’s goal for full-time APPs RVUs or higher in a calendar year. Prorated amounts for staff less than full-time. Utilize APP tracking codes correctly and where appropriate. Maintain required licenses and certifications per system policy and job profile. Follow all Saint Luke’s Health System policies and procedures applicable to position. Maintain BLS, ACLS, ATLS, etc. as deemed necessary by the position. Maintain licenses in MO and KS as deemed necessary by the position. Any other responsibilities deemed necessary by clinic leadership. Be able to evaluate and treat the following conditions (list is not all inclusive):

a.fatty liver, hepatitis B and C, autoimmune hepatitis, PBC, PSC, DILI, elevated liver enzymes, liver lesions, ascites, jaundice, decompensated cirrhosis. In the hospital, our most common consults are for elevated liver enzymes, Tylenol overdose, ascites, cirrhosis (new or established diagnosis), GI bleeding, encephalopathy, jaundice, liver transplants, viral hepatitis. Also typically get consulted on anyone listed for transplant or who is post-transplant.

24) Perform paracentesis and fibroscans

Role:

Liver and Transplant Specialists

1.       Hepatology and Transplant Hepatology

a.       Have a presence in the inpatient and clinic settings

b.       Working in conjunction with our hepatologists

c.       Evaluation and management of elevated liver enzymes, fatty liver disease, alcoholic liver disease, viral hepatitis C, viral hepatitis B, autoimmune hepatitis, PSC, PBC, drug induced liver injury, liver lesions and cirrhosis

d.       Medical management and preventative screening for cirrhosis patients

e.       Managing compensated and decompensated cirrhosis patients, including but not limited to complications of anemia, thrombocytopenia, coagulopathy, portal hypertensive gastropathy, esophageal varices, ascites, jaundice, hepatorenal syndrome

f.        Order and interpret laboratory studies, ascitic fluid analysis and pathology reports

g.       Perform paracentesis

h.       Perform fibroscans

i.         Bridging patients to liver transplant

j.         Post-transplant medical management of liver transplant patients for life

k.       Understand, manage and treat complications related to immunosuppression    

Job Requirements

Applicable Experience:

1 year

Advanced Practice Provider - Various, Basic Life Support - American Heart Association or Red Cross

Master's Degree

Job DetailsFull Time

Day (United States of America)

The best place to get care. The best place to give care. Saint Luke’s 12,000 employees strive toward that vision every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining Saint Luke’s means joining a team of exceptional professionals who strive for excellence in patient care. Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer.