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State of Washington Classified Job Specification


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Class Code: 291F
Category: Health Care


As a health professional ultimately accountable for patient care, leads medical staff in a clinical area and acts as a unit liaison and provides the full spectrum of medical/behavioral health care services to patients, including  performing physical examinations, establishing diagnoses and determining appropriate treatment or referral for medical problems. Treatment and care provided is within the scope of the ARNP practice and licensure. Specialties include, but are not limited to: women's health, pediatrics, adult health, family health, geriatrics, public/community health, emergency care, critical care, diabetes management and/or psychiatric/mental health.

Distinguishing Characteristics

This is the lead worker level of the series. Positions are designated with lead responsibility to regularly assign, instruct, and check the work of other Advanced Registered Nurse Practitioners.

Typical Work

Regularly assigns, instructs and reviews the work of assigned Advanced Registered Nurse Practitioners and other medical staff;

Directs the preparation and maintenance of schedules and staff assignments;

Performs examinations/evaluations, establishes diagnoses and determines appropriate treatment or referral for medical/behavioral problems.

Carries out treatment or case management plans to include referral to other health professionals, patient education, prescribing medicine including legend drugs and controlled substances, prescribing medical devices, medication administration, and/or preventive treatment.

Reviews treatment plans, medical records, diagnoses, and patient-release proposals for quality and adherence to institution policy;

Reviews patient information and interprets findings on the basis of general medical knowledge;

Takes extensive personal health and medical history, both general and specific, including review of patient’s file and family history in order to assess the patient’s physical condition and the extent and nature of diseases, abnormalities and a variety of other conditions;

Refers cases to physicians for conditions outside of their ability to diagnose or treat; confers directly with one or more physicians regarding diagnosis and care management plans;

Orders and interprets laboratory examinations, analyses and X-rays; writes prescriptions;

Performs minor surgical procedures such as suturing lacerations and incising and draining abscesses, including administration of local anesthesia;

Develops and carries out treatment plans; manages cases from beginning to end for such disease and conditions as non-acute heart disorders, hypertension, respiratory diseases, diabetes, dietary deficiencies, and other transmissible diseases;

Performs other duties as required.

Knowledge and Abilities

Knowledge of: methods and principles of general medicine; methods of diagnosing and treating more common medical and/or mental disorders; normal human growth and development, human anatomy and physiology, human behavior, pathology, diagnostic techniques, primary treatment for neuro-muscular injuries, current treatment methods for common human diseases and disorders, medicine commonly used for such diseases and disorders, and contraindications to be watched for.

Ability to: examine, diagnose and recommend treatment of physical diseases and deficiencies; work harmoniously with patients and other health professionals and paraprofessionals; exercise mature judgment in determining when to consult other resources for diagnosis and case management; make clear explanations of technical conditions to professionals and nonprofessionals.

Legal Requirement(s)

A valid Washington State license to practice as an Advanced Registered Nurse, which also requires a valid Washington State Registered Nursing licensure.

There may be instances where individual positions must have additional licenses or certification. It is the employer’s responsibility to ensure the appropriate licenses/certifications are obtained for each position.

Desirable Qualifications

For certain specialized positions, an ARNP¬ with prescriptive authority may be required. For certain specialized positions, a DEA registry license may be required. Some positions may need an active National Provider Identifier (NPI) and/or an active Drug Enforcement Agency (DEA) registration number to prescribe controlled substances.

Class Specification History

New class, consolidates 6222 Health Care Specialist, 51080 Physician Assistant, and 56470 Nurse Practitioner; adopted May 10, 2007, effective July 1, 2007.
General revisions, housekeeping only: revise title (formerly Physician Assistant/Certified Registered Nurse), add class series concept, revise definition and distinguishing characteristics; adopted August 16, 2007, effective August 17, 2007.
Revised title (formerly Physician Assistant/Advanced Registered Nurse Practitioner-Lead), added category, removed class series concept, revised definition, typical work and legal requirements; revised salary range; adopted June 13, 2019, effective July 1, 2019.
Revised title, class series concept, definition, distinguishing characteristics adopted 8/8/2019, effective 7/1/2019; previously Physician Assistant, Certified/Advanced Registered Nurse Practitioner - Lead, previously 74N.