INTRODUCTION: The incumbent is assigned as an Occupational Health (OH) Program Manager and Nurse Practitioner in the Occupational Health Department in addition to performing primary health care provider duties at Navy Medicine Readiness and Training Unit (NMRTU) Fallon Nevada. The purpose of this position is to provide comprehensive medical care to patients with occupational and safety related illnesses/injuries and to perform medical surveillance and qualification examinations for both the active duty and civilian population while augmenting the Primary Care Medical Home as needed. Duties include Occupational Health management and primary care with responsibility for independent examination, diagnosis, and treatment within personnel credentials and privileges delineated by the Medical Treatment Facility (MTF). The incumbent is responsible for the following: implementing and managing the Occupational Medicine Program and Occupational Health Personnel for activities supported by NMRTU Fallon; providing OH Nurse Practitioner support services at NMRTU Fallon as directed; and collaborating with physicians, medical specialists, nurses, occupational health technicians, industrial hygienists, safety specialists and senior management personnel on an ongoing basis. II. MAJOR DUTIES AND RESPONSIBILITIES: 1. Administrative Functions Incumbent implements the OH Program for NMRTU Fallon, NV in collaboration with OH Department at Navy Medical Readiness Training Command (NMRTC) Lemoore. Provides technical and administrative support and oversight regarding continuity of OH and Safety services to the commands and activities assigned. Provides guidance on OH standards and criteria and ensures that appropriate consideration is given to OH matters in the plans and programs for the development of facilities, equipment, and processes. Represents the command at meetings, conferences, and committees involving policy and other matters pertinent to OH and Safety and coordinates program activities with other federal agencies. Receives, reviews, and interprets Department of the Navy, Department of Labor, and other Federal and State OH and Safety regulations. Deals with federal, state and local agencies concerning the interpretation and implementation of regulatory requirements, with resulting impacts and other issues. Advises leadership on OH and Safety matters. Coordinates development of educational programs. Maintains contact with Occupational and Safety Health Administration (OSHA), Navy Medical Forces Pacific and Navy Marine Corps Public Health Center, and others performing research in the areas of OH and Safety to make use of the latest state-of-the-art developments. Provides direct and indirect technical and administrative guidance over the work accomplished within the Navy Medical Forces Pacific Region, OH Program. Coordinates and collaborates with providers and nurses in solving mutual problems and establishing a consistent program among the commands served. Utilizes a system approach to affect change. Collaborates and negotiates with other involved leaders to decide and/or coordinate work-related changes. 2. Occupational Health Clinical Functions The primary clinical responsibility is to perform OH surveillance and certification exams for supported commands. Performs medical assessment with history and physicals, determines diagnosis, and initiates treatment according to standardized medical protocols for occupational and non-occupational injuries and illnesses for the civilian population. Referrals to other providers or specialists are made when the scope of diagnosis and treatment is beyond the realm of standardized medical protocols or safe practice of a Nurse Practitioner. Orders and interprets appropriate laboratory tests and ancillary services and prescribes medications when appropriate. Makes determination regarding restriction or limitations of work duties. Recognizes hazardous exposures and initiates treatment and follow-up. Potential health hazards encompass a broad spectrum including chemical, physical (ionizing radiation, lasers, etc.) and biological agents. Notifies Industrial Hygienist and/or Safety Officer and/or management of unsafe conditions and exposures. In collaboration with these specialists, evaluates the work site to determine if any relationship exists between employees symptoms and hazardous exposures. Consults with physicians regarding occupational exposures and makes treatment recommendations. Makes determination about temporary or total disability to a worker for an occupational injury in the form of light/limited duty or traumatic injury leave. Performs limited palliative care and referral for employees with non-work-related complaints so that the work shift may be completed, minimizing time the employee is out of work. Uses independent judgment in assessing the individual, the medical condition, the relevant data in the medical record, and industrial hygiene reports of the work site, and visits the work site to determine if the illness etiology is occupational or non-occupational. Provides medical support and consultation to the Preventive Medicine division on issues to include but not limited to tuberculosis, communicable disease, sexually transmitted diseases, infectious disease, blood borne pathogen exposure, rabies control, and travel medicine. Performs pre-placement, certification, termination, fit-for-duty, and medical surveillance examinations in accordance with established Navy guidelines utilizing medical history, occupational history, diagnostic testing, position descriptions, industrial hygiene surveys, and workplace exposure data. Independently performs medical surveillance physical examinations for personnel exposed to hazardous agents. Obtains detailed patient history including occupational and environmental data. Performs appropriate physical examinations. Occasionally consults with other health care professionals regarding unusual results. Refers patients to outside medical facilities as appropriate. 3. Primary Care Clinical Functions Provides clinical staffing to the Patient Centered Medical Home (PCMH) mission. Maintain proper medical record documentation on patients receiving treatment in accordance with DHA-PM 6025.02 DoD Health Record Lifecycle Management. Examines patient and performs initial patient work-up and assessment of patients care and treatment; and determines the need for and orders laboratory tests, X-rays, and other procedures necessary to complete patient assessment. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional or mental problems and provide surveillance of adherence to medical and primary care practices and procedures to stabilize chronically ill patients; adjust regiments within established protocols recognizing when to refer the patient to the physician or other primary care members. Nurse Practitioner maintains primary responsibility for primary care, while facilitating other specialty care. The work involves counseling, teaching, coordinating services, and participating with other disciplines in interpreting and evaluating the health care plan. The incumbent also interfaces with physicians and health care providers from other institutes for purposes or patient consultation and referrals as well as ongoing staff education and program development; works independently and collaboratively with physicians in patient management, evaluation, and revision of therapeutic plans; and refers selected or complex medical problems to the appropriate level of care. Provides group, individual and/or family teaching and counseling and/or initiates coordination of health care needs. Prescribe medications, as appropriate, and in accordance with the privileges and local rules and regulations. Provide only those services and prescribe only those drugs for which he/she holds privileges. Uses MHS GENESIS and Joint Legacy Viewer (JLV) for updating notes, ordering of ancillary procedures, such as X-rays, labs, etc., writing orders, such as medication, referrals, etc., including cost efficient, timely, and quality services throughout the continuum of care assuring that patients receive appropriate level of care according to pre-established standards of the Medical Treatment Facility (MTF). Provides care for patients by coordinating, monitoring, and administering outpatient care of medical patients. Ensures all documentation and reports are legible and complete in a timely manner. Abide by all facility rules, regulations, and policies. Performs other duties as assigned.