Advanced Practice Provider (NP or PA) — Rheumatology: Osteoporosis & Bone Health

Key Responsibilities

• Serve as primary provider for osteoporosis, osteopenia, and metabolic bone disease patients (new consults and ongoing management)
• Perform comprehensive fracture risk assessment, including FRAX scoring and fall risk evaluation
• Order DXA scans and review results with the supervising rheumatologist; track serial studies and follow-up compliance
• Initiate and manage the full pharmacologic spectrum: bisphosphonates (oral and IV zoledronic acid), denosumab, romosozumab, teriparatide, and abaloparatide — including anabolic-to-antiresorptive sequencing and denosumab discontinuation/transition planning
• Manage glucocorticoid-induced osteoporosis in the rheumatology population (RA, PMR, lupus, vasculitis patients on chronic steroids)
• Maintain laboratory safety parameters; manage adverse effects and treatment holidays appropriately
• Provide pre-treatment dental clearance coordination and counsel patients on ONJ and atypical femoral fracture risk
• Oversee clinical protocols for in-office IV zoledronic acid infusions and subcutaneous denosumab/romosozumab administration
• Train and supervise clinical staff (MAs/RNs) on injection administration, documentation, and adherence tracking
• Build recall and adherence workflows so no patient misses a denosumab dose window or falls off therapy silently
• Help design and operate a Fracture Liaison Service (FLS)-style pathway: identify post-fracture patients from referring orthopedic and hospital partners and close the treatment gap
• Develop standardized EMR templates, order sets, and patient education materials for bone health visits
• Track program metrics: treatment initiation rates post-fracture, DXA follow-up compliance, adherence/persistence rates, and patient attrition recovery
• Participate in community and referring-provider education (lunch-and-learns, PCP outreach) to grow the program
• Conduct virtual follow-up visits for established bone health patients: DXA and lab review, therapy titration, adherence and side-effect check-ins, and treatment-holiday monitoring
• Triage which patients require in-person evaluation vs. virtual management, and maintain appropriate documentation standards for telehealth encounters
• Extend the program’s reach to patients at distant sites, homebound patients, and post-fracture patients who struggle to travel
• Collaborate with specialty pharmacy on prior authorizations, benefits investigation, and patient assistance programs for branded therapies
• Communicate closely with referring providers to keep them engaged in shared patients' care

Requirements

• Current, unrestricted state licensure as an NP (FNP or AGNP) or PA-C
• National board certification (AANP/ANCC or NCCPA)
• Active DEA registration or eligibility
• 2+ years of clinical experience as an APP (rheumatology, endocrinology, orthopedics, geriatrics, or women's health strongly preferred)
• Comfort managing injectable and infusion therapies
• Strong EMR proficiency and willingness to build/refine templates and workflows
• Comfort and professionalism delivering care via telemedicine, including virtual patient education

PREFERRED

• Direct experience managing osteoporosis pharmacotherapy, including anabolic agents
• Experience with Fracture Liaison Services or bone health program development
• Familiarity with prior authorization and specialty pharmacy processes
• Interest in clinical research; opportunity to serve as sub-investigator on bone health and rheumatology trials