Nurse Practitioner

Summary

This position serves as an Advanced Practice Provider (APP), either a Physician Assistant (PA) or Nurse Practitioner (NP) providing comprehensive outpatient primary care services at the Rosebud IHS Hospital Outpatient Department (OPD) Clinic in Rosebud, South Dakota. Operating within a 35-bed comprehensive medical and surgical facility on the Rosebud Sioux Indian Reservation, the Advanced Practice Provider delivers culturally responsive adult and pediatric primary care, chronic disease management, preventive and wellness services, acute outpatient evaluations, and minor surgical procedures to members of the Rosebud Sioux Tribe (Sicangu Oyate) and surrounding rural communities.

The primary objective of this role is to improve population health outcomes, support structured chronic disease management, and address well-documented health disparities in a predominantly rural and medically underserved population.

Essential Functions and Responsibilities

The Advanced Practice Provider delivers direct patient care across the human lifespan during scheduled outpatient clinic hours. Clinical responsibilities are categorized across primary functional areas:

Adult Primary Care

Comprehensive Intakes and Assessments: Conduct thorough new-patient intake evaluations, including detailed medical, surgical, family, social, and medication histories; complete physical examinations; and systematic review of systems.

Evidence-Based Care Planning: Formulate individualized primary care management plans adhering to current nationally recognized evidence-based clinical practice guidelines and established Indian Health Service (IHS) clinical policies.

Routine Primary Care Encounters: Perform routine follow-up visits, review vital signs, conduct focused physical assessments, execute medication reconciliation, manage active problem lists, and adjust care plans accordingly.

Diagnostic Management: Order and interpret routine primary care laboratory and diagnostic studies, including complete blood count (CBC), comprehensive metabolic panel (CMP), lipid panel, hemoglobin A1c, thyroid-stimulating hormone (TSH), urinalysis, hepatitis screening, HIV, STI panels, and age-appropriate cancer screening tests.

Chronic Disease Management: Diagnose and manage common complex chronic conditions, including hypertension, type 2 diabetes mellitus, hyperlipidemia, asthma, chronic obstructive pulmonary disease (COPD), hypothyroidism, depression, and anxiety. Initiate timely physician consultation or referral for complex conditions exceeding APP scope of practice.

Behavioral Health and Risk Screening: Screen for intimate partner violence (IPV), substance use disorders, and behavioral health concerns using validated screening tools, including PHQ-9, GAD-7, and AUDIT-C. Initiate timely referrals to behavioral health and social service resources.

Patient Education and Care Coordination: Provide patient-centered education regarding chronic disease self-management, nutrition, physical activity, tobacco cessation, and medication adherence. Document and facilitate specialty care and ancillary service referrals.

Pediatric and Adolescent Care

Well-Child Examinations: Perform pediatric well-child examinations consistent with the American Academy of Pediatrics (AAP) Bright Futures periodicity schedule, including formal developmental and behavioral screenings.

Immunization Administration: Administer and document childhood and adolescent immunizations according to current Advisory Committee on Immunization Practices (ACIP) and CDC schedules.

Acute and Chronic Pediatric Care: Diagnose and manage common acute pediatric conditions (e. g., upper respiratory infections, otitis media, pharyngitis, asthma exacerbations, gastroenteritis, dermatologic complaints, minor injuries) and manage common chronic pediatric conditions (e. g., pediatric asthma, allergic rhinitis, ADHD when within scope).

Adolescent Preventive Care: Conduct confidential adolescent preventive visits utilizing HEEADSSS risk-behavior screening, reproductive health counseling, and behavioral health assessments.

Caregiver Guidance: Deliver anticipatory guidance to caregivers on child nutrition, sleep hygiene, injury prevention, safety, school performance, and developmental expectations.

Preventive and Wellness Services

Preventive Examinations: Perform age- and risk-appropriate preventive wellness examinations following nationally recognized evidence-based guidelines.

Cancer and Health Screenings: Order and interpret evidence-based screening tests, including colorectal cancer screening, cervical cancer screening (per ASCCP guidelines), breast cancer screening referrals, lung cancer screening for eligible candidates, and abdominal aortic aneurysm screening.

Adult Immunizations: Administer adult immunizations in accordance with ACIP guidelines, including influenza, Tdap, pneumococcal, shingles, hepatitis B, and COVID-19.

Risk Modification Counseling: Provide structured tobacco-cessation, alcohol-misuse, and substance-use counseling consistent with USPSTF and SAMHSA recommendations.

Acute Outpatient Care and Minor Procedures

Acute Outpatient Evaluation: Evaluate and manage acute, non-emergent outpatient complaints presenting during clinic hours, including urinary tract infections, skin and soft tissue infections, sprains, strains, and uncomplicated musculoskeletal pain.

Minor Outpatient Procedures: Perform minor clinical procedures within approved facility scope and privileges, such as simple laceration repair, incision and drainage (I&D) of superficial abscesses, cerumen removal, removal of superficial skin lesions, joint injections, and minor toenail procedures.

Point-of-Care Testing: Execute and interpret point-of-care diagnostic tests, including rapid streptococcal screening, rapid influenza, rapid COVID-19, dipstick urinalysis, and point-of-care blood glucose testing.

Prescription Management: Manage prescriptions and controlled substances within provider scope of practice, Drug Enforcement Administration (DEA) authority, South Dakota law, and IHS facility prescribing policy.

Documentation, Health Records, and Quality Improvement

EHR Documentation: Complete accurate, legible documentation for all patient encounters, diagnoses, assessments, orders, and care plans within the Government electronic health record system (RPMS/EHR) within twenty-four (24) hours of the encounter.

GPRA Performance Tracking: Document required IHS clinical performance measures under the Government Performance and Results Act (GPRA), focusing on diabetes care, hypertension control, cancer screening, tobacco screening/cessation, immunizations, and behavioral health screenings.

Coding and Quality Review: Utilize appropriate CPT and ICD-10-CM coding for all clinical encounters. Participate in facility quality improvement (QI) initiatives, peer review, clinical huddles, multidisciplinary case conferences, and morbidity and mortality (M&M) reviews.

Skills and Qualifications

Core Clinical Competencies: Demonstrated proficiency in broad-spectrum outpatient primary care across all age groups, including adult chronic disease management, pediatric preventive care, and minor outpatient surgical procedures.

Certifications

Current Basic Life Support (BLS) certification from the American Heart Association (AHA) or equivalent.

Prescriptive & DEA Authority: Unrestricted prescriptive authority compliant with South Dakota law and active federal DEA registration for Schedules II through V.

System & Screening Tools: Proficiency in electronic health record systems (RPMS/EHR) and standardized screening instruments (PHQ-9, GAD-7, AUDIT-C, HEEADSSS).

Cultural Competency: Familiarity with American Indian and Alaska Native (AI/AN) health disparities and demonstrated commitment to culturally respectful, patient-centered care delivery in Native American communities.

Clinical Protocol Compliance: Demonstrated knowledge of opioid stewardship, controlled substance prescribing protocols, and IHS GPRA clinical quality standards.

Education & Experience

Education Requirements

For Physician Assistant (PA) Candidates

Graduation from a Physician Assistant education program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA).

Possession of a Master’s degree from an ARC-PA accredited program, consistent with Office of Personnel Management (OPM) GS-0603 qualification standards.

For Nurse Practitioner (NP) Candidates

Graduation from a Nurse Practitioner education program accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).

Possession of a Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP), or equivalent graduate degree from an accredited institution, consistent with OPM GS-0610 qualification standards.

Experience Requirements

Minimum Clinical Experience: At least one (1) year of post-graduate professional APP clinical experience demonstrating progressive clinical responsibility in outpatient primary care across the lifespan.

Demonstrated Clinical Scope: Verified clinical competence in managing complex patients with multiple chronic comorbidities, performing routine outpatient procedures, and making sound independent clinical decisions.

Preferred Background: Prior professional clinical experience within Indian Health Service (IHS) facilities, Federally Qualified Health Centers (FQHCs), or other rural and underserved community health settings is strongly preferred.

Supervisory Responsibility

Non-Personal Services Status: This position operates under a non-personal services contractual framework in accordance with Federal Acquisition Regulation (FAR) 37.101.

No Direct Supervision of Federal Staff: No supervisory authority is part of this position.

Independent Practice & Governance: The provider functions as an independent clinician, managing their day-to-day patient care responsibilities without federal employee employer-superv