Premera RNHI

Job Description for FNP / AGNP-PC Rural Fellows

Job Title: 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 primary care setting. This fellowship utilizes in depth knowledge of physical assessment and management of illnesses or conditions within the advanced registered nurse practitioner’s scope of practice. This fellowship includes collaboration with other licensed health professionals such as physicians, ARNPs, PAs, and nurses. The ARNP fellow will work directly with APP and Medical Education Program Leadership on issues related to patient care management. This position plays an active role in team-based care that is focused on improving health outcomes for patients as well as building healthy rural communities.


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 Family Nurse Practitioner (FNP) or an Adult Gero Primary Care Nurse Practitioner (AGNP-PC).

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 procedures, and familiarity with clinical decision making in low resource health care settings. 

Knowledge and Abilities: 

  • Time management skills; manage multiple tasks in 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 EPM, and/or assigned software. 
  • Required telehealth training 
  • BLS/CPR certification 

Equipment/Skills: None 

Language: English; bilingual (Spanish proficiency) a plus 

Status classification: Salary not overtime eligible; limited term (12 month) position with benefits and eligibility to apply for permanent position (note: this may vary by fellowship site)


Environment: Office and clinic environment. 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. 

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 medical services within the scope of an Advanced Registered Nurse Practitioner; develop and manage panel of 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 acute or chronic health conditions. 
    • Document patient care accurately and timely in accordance with medical records protocol and chart forms. 
    • Complete fee slips for each patient with appropriate diagnosis and procedure codes. 
    • Refer patients to specialists or diagnostic testing for further evaluation or treatment as appropriate. 
  • Participate in weekly didactic sessions and trainings focused on topics that are high volume/complexity/risk/burden and commonly seen in rural primary care. 
  • Gain valuable clinical experience in specialty areas including: women’s health, pediatrics, dermatology, orthopedics, HIV/Hep C care, healthcare for the homeless, adult behavioral health, child/adolescent behavioral health, newborn nursery, and geriatrics. 
  • Work as part of an integrated primary care team focusing on diversity of chief complaints, efficiency, episodic and acute care. 
  • 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 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 or organization’s Safety and Health Committee; 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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