Psychiatric-Mental Health Nurse Practitioner
13 days ago
Boise
Job Description:\n\nThe PHMNP role in an interventional psychiatry practice involves a broad range of highly specialized skills. The Psychiatric Mental Health Nurse Practitioner (PMHNP) role for ketamine patients involves comprehensive assessment, diagnosis, treatment planning, administration or supervision of ketamine therapy, and ongoing monitoring and collaborative care. Charting, billing, phone call follow ups, telehealth visits and patient education are also a large part of this role. Creating visit templates and entering chart notes is a requirement of this role. The hard skills for the role are IV placement, Spravato session management, psychiatric intakes, medication management, ketamine session management of all types and routes. This role also involves charting, billing, attending staff meetings and working in a collaborative care team. Clinic staffing will be at a minimum a PMHNP and administrative and/or MA staff, days with RN support as well. The current role involves soft skills of therapeutic communication, intuition, decision making, patient education, crisis management, harm reduction and critical thinking. It involves a strong collaborative team approach and communication skills with the clinic staff and practice owners. Acceptance of this position is open until it is filled. We would require a NDA/Non-compete that is specific to ketamine. This NDA/non-compete does NOT apply to traditional medication management or Spravato, it only applies to the highly specialized ketamine skill set we will work with the PMHNP to develop. New Grad Hourly Rate while awaiting credentialing (after passing boards & getting license, training in ketamine): $70 Fully Credentialed/Medication Management Hourly Rate: $75-89, negotiable with experience, plan to increase up to $89/hr as billable hours increase with a planned 2.5% annual raise so long as KPIs are met. Hours per week: 24 minimum guaranteed, up to 40 as desired by employee In Clinic Schedule: Monday: 9-5 Tuesday: 10-6 Wednesday: 9-5 Thursday: 10-6 Friday: 9-5 *To support this role we would need a minimum of 1 billable visit per hour FTE worked. These could be telehealth or in clinic days. We are willing to be flexible with scheduling and can make changes as we work through things together as this is a new role for the clinic. We are looking for strong leadership and team collaboration. This position is a minimum of 24 hours per week with a maximum of 40 as desired by the employee. Scheduling can be flexible with enough notice, and telehealth visits can also be performed from home as desired. The higher range of this payscale is associated with completing the required medication management visits, so pay would rise accordingly based on performance and billable hours over time and the PMHNP case load builds. PTO: 4 weeks accrued, does not carry over into next year Non-compensated flexible PTO: 2 weeks maximum based on FTE, can be used for federal holidays, sick leave, funeral leave, does not carry over into the new rolling year. We would appreciate 60+ days notice for vacation requests so that the practice can make staffing adjustments, and will require at least 30 days notice for vacation requests. It will be the clinician’s responsibility to mark their schedule off for vacation. This position makes federal holidays optional, not mandatory, though unpaid leave would be used for these dates and we’d offer time and a half if a clinician chose to be available on the holiday. The clinic is closed on Thanksgiving Day and Christmas Day. OSHA: Up to 50 pounds lifting, assisting with patient transport and safe movement about the clinic, possibility for assisting with toileting or helping patients to and from the car. Worker’s Compensation: The practice carries Worker’s Compensation that will cover an employee in the event of workplace injury, most common workplace injury for this setting is an accidental needle stick injury. Retirement: 5-10% of salary which varies depending on the patient volume of the practice. An employee is eligible for contribution after 1 year of employment. CE & Licensing: EleMental Health will reimburse up to $1500 per year which can be used for DEA, RN, PMHNP, BOP license renewal or continuing education. This must be used in the calendar year it is offered and does not accrue nor roll over. Special Considerations: The PMHNP role in an interventional psychiatry practice is a mix of medication management and ketamine/Spravato patients. The day could look like seeing ketamine patients on the even hours of the work day, 10, 11, 12, etc. and then medication management patients on the half hour while the MA or RN start IM, nasal or Spravato patients. The KAP/KAT/IVK patients should be prioritized on the even hours. It could also look like a PMHNP and MA staffing the clinic focusing on ketamine and Spravato with MM visits being done by telehealth on non clinic staffed days. This process will be collaborative and supportive. If the PMHNP has not had experience with ketamine or Spravato we will spend 1-3 months working 1:1 with them until they are comfortable in the role and have demonstrated the required skillset and competency. The PMHNP increased salary necessitates at least 1 medication management visit per hour of FTE. For example, if the FTE is working 24 hours per week, we would need 24 medication management visits per week billed to support salary, benefits and PTO. If hours are increased to 30 then billable appointments would need to increase to 30 as well. A medication management practice takes time to build and we understand that it will take 6-12 months to reach a sustainable and consistent patient volume. The practice has anticipated and planned for this adjustment. While this is a starting role we do anticipate collaborative and mutually agreed upon changes to the role as the practice needs evolve, these changes will be discussed and agreed upon by both parties then placed in writing. It is likely that MM visits increase in need, the position as listed, is what is expected to work 1-2 years and this role will evolve as the practice grows and we are looking for a provider who can evolve and grow with us. Clinician Expectations: As outlined by EleMental Health policy and procedures. Severence: In the event of vacating this role we would request a minimum notice of 90 days, as is standard in advanced professional roles. This notice is non-punative and simply allows for hiring and training of the replacement PMHNP. We would expect 30-60 days training of the new employee before transitioning out. Interventional Psychiatry is a unique field and this policy is written to ease transitions between providers for this vulnerable patient population. We would expect an ongoing NDA, and that the employee does not work at nor open a competing ketamine/Spravato practice for one year post severance with EleMental Health. Employees would be eligible to do traditional medication management for another practice post severance immediately without violating the NDA. EleMental Health would retain our medication management patients, who would transition to a new provider with our practice upon employment severance, since the practice spends significant time and resources to help build the clientele and practice of individual providers. These patients would not transfer when the PMHNP severs from the company. Bonus and Incentive Pay: In the event of illness, holiday or short notice (less than 72 hours) request that results in the employee picking up work to help the practice out we would offer 1.5x pay for that shift. It is not possible to anticipate every need and desire of the PMHNP role in this offer as this is nuanced and ever changing work in a rapidly growing practice environment. We would ask for open communication, prompt addressing of issues and collaborative problem solving as the role expands and evolves. We do conduct quarterly employee check ins, do one annual performance review and hold weekly administrative staff meetings and bi-annual clinical staff meetings. In the future other treatment modalities such as TMS, psilocybin, MDMA, and others are all a possibility. We would ask for openness to adding these modalities and clear communication and expectation management as the practice evolves. Key Responsibilities & PoliciesComprehensive Evaluations: Conducting thorough psychiatric evaluations, including health history, mental status assessment, and risk assessment, to determine patient suitability for ketamine treatment.Diagnosis and Treatment Planning: Analyzing health data to determine diagnoses and developing individualized, evidence-based care plans that may include ketamine, other medications, TMS, or psychotherapy.Administration and Monitoring: Preparing and administering ketamine (via IV, intramuscular injection, or Spravato) in accordance with established protocols and closely monitoring patients for side effects, adverse reactions (e.g., dissociation, blood pressure changes), and complications during treatment sessions.Patient Education and Support: Educating patients and their families about the treatment process, potential effects, expected outcomes, and post-treatment care.Collaboration: Working within a multidisciplinary team (including psychiatrists, CRNAs, and psychotherapists) to ensure coordinated and comprehensive patient care.Documentation: Maintaining accurate and detailed patient records in compliance with legal and facility requirements.Medication Management: Utilizing prescriptive authority to order or prescribe medications and adjust treatment plans as needed. Controlled Substance Handling: Training and familiarity with controlled substance handling, record keeping, documentation and tracking is required. Technology Proficiency: Familiarity and competency with Word, Xcel, Google Drive, Google Email, Tebra, Acuity, IntakeQ and other scheduling and charting tools as incorporated by the practice. Frequent checking of work email, response time within 2 work days unless it is an urgent matter.Quarterly Reporting: Meeting with the billing team and practice management team (30-60 minutes) to review monthly visit numbers for past three months, address any charting or billing issues and address any specific issues related to staffing or patient care that need to be handled by management. Staff Meeting: Regular attendance of staff meetings is an expectation for this role. Current staff meetings are held on Tuesday morning virtually for one hour. The clinician portion of this meeting is 15-30 minutes when needed. Written Changes: Any agreements made verbally or otherwise, will be written and signed by both parties and updated in the employee file so that there is clarity and record for both parties. Policy Adherence: Any role within the company involves adhering to our Policy and Procedures as outlined and available in Google Drive & IntakeQ and printed and kept in the BKC handbook. Key Performance Indicators: Employee agrees to strive to meet the key performance indicators as outlined above. We do anticipate and expect that it will take 12 months to fully fill the PMHNP MM schedule. Credentialing: Ongoing license maintenance, completing CE, responding to billing and insurance and CAQH requests in a timely manner is expected. 2 working days for billing and insurance related requests, 3 working days for CAQH. CAQH is maintained by the clinician every 90 days in order to bill. EHR Compliance: We will provide an EHR, templates and E-prescribing features, we will also pay an additional fee to have AI chart note help feature. We expect the clinician to chart accurately and have appointments finalized and sent to billing by the end of the work day. Templates are customizable and may be set up as desired by the clinician with approval from practice management and billing to ensure it meets documentation standards. Orientation: For new graduates we will provide 1-3 months of orientation 1:1 until the provider is feeling comfortable in this role and has demonstrated core competencies. This list will be provided to the PMHNP upon acceptance of the role. Open Communication: We are a small and growing practice who fills a unique niche in the interventional psychiatry field, with a vulnerable and rewarding patient population. We would require open, honest, direct communication with us as small business owners, with our existing team of administrative staff and with the therapists and other professionals with whom we share patients. Open, direct communication is our preferred method of communication and this skill set is vital to success in this role.Flexibility: This position will require some fine tuning as we find what works best for our patients and for our PMHNP in this role. We ask for time and grace as we work together to find the best solutions for scheduling and filling this role. Accountability & Workplace Culture: We use The Four Agreements as clinic culture and communication guidelines, these agreements are: Be Impeccable With Your Word, Don’t Take Anything Personally, Don’t Make Assumptions and Always Do Your Best. We structure our team communication around these four agreements and have an annual communication training. We also provide a communication coach when needed or desired.Severance: When the time comes to part ways we ask for a few things. First, non solicitation of current patients. Second, 90 days of transition to allow patients to switch providers more seamlessly and allow credentialing to go through for new employer. Third, patients will of course be allowed to transfer care if they desire, though after this 90 day transition period. Mutual Non-Disparagement and Non-Disclosure Agreement to be reviewed and signed separately upon or prior to acceptance of the offered position. \n\nCompany Description:\n\nEleMental Health has been a trusted leader in interventional psychiatry for over a decade. We safely provide ketamine therapy in a variety of applications to treat chronic nerve pain and mood disorders like depression and PTSD when other traditional treatments have not worked. Our clinic maintains a calm atmosphere through our friendly staff and soothing surroundings. We are excited to be growing and need a dynamic individual to work closely with other staff and deliver quality care.EleMental Health has been a trusted leader in interventional psychiatry for over a decade. We safely provide ketamine therapy in a variety of applications to treat chronic nerve pain and mood disorders like depression and PTSD when other traditional treatments have not worked. Our clinic maintains a calm atmosphere through our friendly staff and soothing surroundings. We are excited to be growing and need a dynamic individual to work closely with other staff and deliver quality care.
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