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

We are seeking a Nurse Practitioner or Physician Assistant to lead and grow a dedicated

Osteoporosis & Bone Health program within our rheumatology practice. This is a specialty focused

role: the APP will serve as the primary clinician for metabolic bone disease patients,

operating with a high degree of autonomy under the supervision/collaboration of a board certified

rheumatologist. The role combines direct patient care, infusion and injectable

therapy management, fracture prevention program development, and care coordination with

referring specialties (orthopedics, endocrinology, primary care, oncology, and women’s

health).

This is a hybrid role combining on-site and telemedicine care. In-person days center on

new consults, infusion/injection oversight, and procedures; telemedicine sessions cover

follow-ups, DXA and lab result reviews, medication monitoring, and adherence check-ins.

This structure allows the APP to serve patients across multiple sites and geographies while

maintaining a hands-on clinical anchor.

This position is ideal for an APP who wants true subspecialty ownership — building a Bone

Health Center of Excellence rather than functioning as general clinic overflow.

Key Responsibilities

Clinical Care

• 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
• Conduct secondary osteoporosis workups (celiac disease, hyperparathyroidism, vitamin
• D deficiency, hypogonadism, monoclonal gammopathy, glucocorticoid-induced
• osteoporosis, etc.)
• 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)
• Monitor 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

Infusion & Injection Program

• 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

Program Development

• 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

Telemedicine Care Delivery

• 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
• Use virtual visits to extend the program’s reach to patients at distant sites, homebound
• patients, and post-fracture patients who struggle to travel

Collaboration

• Work under a collaborative/supervisory agreement with the practice rheumatologist(s),
• with structured case review for complex patients
• Coordinate 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