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Director, Advanced Practice Nursing / CNS

HEALTH SYSTEM Full Time Durham, North Carolina
Requisition Number: 236358

Duke Health strongly recommends getting up-to-date vaccinations against COVID-19, especially for those with conditions that place them at higher risk. However, COVID-19 vaccination is no longer a requirement for team members at Duke Health.

Director of Advanced Practice Nursing / CNS

Job Location – Duke University Hospital

Job Summary

Provide overall direction and leadership for activities and operations associated with the provision of advanced clinical practice services in accordance with the hospital and health system strategic plan and objectives, internal and external credentialing and regulatory requirements, and evidence based practice standards on a 24 hour basis.  The Director of Advanced Practice is responsible for 24/7 management of all aspects of those advanced practice positions within a Clinical Service Unit (CSU) or Units. In addition the director is responsible for maintaining productive working relationships with medical staff and hospital / health system leadership.  The Director also serves as an expert resource for requirements related to licensure, regulatory, and practice issues for advanced practice nursing positions to include Nurse Clinicians  (NC), Clinical Nurse Specialists (CNS), Nurse Practitioners (NP), Critical Care Nurse Practitioners (CCNP) and Certified Nurse Midwives (CNM); Critical Care Physician Assistants (CCPA), and for Physician Assistants (PA).

Job Duties and Responsibilities

  • Remain clinically relevant by providing 20% effort in appropriate clinical area.
  • Direct and coordinate work of designated advanced practice employees, manage personnel activities to meet CSU/ Departmental, Hospital, and Health System objectives related to the provision of patient care within designated clinical areas.
  • In collaboration with CSU Vice President, ACNO, Medical Director and other key leadership personnel, establish strategic and operational plan to ensure adequate advanced practice staffing, space and facilities.  Communicate and continuously evaluate plans.
  • Ensure effective processes for recruitment, orientation, on-boarding, competency assessment, staff development, and retention.  Assure staff participation in hospital/health system, departmental, CSU, and unit structures as appropriate.
  • Collaborate with DUHS and entity leadership to determine need for advanced clinical practice positions, based on hospital metrics, patient care needs, clinical coverage requirements, staffing plans, and projected areas of growth.
  • Partner with physician and hospital senior leadership to develop and communicate vision for MD / NP / PA / CNM / care delivery models and facilitate implementation and ongoing refinement of such models in designated CSUs across the continuum including critical care, step-down, intermediate, and ambulatory settings.  
  • Hire qualified staff and maintain appropriate staffing ratios consistent with the needs of the organization and within budgetary parameters.
  • Provide leadership and direction for policy and procedure recommendations related to advanced clinical practice issues within specific CSU and across the Health System. Serve as an expert resource to CSU, entity, and DUHS leaders about advanced practice requirements for practice, licensing, regulatory and compliance requirements.
  • Ensure the activities of all advanced practice personnel under director’s leadership meet The Joint Commission, the NC Board of Nursing, the Medical Board of North Carolina, and other regulatory body standards for credentialing, orientation, ongoing development and evaluation of staff. 
  • Provide leadership and administrative direction to Team Leaders including supporting plan development, priority-setting, decision-making, fiscal planning, and professional development.
  • Hire qualified staff and maintain appropriate staffing ratios consistent with the needs of the organization and within budgetary parameters
  • Provide coaching and feedback on performance to Team Leaders and advanced clinical practice staff and colleagues.  Conduct thorough performance appraisal and development planning in a timely manner.  Institute corrective action plans, disciplinary action, and termination, when appropriate.
  • Direct the development and implementation of educational programs for advanced clinical practice staff.  Ensure developmental opportunities for advanced practice employees and other DUHS staff.   Ensure effective communication through team meetings, one-on-one meetings, retreats, electronic communications, etc.
  • Direct the planning, coordinating and conducting of team meetings, leadership development retreats, hospital and health system meetings to ensure compliance with established practices and regulatory requirements, to implement new policies, and provide communication to staff, and to engage leadership at all levels in strategic planning.
  • Ensure effective communication to all advanced practice staff, team leaders, nursing leadership, health system/hospital leadership, and medical staff.
  • Champion collaboration and communication across work areas and departments.  Facilitate solutions to problems and resolve complaints regarding departmental services and activities.
  • Remain current with trends and changes in practice both within advanced practice roles and in regard to the overall organization and health care environment.
  • Provide leadership and direction for assigned Nursing Champion Programs including program structure, expectations, metrics, and budget.
  • Represent the Assistant Vice President of Nursing - Advanced Practice regarding advanced clinical practice issues.
  • Perform other related duties incidental to the work described herein.

Job Eligibility Requirements


  • Must have minimum of Master’s Degree in Nursing or Physician Assistant Studies, MSN or DNP preferred.


  • Must have Advanced Practice Certification, NP or CNS preferred.


  • Must have unrestricted RN license issued by or recognized by the NCBON with authorization to practice as a Nurse Practitioner OR Must have unrestricted medical license issued by the NCMB with authorization to practice as a Physician Assistant


  • Minimum of 3 years’ experience in advanced clinical practice as a working NP or PA with proven leadership experience and evidence of operations / administrative responsibilities.


Knowledge, Skills and Abilities

  • Ability to manage multiple organization missions. Facilitation, consensus-building, and negotiation skills
  • Sensitivity for and understanding of clinical disciplines and issues.
  • Understand cost containment and managed care systems.
  • The ability to work with all types of individuals in multiple settings and locations and to promote diversity in the workplace.
  • Knowledge of necessary regulatory bodies including The Joint Commission, North Carolina Board of Nursing, and Medical Board of North Carolina.
  • Expert communication skills.

Physical and mental requirements:

  • Able to clearly articulate scope of practice, and practices within those guidelines as a Nurse Practitioner / Physician Assistant in the state of North Carolina and within the Duke University Health System.
  • Able to independently seek out resources and work collaboratively to solve complex problems
  • Able to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership, and others.
  • Able to use sensory and cognitive functions to process and prioritize information, perform health assessments, treatment, and follow-up.
  • Able to use fine motor skills
  • Able to record activities, document assessments & interventions; prepare reports and presentations;
  • Able to use computer and learn new software programs
  • Able to provide leadership in clinical area of expertise and in meeting organizational goals
  • Able to navigate the Hospital and DUHS to provide clinical expertise to specific patient populations
  • Able to withstand prolonged standing and walking with the ability to move or lift at least fifty pounds
  • Able to remain focused and organized
  • Able to work collaboratively with all levels of personnel
  • Ability to manage multiple organization missions
  • Ability to work with all types of individuals in multiple settings and locations and to promote diversity in the workplace.
  • Facilitation, consensus-building, and negotiation skills.
  • Sensitivity for and understanding of clinical disciplines and issues.
  • Understand cost containment and managed care systems.
  • Knowledge of necessary regulatory bodies including The Joint Commission, North Carolina Board of Nursing, and Medical Board of North Carolina.
  • Expert communication skills.

Job Hours

Salaried position, primarily Monday - Friday dayshift with oversight of 24/7 APP coverage models

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

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