Advanced Practice Provider (NP/PA) – Transplant Nephrology Waitlist Clinic (PRN)
Position Summary
The PRN Advanced Practice Provider (APP) provides comprehensive outpatient care for kidney transplant candidates throughout the transplant evaluation and waitlist process. Working collaboratively with transplant nephrologists, transplant surgeons, nurse coordinators, social workers, dietitians, financial coordinators, and other multidisciplinary team members, the APP evaluates, monitors, and optimizes transplant candidates while ensuring compliance with UNOS/OPTN, CMS, and institutional requirements.
The APP independently manages established waitlisted patients within the scope of practice and assists in new transplant evaluations, re-evaluations, medical optimization, and ongoing surveillance while promoting excellent patient outcomes and regulatory compliance.
Essential Roles & Responsibilities
Clinical Care
Perform comprehensive medical evaluations for kidney transplant candidates.
Conduct annual and interval waitlist re-evaluations.
Assess transplant candidacy and identify barriers to transplantation.
Develop and implement individualized treatment plans in collaboration with transplant nephrologists.
Evaluate changes in medical status that may affect transplant eligibility.
Manage common chronic kidney disease and transplant-related medical issues within scope of practice.
Order, interpret, and review laboratory studies, diagnostic imaging, and specialty consultations.
Initiate appropriate referrals to specialists as needed.
Address acute concerns identified during clinic visits.
Document medical necessity and transplant readiness.
Waitlist Management
Monitor candidates for ongoing transplant eligibility.
Review hospitalizations, surgeries, infections, malignancies, and cardiovascular events impacting candidacy.
Ensure required testing remains current, including:
Cardiac testing
Cancer screening
Infectious disease screening
Imaging
Vascular studies
Identify patients requiring temporary inactive (Status 7) designation and coordinate reactivation.
Collaborate with transplant coordinators regarding listing decisions and waitlist maintenance.
Participate in multidisciplinary waitlist review meetings.
Patient Education
Provide education regarding:
Kidney transplantation
Living donation
Deceased donor transplantation
High KDPI kidneys
HCV-positive donor organs
Living donor process
Waitlist expectations
Medication adherence
Health maintenance
Vaccinations
Lifestyle modifications
Importance of maintaining transplant readiness
Care Coordination
Collaborate with:
Transplant nephrologists
Transplant surgeons
Nurse coordinators
Social work
Dietitians
Financial coordinators
Living donor team
Dialysis centers
Community nephrologists
Primary care providers
Specialty consultants
Coordinate timely completion of required evaluations and follow-up care.
Diagnostic & Therapeutic Management
Within scope of practice:
Order laboratory testing
Review diagnostic studies
Prescribe medications
Adjust antihypertensive therapy
Manage diabetes medications as appropriate
Treat uncomplicated medical conditions
Coordinate vaccinations
Monitor infectious disease screening
Complete medication reconciliation
Documentation
Complete timely and accurate documentation including:
Initial transplant evaluations
Waitlist follow-up visits
Annual re-evaluations
Telephone encounters
Patient portal communications
Medical decision making
Billing documentation
Regulatory documentation
Quality & Regulatory Compliance
Support compliance with:
CMS Conditions of Participation
OPTN/UNOS policies
Institutional protocols
Quality improvement initiatives
Clinical performance metrics
Patient safety initiatives
Assist with:
Chart audits
Performance improvement projects
Waitlist quality metrics
Regulatory readiness activities
Communication
Communicate effectively with:
Patients and caregivers
Referring nephrologists
Dialysis units
Community providers
Hospital teams
Multidisciplinary transplant team
Provide timely responses to clinical questions and urgent issues.
PRN Responsibilities
Provide clinic coverage during provider absences, vacations, and periods of increased patient volume.
Maintain flexibility in scheduling based on clinic needs.
Participate in orientation and competency assessments.
Maintain required certifications and licensure.
Complete mandatory education and regulatory training.
Qualifications
Required
Graduate of an accredited Nurse Practitioner or Physician Assistant program
Current state licensure
DEA registration (if applicable)
National board certification
Current BLS certification
Preferred
ACLS certification
Minimum 2 years of nephrology, transplant, or CKD management experience preferred
Previous transplant experience preferred
Experience with Epic or other electronic medical records
Knowledge, Skills & Abilities
Knowledge of chronic kidney disease and end-stage kidney disease management
Understanding of kidney transplant evaluation and waitlist processes
Familiarity with OPTN/UNOS policies and CMS transplant regulations
Ability to independently assess and manage complex medical patients
Strong clinical judgment and critical thinking
Excellent communication and patient education skills
Ability to function effectively within a multidisciplinary team
Strong organizational and time-management skills
Proficiency with electronic health records
Typical Scope of Practice
The PRN APP may independently manage:
Waitlist follow-up visits
Annual transplant re-evaluations
Status updates
Medical optimization visits
Review of testing and specialty consultations
Routine transplant candidate surveillance
Patient education and counseling
Medication management within scope of practice
The APP collaborates with the transplant nephrologist regarding:
New transplant listing decisions
Complex medical management
High-risk transplant candidates
Changes in transplant candidacy
Waitlist inactivation/reactivation decisions
Significant abnormal diagnostic findings
Complex immunologic or infectious disease concerns
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