Premera RNHI

Job Description for CNM Rural Fellows

Job Title: Certified Nurse-Midwife/Advanced Registered Nurse Practitioner (ARNP) 

Fellow Reports to: Fellowship Program Director 


The ARNP Rural Fellowship offers a unique employment and training opportunity for new ARNPs to start their primary care practice career in a high-performance health system within a supported learning environment. This 12-month, paid full-time, limited term position provides a highly structured transition from academic preparation to clinical practice that supports the development of confidence, competence, and mastery in the rural care setting. This fellowship allows the new grad to expand on their training and become a full scope midwife, and care will include well person care and management of pregnancy, labor, delivery, postpartum, and newborn care within the advanced registered nurse practitioner’s scope of practice in both hospital and home settings. This fellowship includes collaboration with other licensed health professionals including physicians, ARNPs, PAs, and nurses. The ARNP fellow will work directly with the practice CNMs to expand services within the community, including the continued development of a small business and creation of a business plan for a freestanding birth center. This position plays an active role in team-based care that is focused on supporting people, women, and families to improve or continue good health.


Education: Recent graduate (less than 18-months) from an accredited Masters or Doctor of Nursing Practice Advanced Registered Nurse Practitioner (ARNP) program, licensed or eligible for licensure as a Certified Nurse-Midwife.

Licensure/Certification: Registered as RN (Registered Nurse) and ARNP in the State of Washington or licensed as an ARNP with prescriptive authority in the state of Washington by the start of the fellowship program. National Provider Identification (NPI) number and Drug Enforcement Administration (DEA) registration obtained before start of fellowship.

Required Experience: One year of full-time work experience.

Preferred Experience: Work experience equivalent to one year of full time in a patient facing role
(e.g. RN, MA, EMT, etc), ideally in a rural health care setting. Familiarity with team-based care, support or practice with minor (contraceptive/pap) procedures, cesarean assist, and familiarity with clinical decision making in low resource health care settings.

Knowledge and Abilities:

  • Time management skills; manage multiple tasks in a busy clinical environment and organize/prioritize work assignments
  • Work independently
  • Interpersonal relations and listening skills
  • Strong communication skills, verbal and written
  • Medical problem solving and decision making based on the best available evidence
  • Maintain patient confidentiality of information
  • Knowledge of electronic health records, patient intake evaluations, EHR, and/or assigned software.
  • Required telehealth training
  • BLS/CPR certification
  • NRP certification
  • Training and experience with electronic fetal monitoring
  • Training and experience with intermittent auscultation
  • Extra bonus skills we would love to know about include but are not limited to lactation training/experience, cesarean first assist experience/training, out of hospital birth experience, IUD and Nexplanon training/experience.

Equipment/Skills: None

Language: English; bilingual (Spanish proficiency) a plus

Status classification: Salary / not overtime eligible; limited term (12 month) position


Environment: Clinic, hospital and home care environments. Reliable transportation required.

Work schedule: Days and hours to be arranged; must be flexible and prepared to adjust hours to provide coverage or back-up as needed to share 24 hour coverage.

Physical demands: Ability to physically perform the functions of the job, including sitting, standing, walking, lifting, carrying, bending, and reaching with or without reasonable accommodation.


  • Provide professional services within the scope of a Certified Nurse-Midwife and Advanced Registered Nurse Practitioner; develop and manage shared patients with a ramp-up schedule and progressive responsibilities and autonomy, with dedicated preceptor support as needed. Standards include:
    • Obtain/review patient history and perform physical examinations on patients; order and evaluate basic laboratory results and diagnostic tests.
    • Assess and adjust care/treatment to be compatible with the age, growth and development and needs of the patients.
    • Assess a patient’s level of understanding and adjust care appropriately.
    • Implement interventions designed to achieve positive health outcomes.
    • Provide patient and/or family with information about the various aspects of the procedures/treatment and plan of care.
    • Assess age-related psycho/social issues e.g. educational needs, community resources, spiritual/cultural needs.
    • Prescribe drugs according to licensed prescriptive authority, dispense supplies and prescribe other treatments to aid in the management for pregnancy, acute or chronic health conditions.
    • Document patient care accurately and timely in accordance with medical records protocol and chart forms.
    • Complete billing in a timely manner
    • Refer patients to specialists or diagnostic testing for further evaluation or treatment as appropriate.
  • Participate in bi weekly chart review.
  • Establish collaborative relationships with primary care providers within the clinic setting and medical providers and specialists in the community for case management, referral, and consultation purposes.
  • Train to a high-performance Quality Improvement model; actively take part and initiate seminars/projects and/or process improvement to attain quality service delivery.
  • Maintain professional standards in all settings; calm, compassionate, and empathetic manner when caring for patients, even in crisis situations; use sound judgment in making decisions utilizing medical data and evidence- based information.
  • Communicate effectively with patients, their families, and colleagues and staff in all situations.
  • Attend all required safety training and meetings; use, maintain and replace assigned personal protective equipment; report all injuries and illnesses to supervisor immediately; complete and submit incident/accident reports as required; report hazardous conditions or unsafe work practices to supervisor;  and follow all safety and health guidelines, practices, policies and procedures and actively support and participate in the Emergency Preparedness Program and tasks.
  • Attend all monthly department meetings/trainings and complete annual online training as defined/specified by the health system to include items such as: HIPAA Training, Cultural Diversity Training, Blood Borne Pathogens Training, Sexual Harassment Training, and trauma informed care.
  • Follow applicable federal, state, and local laws and regulations, organization’s policies and procedures, including Privacy, Security and Compliance policies and procedures; Code of Conduct; the Federal Tort Claims Act (FTCA); Fraud, Waste and Abuse and HIPAA.
  • Comply with the organization’s Infection Prevention and Control policies and procedures and adhere to the immunization, influenza, and TB testing requirements
  • Supports the organization’s Mission, Vision, and Values.
  • Perform additional related duties as assigned.
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