Advanced Practice Provider (NP/PA) Maternal Fetal Medicine I (West/South Region)

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The MFM APP will work collaboratively with the Maternal-Fetal Medicine physicians as a licensed independent provider caring for high-risk obstetric patients. These patients have acute and medical conditions, obstetric comorbidities, fetal anomalies, or other high-risk pregnancy conditions. The primary role is to support the Maternal-Fetal Medicine physicians in managing these patients and in supporting the program for diabetes during pregnancy.

The MFM-APP will provide outpatient antenatal and postpartum care to MFM patients, which includes prenatal visits, consultations for a spectrum of higher risk conditions (gestational diabetes, chronic hypertension, history of preterm birth, etc), and postpartum visits. The MFM-APP can perform office procedures including interpretation of NSTs, placement long-acting reversible contraception (IUD, implants), and removing cerclage sutures.  Additionally, the MFM-APP will staff the online shared medical appointment program for gestational diabetes (a  collaborative multidisciplinary program involving MFM, nutritionists, diabetes educators), during which the MFM-APP will provide the gestational diabetes consultations.   The MFM-APP will assist in the ongoing management of blood glucose levels for diabetic patients through weekly MyChart encounters or telephone/virtual visits. The MFM-APP will have the clinical support of the entire MFM provider team, and generally works alongside the MFM providers in the office.

In our academic Maternal Fetal Medicine practice, engagement with trainees and learners (medical students, residents, nursing students) and patient research studies is anticipated. 

Applicants with previous experience in Maternal-Fetal Medicine, Obstetrics, Labor & Delivery, Nutrition, Diabetes Education and/or Women's Heath is preferred but not required.

Clinic Responsibilities Include but not limited to:

• Provide prenatal care, postpartum care
• Provide consultations for a spectrum of high risk pregnancy conditions (such gestational diabetes, chronic hypertension, history of preterm birth)
• Perform history and physical examinations
• Order and interpretation of laboratory tests including standard prenatal labs and diagnostic labs for obstetric complications
• Interpretation of antenatal testing (e.g. fetal non-stress tests, biophysical profile)
• Communication of lab and testing results to patients in a timely manner
• Review blood pressure logs, evaluate hypertensive disorders, and adjust medical therapy.
• Review blood sugar logs, initiate and adjust medical therapy which can include insulin and oral agents
• Screen and triage requests to determine level of care. Includes review/request records, ordering appropriate tests, and defining appointment timing.
• Participate in the development of office and Division guidelines.
• Participate in MFM office and Department of OBGYN meetings, quality improvement committees and activities, or other meetings and/or committees as appropriate.

Prior Experience Desired but not Required

• Outpatient MFM and/or OB experience
• Diabetes care, nutrition, and hypertensive care
• Labor and delivery
• Fetal heart rate interpretation
• Procedural competency (IUD, Nexplanon, other outpatient Ob/Gyn procedures
• Point of care ultrasound
  

Schedule: The team is currently considering two scheduling options for this role and is open to discussing either five 8-hour shifts (5x8s) or four 10-hour shifts (4x10s). The final schedule will be determined collaboratively and will take into account both departmental needs and candidate preference whenever possible.

Responsibilities:

• Conducts thorough medical histories, performs complete physical examinations (where indicated), initiates appropriate lab, radiology tests or other special tests required for evaluation of illness, and scrutinizes lab data to establish a record of the patient's current health status and to develop a working diagnosis and treatment plan.  Works in collaboration with the health care team.
• Performs and interprets common laboratory, radiologic, cardiographic and other routine diagnostic procedures used to identify pathophysiologic processes as credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals.
• Performs routine and specialized procedures as credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals.
• May prescribe and monitor medications as allowed by license through applicable state board and Cleveland Clinic policies.
• Educates patients and answers questions regarding their disease, treatments, related drug and treatment side effects and hazards.
• Participates in medical team rounds; collaborates with nursing, medical and other healthcare team members regularly to ensure quality patient care.
• Refers patients to specialists as appropriate for consultation or for specialized health resources and treatment.
• Ensures continuity of care by serving as a liaison between patient and other members of the multi-disciplinary care team or with other specialty areas as necessary.
• Participates in quality monitoring thru the review of records and treatment plans for patient outcomes on a periodic basis to assure quality care.
• Facilitates appropriate length of stay, discharge planning and compliance with regulatory standards for inpatient management.
• Supports professional development of the health care team.
• Promotes translation of evidence-based practices, guidelines, and research.
• May conduct research studies.  May assists in data collection and analysis.
• May serve as clinical preceptor for students. May onboard new caregivers.
• Other duties as assigned.

Education:

APRN 

Effective 05/01/2014: MSN required upon hire or within 3 years of hire for external hires and internal hires moving from a non-APRN licensed role to an APRN licensed role. 
Graduate of an accredited APRN program. 
If in neonatal care service area Master’s Degree is required upon hire. 

PA 

Graduate of an A.R.C. approved Physician Assistant Program. 
Master’s degree in Physician Assistant Studies and/or higher degree obtained from a program recognized by their practicing states Licensing Board. 

Languages:

• Oral and written communication in English

Certifications:

NP 

• Currently licensed as a Nurse Practitioner in applicable state(s). 
• Must be licensed as an RN in applicable state(s). 

• National certification as a Nurse Practitioner by nationally accredited organization recognized by state Board of Nursing. 

• Basic Life Support (BLS) through the American Heart Association (AHA) required. 

• Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) through the American Heart Association (AHA); or Neonatal Resuscitation Program (NRP) through the American Academy of Pediatrics (AAP) may be required based upon work setting. 

• Must have arrangements with at least one physician in accordance with requirements set forth by the State Board of Nursing in applicable states. 

• Must be credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. 

PA 

• Certification as a Physician Assistant through the NCCPA or successor organization recognized by their practicing states Licensing Board. 

• License to practice and prescribe issued by their practicing states Licensing Board. 

• Current DEA License or DEA designee as required by NCQA. 

• Basic Life Support (BLS) through the American Heart Association (AHA) required. 

• Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) through the American Heart Association (AHA); or Neonatal Resuscitation Program (NRP) through the American Academy of Pediatrics (AAP); or Advanced Trauma Life Support (ATLS) American Heart Association may be required based upon work setting. 

• If a candidate has held a license to prescribe within another jurisdiction and needs to obtain a master's degree in order to apply for prescribing privileges the candidate will be subject for review for eligibility for hiring within our system. 
• Must have a Physician Supervision Agreement and signed addendum to Physician Supervision Agreement. 

• Must be credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. 

Complexity of Work:

• Excellent analytical and decision-making skills are required.
• Strong written and verbal communication skills.
• Ability to work as a member of a multi-disciplinary team.
• Demonstrated competency and the ability to perform advanced assessment and diagnosis.
• Demonstrated ability to utilize the electronic medical record.
• Demonstrates a high standard of moral and ethical behavior.
• Demonstrates compassion and professionalism and a commitment to excellent patient care.
• Requires critical thinking skills, decisive judgement, and the ability to work independently.
• Must be able to work in a stressful environment and take appropriate action.

Work Experience:

• Related clinical experience preferred.

Physical Requirements:

• Typical physical demands include the ability to walk and stand for long periods of time.
• Manual and finger dexterity and eye/hand coordination to perform physical examinations.
• Requires corrected vision and hearing to a normal range.
• Occasionally lifts and carries items weighing up to 50 pounds.
• May require exposure to communicable diseases and/or body fluids.

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment as required.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances.

Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility. 

If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/

Please review the Equal Employment Opportunity poster. 

Cleveland Clinic is pleased to be an equal employment opportunity employer.