Nurse Practitioner - Dually Licensed (PMHNP and FNP/AGNP)

Job Title:

Nurse Practitioner - Dually Licensed (PMHNP and FNP/AGNP)

Reports To:
Medical Director / Executive Director

Department:
Medical

Location:
On-site, Dumfries, VA

Employment Type:
Full-time | Salaried | Exempt

Compensation:

The pay for this position is $170,000-180,000 salary, set in good faith based on the responsibilities of the role, qualifications, and market conditions

Job Summary

Mainspring Recovery is seeking a Nurse Practitioner to join our interdisciplinary clinical team supporting individuals in recovery from substance use disorders (SUD) and co-occurring mental health conditions. This position may be filled by a Psychiatric Nurse Practitioner (PMHNP) or a Medical Nurse Practitioner (FNP/AGNP) depending on the candidate's licensure and area of expertise. The NP will provide specialty-focused care — psychiatric or medical — while maintaining a whole-person approach aligned with Mainspring's mission.

Key Responsibilities

• Upon admission, conduct a comprehensive specialty-specific intake evaluation:

For Psychiatric NPs (PMHNP):

• Complete psychiatric intake evaluation including mental status exam (MSE), trauma history, and psychiatric review of systems

• Diagnose and document DSM-5 psychiatric conditions (e.g., mood disorders, anxiety, PTSD, psychosis) co-occurring with SUD

• Assess suicide/homicide risk andestablisha safety plan

• Review current psychotropic medication history andidentifymedication-assisted treatment (MAT) need

• Establish an individualized psychiatric treatment plan with short- and long-term goals

• Routinely approve continuation of medications upon intake until full assessment can be completed.

For Medical NPs (FNP/AGNP):

• Perform a full history and physical examination (H&P) upon admission

• Identifyand document acute and chronic medical conditionsimpactingSUD/MH treatment

• Complete a medical review of systems, addressing concerns common in SUD populations

• Order and interpret admission labs, toxicology screens, and diagnostic imaging/testsas indicated

• Establish an individualized medical treatment plan addressing the patient's needs during Mainspring care

• Routinely approve continuation of medications upon intake until full assessment can be completed

SUD & Mental Health Focus During Mainspring Care

• Identifyand address SUD-specific clinical needs including withdrawal management, detox monitoring, and MAT initiation or continuation (buprenorphine, naltrexone, etc.)

• Collaborate with counselors, case managers, and behavioral health staff to ensure psychiatric and medical needs are integrated into the patient's individualized treatment plan

• Participate in interdisciplinary treatment team meetings and case conferences

• Provide clinical consultation to staffregardingthe intersection of medical/psychiatric conditions and SUD recovery

• Screen for co-occurring disorders and refer internally or externally as appropriate

Routine Follow-Up & Ongoing Care

• Conduct scheduled follow-up appointments throughout the patient's stay tomonitortreatment response, medication efficacy, and overall health status

• Reassess and update the care plan based on patient progress, emerging concerns, or changes in clinical status

• Document all clinical encounters, assessments, and care plan updates accurately andin a timely mannerin the EHR

• Monitor vital signs, labs, and diagnostic results; communicate critical values andinitiateappropriate follow-up

• Provide patient educationregardingdiagnosis, medications, side effects, and self-management strategies relevant to SUD recovery

Medication Ordering & Prescribing

• Prescribe and manage medications within scope of practice, including MAT medications, psychiatric medications, and medications for co-occurring medical conditions

• Conduct medication reconciliation upon admission, during treatment, and at discharge

• Monitor for medication interactions, contraindications, and adverse effects with attention to substances common in SUD populations

• Utilize the Virginia Prescription Monitoring Program (PMP) asrequiredprior to prescribing controlled substances

• Collaborate with the Medical Director on complex or high-risk medication regimens

Peer-to-Peer Reviews & Utilization Management

• Complete peer-to-peer (P2P) reviews with insurance medical directors asrequiredto advocate for medically necessary levels of care, continued stays, or treatment services

• Document clinical justification for level-of-care determinations in alignment with ASAM criteria

• Communicate with payers andutilizationmanagement teams to support authorization of clinical services