Metabolic & Perioperative Support Nurse Practitioner (NP) / Physician Assistant (PA)

Department/Unit:

General Surgery AMCPR - Metabolic and Perioperative Support

Work Shift:

Day (United States of America)

Salary Range:

Salary Range: $117,766- $138,548

The Advanced Practice Provider (Nurse Practitioner or Physician Assistant) provides specialized inpatient care at the intersection of palliative medicine, metabolic optimization, and geriatric surgical co-management. This role partners closely with surgical teams, hospital medicine, geriatrics, nutrition, and palliative care to improve outcomes for medically complex, frail, or high-risk surgical patients. The APP serves as a clinical leader who advances patient-centered care, symptom management, and evidence-based perioperative optimization.

Key Responsibilities

1. Inpatient Clinical Management

• Provide daily evaluation and management of hospitalized patients requiring palliative, metabolic, or geriatric co-management.
• Conduct comprehensive assessments including functional status, frailty, nutritional risk, symptom burden, and goals of care.
• Develop and implement individualized care plans in collaboration with surgical and interdisciplinary teams.
• Manage acute and chronic symptoms such as pain, dyspnea, nausea, delirium, and anxiety using evidence-based approaches.
• Optimize metabolic and nutritional status, including coordination of enteral/parenteral nutrition, glucose management, and micronutrient support.
• Lead geriatric-focused interventions such as delirium prevention, mobility protocols, medication reconciliation, and polypharmacy reduction.

2. Palliative Care Integration

• Facilitate goals-of-care discussions, advance care planning, and shared decision-making with patients and families.
• Provide primary palliative care support for symptom management and psychosocial needs.
• Identify patients who require specialty palliative care consultation and coordinate referrals.
• Support transitions of care, including hospice referrals when appropriate.

3. Outpatient Pre-Operative Optimization Clinic

• Conduct comprehensive pre-operative evaluations for frail, high-risk, or medically complex surgical patients.
• Perform frailty assessments, functional evaluations, nutritional screening, and metabolic risk stratification.
• Identify modifiable risk factors and develop individualized optimization plans (nutrition, mobility, glucose control, medication adjustments, symptom management).
• Lead shared decision-making conversations that integrate surgical risk, patient goals, and expected recovery trajectories.
• Coordinate referrals to geriatrics, cardiology, pulmonology, nutrition, palliative care, or other specialties as needed.
• Educate patients and families on perioperative expectations, enhanced recovery pathways, and postoperative support needs.
• Collaborate with surgeons and anesthesiology to determine surgical readiness and align on risk-mitigation strategies.
• Track optimization metrics and postoperative outcomes to support continuous improvement.

4. Surgical Co-Management & Perioperative Optimization

• Partner with surgical teams to identify high-risk patients pre- and post-operatively.
• Implement evidence-based protocols for frailty assessment, enhanced recovery, and metabolic optimization.
• Monitor postoperative complications and intervene early to prevent decline.
• Participate in multidisciplinary rounds, case conferences, and care coordination meetings.

5. Communication & Family Support

• Serve as a consistent point of contact for families navigating complex surgical hospitalizations.
• Provide clear, compassionate updates and education regarding prognosis, treatment options, and expected recovery trajectories.
• Support culturally sensitive communication and shared decision-making.

6. Interdisciplinary Collaboration

• Work closely with surgery, geriatrics, palliative care, nutrition, PT/OT, case management, and nursing.
• Promote a team-based approach that centers patient dignity, functional recovery, and quality of life.
• Participate in care pathways and clinical protocols that integrate metabolic and geriatric principles into surgical care.

7. Quality Improvement & Clinical Excellence

• Contribute to departmental QI initiatives related to frailty, delirium, nutrition, readmissions, and end-of-life care.
• Track and report clinical outcomes, documentation quality, and adherence to care pathways.
• Participate in morbidity and mortality reviews, geriatric surgery initiatives, and palliative care quality metrics.

7. Education & Professional Development

• Provide education to medical students, residents, fellows, and nursing staff on palliative, metabolic, and geriatric principles.
• Stay current with evolving evidence in perioperative geriatrics, palliative care, and metabolic optimization.
• Participate in departmental teaching conferences and continuing education.

Qualifications

• Master's degree from an accredited NP or PA program.
• National certification and state licensure as an NP or PA.
• Experience in palliative care, geriatrics, hospital medicine, or surgical co-management preferred.
• Demonstrated skill in complex communication, interdisciplinary teamwork, and high-acuity inpatient care.
• Commitment to patient-centered, culturally responsive care.

Thank you for your interest in Albany Med Health System!

Albany Med Health System is an equal opportunity employer.

This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.