Placer County

Mid-Level Practitioner - Senior (#13554)

$50.47-$63.03 Hourly / $8,748.13-$10,925.20 Monthly / $104,977.60-$131,102.40 Yearly


To perform clinical services and/or provide program coordination as a nurse practitioner or physician assistant; to assess and manage the most difficult and complex medical care needs of patients in a clinic setting; and to exercise direct supervision over professional, technical and clerical staff.


This is the advanced journey level class in the Mid-Level Practitioner series.  Positions at this level are distinguished from other classes within the series by the level of responsibility assumed, complexity of duties assigned, independence of action taken, by the amount of time spent performing the duties and by the nature of the public contact made.  Employees perform the most difficult and responsible types of duties assigned to classes within this series including the assessment and management of the most difficult and complex medical care needs of patients, management of a specific program, and the exercise of direct supervision over professional, technical and clerical staff.  Employees at this level are required to be fully trained in all procedures related to assigned area of responsibility.


Receives general direction from the Deputy Director, Public Health Nursing and/or the Medical Services Manager and/or the Health Officer; may receive technical and functional supervision from other professional medical staff.

Exercises direct supervision over professional, technical and clerical staff.


Duties may include, but are not limited to, the following:
  • Coordinate program areas as assigned; assist in developing new and evaluating existing, public health programs; prepare grant applications to fund or expand existing programs consistent with the goals of the assigned division; assist in the development, evaluation and management of program budgets.
  • Participate in the selection of staff; provide or coordinate staff training; conduct performance evaluations; recommend discipline; implement discipline procedures as directed.
  • Provide for the care of superficial wounds and burns, removal of foreign bodies from the skin, incision and drainage of infections, suturing of wounds and incisions, casting or splinting of sprains and simple fractures.
  • Order and interpret electrocardiography and radiography.
  • Assist in developing new and evaluating existing, public health nursing programs.
  • Assist and consult with physicians regarding treatment of patients.
  • Assess medical histories, perform comprehensive physical examinations, record findings and make evaluations.
  • Order, interpret and may perform laboratory and other diagnostic testing.
  • Perform routine and specialized therapeutic procedures.
  • Diagnose, instruct and counsel patients and family members as appropriate, regarding medical problems.
  • Develop and implement treatment plans under protocol.
  • Evaluate basic dental diseases for referral.
  • Provide emergency services in the absence of a physician, including life saving emergency procedures in order to stabilize a patient sufficiently to transport to a hospital facility.
  • Participate in clinical investigations, collaborate with physician's staff and appropriately refer complex medical conditions to a physician.
  • Perform other related work as required within the guidelines established by the State of California Board of Registered Nursing and/or Medical Quality Assurance.
  • Aid in the prevention and control of communicable disease through the instruction of preventive health measures.
  • Participate in interagency conferences.
  • Build and maintain positive working relationships with co-workers, other County employees and the public using principles of good customer service.
  • Perform related duties as assigned.


Experience and Training
Any combination of experience and training that would provide the required knowledge and abilities is qualifying.  A typical way to obtain the required knowledge and abilities would be:

Experience: Two years of responsible nurse practitioner or physician assistant experience performing duties similar to a Mid-Level Practitioner II with Placer County.

Training: Equivalent to completion of a formal Nurse Practitioner or Physician Assistant training program at an accredited educational institution.

Required License or Certificate:

  • Possession of a valid license as a Registered Nurse and Nurse Practitioner, Pediatric Nurse Practitioner, Family Nurse Practitioner or Family Planning Nurse Practitioner, or a valid Certificate or Letter of Approval to practice as a Physician Assistant issued  by the State of California Board of Medical Quality Assurance.
  • May need to possess a valid driver's license as required by the position.  Proof of adequate vehicle insurance and medical clearance may also be required.


Knowledge of:

  • Current principles, practices, methods and techniques in the field of medicine.
  • Ethics and special human relationships in the field of medicine.
  • Medications and their desired effects, side effects, contra-indications and complications.
  • Medical symptoms and findings for the purpose of determining treatment or referral.
  • Policies and procedures of a health services department, especially as related to assigned division.
  • Practices, standards and trends of program areas to which assigned.
  • Differing cultural, religious, economic and social groups and their relationships to the delivery and acceptance of health care services. 

Ability to:

  • On a continuous basis, know and understand all aspects of the job; intermittently analyze work papers, patient charts, reports and special projects; identify and interpret technical and numerical information; observe and problem solve operational and technical policies and procedures; explain medical procedures.
  • On an intermittent basis, sit at desk for long periods of time while reviewing patient charts and histories and preparing patient charts and reports; intermittently walk, stand, bend and reach while examining/treating patients or conducting tests.  Intermittently twist to reach equipment surrounding desk and treatment areas; perform simple grasping and fine manipulation; use telephone and write or use a keyboard to communicate through written means; see and hear with sufficient acuity to examine patients and make diagnoses; and lift moderate weight.
  • Supervise, train and evaluate the work of subordinate personnel.
  • Coordinate program areas as assigned.
  • Assess and manage the most difficult and complex medical care needs of patients.
  • Understand and carry out complex written and oral directions.
  • Effectively use the community referral system to assist clients in obtaining additional personal, medical and psychological assistance.
  • Work with various cultural and ethnic groups in a tactful and effective manner.
  • Act quickly and calmly in emergency situations.
  • Obtain information through interview; deal fairly and courteously with the public; handle multiple cases; and work effectively with interruption.
  • Analyze situations quickly and objectively and determine proper course of action.
  • Use equipment and supplies appropriate to medical diagnosis and treatment.
  • Communicate clearly and concisely, both orally and in writing.
  • Establish and maintain effective working relationships with those contacted in the course of work.

CLASS: 13554; EST: 9/2/1995; REV: 9/1/2002;