Advanced Practice Provider (APP), Rheumatology Practice

Title: Advanced Practice Provider (APP), Rheumatology Practice

Position: PRN, Non-Exempt

Hours: Less than 40 hours per week
Location: Onsite in Fresno, CA

Position Summary

The Advanced Practice Provider (APP) will work collaboratively with the rheumatologist to provide high-quality, comprehensive care to patients with rheumatologic and autoimmune conditions. This role involves patient evaluation and management, chronic disease follow-up, medication management (including biologics and DMARDs), patient education, and coordination of care. The ideal candidate is a compassionate, detail-oriented clinician who thrives in a small-practice environment and is comfortable managing a complex, chronic-disease patient population.

Key Responsibilities

Clinical Care

• Perform comprehensive history and physical examinations, including detailed musculoskeletal and joint exams.
• Evaluate, diagnose, and manage patients with rheumatologic conditions such as RA, SLE, psoriatic arthritis, gout, osteoarthritis, vasculitis, Sjögren's syndrome, and other autoimmune/connective tissue diseases.
• Order, perform, and interpret diagnostic tests, including labs, imaging, and joint aspirations/injections as credentialed and permitted by state scope of practice.
• Develop and manage treatment plans, including prescribing and monitoring DMARDs, biologics, and other specialty medications.
• Monitor for medication side effects, drug interactions, and disease complications; adjust treatment plans in collaboration with the supervising physician.
• Perform joint injections and aspirations (e.g., corticosteroid injections) as appropriate to training and state regulations.
• Provide follow-up care for chronic disease management and titrate therapies based on clinical response.
• Respond to patient questions, symptom changes, and urgent concerns via phone or patient portal in a timely manner.

Patient Education & Communication

• Educate patients and families on disease processes, treatment options, medication administration, and self-management strategies.
• Counsel patients on lifestyle modifications, infection precautions related to immunosuppressive therapy, and vaccination guidelines.
• Communicate clearly and compassionately with patients managing chronic, often complex and unpredictable, disease courses.

Documentation & Compliance

• Maintain accurate, timely, and complete documentation in the electronic health record (EHR) in accordance with practice, state, and federal standards.
• Ensure proper coding and documentation to support billing and prior authorization requirements for specialty medications.
• Complete prior authorization and appeal documentation for biologic and specialty drug therapies as needed.
• Maintain compliance with HIPAA, OSHA, and other applicable regulatory requirements.

Care Coordination & Team Collaboration

• Collaborate closely with the supervising rheumatologist on complex cases and treatment decisions.
• Coordinate care with primary care providers, specialists, physical/occupational therapists, and infusion centers as needed.
• Work with front-office and clinical staff to ensure efficient patient flow and a positive patient experience.
• Participate in practice quality-improvement initiatives and adherence to evidence-based rheumatology guidelines (e.g., ACR recommendations).

Qualifications

• Master’s or Doctoral degree from an accredited Nurse Practitioner program (CCNE or ACEN) or Physician Assistant program (ARC-PA).
• Current, unrestricted California license as a Nurse Practitioner (with active RN license) through the Board of Registered Nursing, or as a Physician Assistant through the Physician Assistant Board of California.
• Board certification:
• NPs: Family Nurse Practitioner (FNP), Adult-Gerontology Nurse Practitioner (AGNP), or equivalent through ANCC or AANP.
• PAs: current NCCPA certification (PA-C).
• Current DEA registration or eligibility to obtain one.
• NPs must hold or be eligible for a California NP Furnishing Number.
• PAs must be able to practice under a practice agreement with a supervising physician.
• Current BLS certification (ACLS a plus).
• Ability to obtain and maintain credentialing as required.
• Prior experience in rheumatology, internal medicine, or a related specialty (e.g., orthopedics, dermatology, nephrology with autoimmune focus).
• Familiarity with biologic and DMARD therapies, including prior authorization processes.
• Proficiency with electronic health records (EHR) systems.
• Excellent communication, interpersonal, and organizational skills.
• Ability to multitask in a fast-paced, patient-focused environment.
• Proficiency in a second language, particularly Spanish, is preferred.

As a small practice, teamwork and flexibility are essential. All employees may be required to perform duties outside their primary job responsibilities to support overall practice operations and ensure continuity of patient care.

Pay: $60.00 - $70.00 per hour

Expected hours: 16.0 – 20.0 per week

Education:

• Master's (Preferred)

Experience:

• Advanced practice provider: 2 years (Preferred)

License/Certification:

• BLS Certification (Preferred)

Work Location: In person