Nurse Practitioner

Brown & Toland Health Practices San Francisco, CA




My Health Medical Group






JOB TITLE:Nurse PractitionerFLSA STATUS:

REPORTS TO: Lead Physician, My Health Medical GroupDEPARTMENT:  MHMG





The adult or family Nurse Practitioner provides clinical care including primary care, continuity care, acute care, co-management of patients with healthcare team, and participates in coverage of providers at My Health Medical Group.  The Nurse Practitioner works closely with practice manager, team physician, lead physician and medical assistants to oversee practice and clinical operations in the Patient-Centered Medical Home practice




Position does not supervise anyone.




  1. Functions as part of a clinical practice team to provide patient care.

a.       Use patient centered care concepts in delivering patient care and performing related activities; actively participate in team huddles to review daily schedule tasks and prepare for patient visits the day prior; discuss and plan accordingly for patients on the day’s schedule.

b.      Actively participate on a team for data collection, health outcomes reporting, clinical audits, population management and quality improvement activities, including use of PDSA cycles where appropriate.

c.       Coverage of practice patients (beyond the MD-NP team): whether on vacation or leave, including provision of same day  care, management of tasks, results verification, and e-prescribing in EHR. Primarily such coverage will be within the team, but on occasion may include any provider in the practice.

d.      Evaluate clinical care, utilization of resources, and development of new clinical tools, forms, and procedures.

e.       Independently resolves practice operation challenges without direction.

f.        Ensures best practice use of the Electronic Medical Records, including meeting CMS Meaningful Use requirements, and contribute to improved practice workflows.

g.      Expert use of patient portal and electronic communications (for sharing results, patient convenience and access, appropriate triage and outreach).

h.      Contributing to the on-call needs of the practice, based on the practice on-call standards. 

i.        Participates in professional development activities and maintains professional affiliations.


  1. Provides care to patients of the practice:

a.       Perform certain functions and procedures, which overlap those of physician; details listed out on the Family Nurse Practitioner Standardized Procedures  in accordance to The Nurse Practice Act In The California Business and Professions Code,Chapter6 Article2,Section2725,and The California Administrative Code,Title16, Article7,Section1470-4 and Title22, Division3, Section 51240(Medi-Cal).

b.      Duties include helping grow the practice: seeing new patients with the establishment of a primary care relationship with the NP. Provision of ongoing care of existing practice patients, including co-management with physician of complex patients, and availability for acute/same day appointments. This includes supporting patients to get the care they need while supporting patient preferences.

c.       The role of the NP on the team can be summarized   as unique yet complimentary to the physician. Patients may designate the NP as their provider of care.

d.      NP role is integral to the population health/proactive outreach activities of each team. As such NP participation in population health meetings is expected. It is expected that working with case management/social worker may be also necessary with some complex patients.

e.       Practice of evidence based medicine and adherence to both national and internal practice guidelines and policies.

f.        Collaborates with providers, ancillary personnel, community resources and other interdisciplinary team members to coordinate care and takes action to proactively resolve patient needs.

g.      Utilizes screening, assessment and treatment data to plan patient/family care and education.

h.      Provide overview of additional follow-up care needed, coordinate, plan and schedule diagnostic tests; participate and provide patient and family education.

i.        Identifies actual or potential risks, based upon observation of physiological and/or behavioral data and respond appropriately.

j.        Provides direct and indirect patient care as part of the treatment regime; Refers problems when they are beyond his/her scope of authority or ability to team Physician as appropriate

k.      Perform telephone triage and respond to patient inquires with provider direction or using protocols.


  1. Uses effective and appropriate communication styles with patients, their families, significant others, physicians, visitors, vendors, peers, staff and professional colleagues.

a.       Greets and interacts in a pleasant and courteous manner, specifically demonstrating respect, trust caring and empathy.

b.      Listens effectively, recognize and accept constructive criticism, and is open to opposing points of view.

c.       Treats all patients, their families, significant others, visitors, peers, staff, provides and professional colleagues in a pleasant and courteous manner.

d.      Demonstrates appropriate and acceptable verbal and non-verbal behaviors while recognizing varying health literacy.


  1. Functions as a team member to support practice’s mission statement, goals and objectives.

a.       Acts as a willing and available resource to patients and team members.

b.      Assures the work environment is safe for employees, patients, and visitors.

c.       Contributes to the development of policies and procedures.


  1. Contributing to meeting overall MHMG practice goals of:

a.       At or above 75th percentile in  patient satisfaction based on standardized survey tools

b.      At or above the 75th percentile in a number of clinical outcomes.  Focus on Preventive health, Diabetes, Depression, Coronary artery disease and Vulnerable Populations, with use of action plans in caring for above populations.

c.       High levels of patient engagement  through patient education, self management support and outreach, and use of action plans

d.      Improved access and scheduling efficiencies tracked by 3rd next available appointment, fill rate,  survey and reporting tools.

e.       Sustainable business model, including accurate coding and documentation and support of HCC efforts when appropriate, and meeting patient panel capacity goals.

  1. Complies with the practice’s established policies.

a.       Support the practices policies and procedures including scheduling guidelines.

b.      NP Practice standards include: average 5-8 patients seen per 3 hour Direct Care session with a goal of 6 patients per session, depending on patient needs and visit types: Long (for complex and new patients)  and Short (for follow up and acute). Participation in provider, All Hands, and population health meetings is expected .

c.       Face to Face sessions should be complementary of the physicians ensuring there is provider to see patients throughout the week.

d.      Adheres to the practice’s confidentiality, compliance, HIPAA, policies and guidelines.

e.       Complies with the Safety Management Program; corrects and reports unsafe situations and     practices.

f.        Demonstrates respect for the rights of patients and their families




Supports members of the care delivery team as determined by practice needs; accept and perform other duties as assigned. 




The three Core Competencies listed below will be linked to the new Performance Appraisal in 2013.


a.         Job related Knowledge, Skills, and Abilities, including Documentation,

Have a thorough knowledge of medical assisting responsibilities;  Knowledge of patient centered care concepts in delivering patient care and performing related activities; Experience with an electronic medical record, MS word, Excel, Outlook and the ability to learn new applications; skills developing and maintain clinical quality assurance.


b.         Creative, Problem-solving, and Innovation Skills

Act as a willing and available resource to patients and team members; ability to measure and implement continuous quality improvement in a patient centered medical home, actively participate in team meetings and patient care plan and delivery.


c.         Customer Focused and Communication Skills.

Use effective and appropriate communication styles with patients, their families, significant others,    physicians, visitors, vendors, peers, staff and professional colleague; Provide excellent communication and coordination among the team members.





  • Active and good standing RN licensure and Nurse Practitioner Certification in the State of California
  • Active and good standing NPI number
  • Active and good standing  DEA number from the United States Drug Enforcement



  • Initiates and is able to function independently as well as interdependently.
  • Ability to initiate, accept and adapt to change.
  • Work effectively with others to promote teamwork and productivity.
  • Maintain confidentiality of client information and ensures compliance with privacy regulations. 
  • Maintains confidentiality of internal business matters.
  • Exhibits behaviors critical to supporting professional work atmosphere.
  •     Organizes effectively and efficiently to accommodate interruptions and changing priorities.
  •     Displays positive and friendly attitudes to all.




  • Minimum of 4 years of clinical Nurse Pracitioner experience in an outpatient office setting.
  • Experience with Electronic Medical Records is preferred.



PERSONAL ERGONOMICS:Complies with policies and procedures, equipment orientation and workspace set up to ensure personal safety and well being as it relates to ergonomically sound usage, reporting immediately to management any complications or difficulties regarding appropriate usage of workplace and equipment.


OTHER CRITERIA:     Motivated individual desired who takes initiative and approaches work with enthusiasm in a team environment.  Complies with policies and procedures; performs job professionally with respect to others, to property, and to individual safety; works effectively with others to encourage teamwork and productivity.  Maintains strict confidence of client information, ensuring client's privacy, and does not discuss internal business with external entities.




The work of this position is performed in an environmentally controlled office environment. The position requires the ability to work under pressure and with a diverse population, including staff, physicians, clients, patients, insurance companies and other members of the public on a regular basis. The position may cause frequent exposure to communicable diseases, bodily fluids, toxic substances, ionizing radiation, medicinal preparations and other conditions common to a clinical environment.




  • Cardiopulmonary Resuscitation (CPR)
  • Knowledge of workplace health and safety concepts and OSHA regulations
  • Certification in Basic Cardiac Life Support




A pre-employment background check will be conducted for all positions. All offers of employment are made on a contingency basis.  All prospective employees must pass a medical exam (fitness for duty) and also provide proof of American citizenship, or legal resident status and the legal right to work in the United States.


Prospective employees with patient contact are also required to submit and successfully pass a medical examination, urine drug test and TB (PPD) test by our designated physician. Brown & Toland reserves the right to rescind the contingent offer of employment to any prospective employee when the results of pre-employment checks or tests are not acceptable to Brown & Toland.


SCOPE OF JOB DESCRIPTION AND MODIFICATIONSThis job description does not limit the tasks that an employee may reasonably be requested to perform.  Substantive changes to this job description may be necessary to meet the changing business needs of the firm.  Notwithstanding this Job Description, all Brown & Toland employees are at-will employees – each may resign at any time and the firm is free to terminate the employee at any time, with or without cause and with or without notice








Job Title:  Nurse PractionerDepartment:  PCMH


1. Check the frequency and number of hours a day the worker is required to do the following specific types of activities:
















a. Sitting












b. Walking












c. Standing












d. Bending












e. Squatting












f. Climbing












g. Kneeling












h. Twisting












i. Lifting












Hand Use:

Dominant Right hand _ x

Dominant hand: Left_ x __










Simple Grasp (right)












Simple Grasp (left)












Power Grasp (right)












Power Grasp (left)












Fine Manipulation












Computer keyboarding












Mouse Usage












Pushing & Pulling












Reaching (above Shoulder level)












Reaching (below Shoulder level)












Lifting and or carry 

0-10 lbs











Lifting and or carry 

11-25 lbs.











Lifting and or carry 

26-50 lbs











Lifting and or carry 

51-75 lbs











Lifting and or carry 

76-100 lbs











Lifting and or carry 

100+ lbs.











Please list specific tools and equipment utilized:  Computer, Keyboard, Mouse, Printer, Copier, Scanner, Telephone, Paper Shredder, Credit Card Swiper, Medical Equipment (Ear, Heart, Blood Pressure, Urine Analysis, Syringes), Autoclave, Stethoscope, Scale, Audiometer, Nebulizer, EKG, PFT Machine



I have received a copy of the Job Description and have read and understand its contents.



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