Nocturnist APP-Clinical Decision Unit (CDU), Emergency Department

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Department

Emergency Department Clinical Decision Unit Advanced Practice Provider (PA/NP)

Physician Assistant (PA-C) or Nurse Practitioner (NP) – Emergency Department Observation Unit

Position Summary

The Emergency Department Clinical Decision Unit Advanced Practice Provider (APP) provides comprehensive evaluation, treatment, monitoring, and disposition planning for patients requiring extended observation following Emergency Department evaluation. The APP manages patients placed in observation status under established clinical pathways and evidence-based protocols, typically for stays up to 24 hours.

Working collaboratively with Emergency Medicine physicians, consulting specialists, nursing staff, case management, rehabilitation services, and ancillary departments, the APP is responsible for ongoing patient assessment, treatment optimization, coordination of care, and determining appropriate discharge or admission disposition.

This position offers an opportunity to provide high-quality, protocol-driven care while maintaining close collaboration with Emergency Medicine and inpatient teams.

Essential Responsibilities

Clinical Management

• Perform comprehensive history and physical examinations on observation patients.
• Develop and implement individualized treatment plans within established observation pathways.
• Monitor patient progress through serial assessments and reassessments.
• Order, interpret, and act upon diagnostic studies including laboratory testing, imaging, and cardiac monitoring.
• Initiate and manage evidence-based treatment protocols.
• Perform medication reconciliation and adjust treatment plans as clinically indicated.
• Identify patients requiring escalation of care and facilitate admission or specialty consultation when appropriate.
• Coordinate safe and timely discharge planning.

Observation Pathway Management

Manage patients within established observation protocols, including but not limited to:

• Congestive heart failure (CHF) exacerbation
• Cellulitis requiring oral antibiotic therapy
• Hyperglycemia and diabetes-related management
• Asthma exacerbation
• COPD exacerbation
• Syncope evaluation
• Chest pain risk stratification
• Transient ischemic attack (TIA) workup
• Dehydration and electrolyte abnormalities
• PT/OT evaluations and mobility assessments
• Case management and placement evaluations
• Other observation diagnoses as approved by department leadership

Care Coordination

• Collaborate closely with Emergency Medicine physicians regarding patient management and disposition.
• Coordinate care with consulting services, hospitalists, specialists, nursing, pharmacy, respiratory therapy, case management, social work, and rehabilitation services.
• Facilitate PT/OT assessments and recommendations.
• Communicate treatment plans and discharge instructions effectively with patients and families.
• Ensure timely transitions of care.

Documentation and Quality

• Complete accurate, timely, and compliant documentation within the electronic medical record.
• Maintain knowledge of observation medicine regulations, billing requirements, and quality metrics.
• Participate in departmental quality improvement initiatives.
• Support departmental goals related to patient throughput, length of stay, and patient satisfaction.

Schedule

• 12-hour shifts:
  • 7:00 AM – 7:00 PM
  • 7:00 PM – 7:00 AM
• Rotating schedule including:
  • Days and nights
  • Weekends
  • Holidays
• Mixed shift coverage required.

Minimum Qualifications

Education:

• PAC-Certified Physician Assistant - NCCPA - National Commission for Certifying Agencies Required or
• NP-Nurse Practitioner - AANPCB - American Academy of Nurse Practitioners Certification Board Required
• APN - Advanced Nurse Practitioner - DORA - Department of Regulatory Agencies Required or
• PA-Physician Assistant - State Medical Board Required

Licensure

• DEA registration (or eligibility).
• Current BLS certification.
• ACLS certification required or obtained within designated timeframe.

Experience

• Minimum of one (1) year of hospitalist, emergency medicine, observation medicine, internal medicine or other equivalent inpatient/acute care experience as an APP.
• Experience managing medically complex adult patients preferred.

Preferred Qualifications

• Two or more years of Emergency Medicine, Observation Medicine, or Hospital Medicine experience.
• Experience with protocol-driven clinical pathways.
• Strong skills in patient assessment, clinical decision-making, and disposition planning.
• Familiarity with multidisciplinary care coordination and discharge planning processes.

Knowledge, Skills, and Abilities

• Ability to independently evaluate and manage observation patients within established protocols.
• Strong clinical reasoning and diagnostic skills.
• Excellent communication and interpersonal abilities.
• Ability to prioritize multiple patients and adapt to changing clinical needs.
• Commitment to patient-centered care and teamwork.
• Proficiency with electronic medical records and computerized provider order entry systems.

Work Environment

The Emergency Department Observation Unit is a fast-paced clinical setting designed to provide short-term treatment, monitoring, diagnostic evaluation, and care coordination for patients requiring additional observation beyond their initial Emergency Department evaluation. APPs work collaboratively with Emergency Medicine physicians and multidisciplinary teams to deliver efficient, high-quality care while facilitating appropriate discharge or admission decisions.

Reports To: Medical Director, Clinical Decision Unit and  APP Director 

Department: Emergency Medicine – Clinical Decision Unit

This description is intended to outline the primary responsibilities and qualifications of the position and is not intended to be an exhaustive list of all duties performed.

Shift

Work Type

Salary

Benefits

At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future — with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development — while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you’re joining a mission-driven organization that invests in you.

Here is a small list of our benefit programs:

• Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
• 100% paid parental leave up to 6 weeks
• Immediate eligibility for retirement plans with employer contribution up to 9.5%
• Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
• Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
• Free RTD EcoPass (public transportation)
• Childcare discount programs & exclusive perks on large brands, travel, and more
• Tuition reimbursement & assistance
• Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
• Professional clinical advancement program & shared governance
• Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
• National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health

Denver Health is an integrated, high-quality academic healthcare system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation.

As Colorado’s primary, and essential, safety-net healthcare system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.

Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.