Advanced Practice Registered Nurse; APRN

Description

The APRN provides psychiatric and addiction-focused medical care to clients receiving residential treatment at our ranch and lodge campuses. This role meets with clients for scheduled and as-needed medical appointments, completes psychiatric evaluations, and prescribes and manages medications for co-occurring mental health and substance use disorders.

This is the sole on-site prescribing provider role, and it is a traveling position. The APRN divides scheduled clinic time between our Ranch and Lodge campuses, holding client appointments at each site, and is supported by remote consulting physicians and a small on-site nursing team. Because on-site physician coverage is not available, the position requires a clinician who practices autonomously, exercises independent judgment, and is comfortable working with limited on-site nursing support.

Confidence and competence in medication-assisted treatment is the central requirement of this role. The APRN independently manages buprenorphine, naltrexone, and other approved medications for opioid and alcohol use disorder across the full client census, alongside psychotropic medication management for co-occurring mental health conditions.

Recovery Centers of Montana currently operates at ASAM Level 3.5 (clinically managed high-intensity residential). The organization intends to expand to ASAM Level 3.7 (medically monitored intensive inpatient) in the future, and this position will help build toward that transition as medical and nursing capacity grows.

• Meet with clients at the ranch and lodge for scheduled medical and psychiatric appointments, including admission assessments, follow-up visits, and urgent or same-day requests.
• Complete comprehensive psychiatric and substance use evaluations, including history, mental status examination, risk assessment, and diagnostic formulation using current DSM criteria and ASAM criteria.
• Prescribe, monitor, adjust, and discontinue psychotropic and addiction-related medications within the scope of Montana APRN licensure and prescriptive authority.
• Order, interpret, and act on laboratory studies, drug screens, and diagnostic tests; identify and manage medical conditions that commonly accompany substance use.
• Assess and respond to psychiatric crises, including suicidal or homicidal ideation, psychosis, and acute intoxication or withdrawal, and coordinate transfer to a higher level of care when clinically indicated.
• Educate clients and, with appropriate consent, families on diagnoses, medications, side effects, and the role of medication in sustained recovery.

• Independently initiate, titrate, monitor, and taper buprenorphine for opioid use disorder, including induction planning and management of precipitated withdrawal risk.
• Prescribe and manage naltrexone (oral and extended-release injectable) and other approved medications for alcohol and opioid use disorder.
• Assess appropriateness of medication for each client, discuss options without bias toward any single modality, and document informed consent and shared decision-making.
• Oversee withdrawal management using standardized assessment protocols, in coordination with nursing staff, and determine when withdrawal severity exceeds the on-site level of care.
• Manage psychotropic medications for co-occurring depression, anxiety, PTSD, bipolar disorder, and psychotic disorders, including attention to interactions with MAT medications.
• Query the Montana Prescription Drug Registry as required, maintain DEA compliance, and follow written protocols for controlled substance prescribing and storage.
• Establish continuing MAT prescriptions and community pharmacy or provider linkage prior to discharge so that treatment is not interrupted.

• Hold scheduled client appointments at both the Ranch and Lodge campuses according to an established weekly clinic schedule.
• Travel between campuses using personal or agency vehicle, with mileage reimbursed at the current agency rate.
• Remain reachable for medical consultation by phone or telehealth for the campus not staffed on a given day, and travel on site when clinically necessary, including within 24 hours of a new admission.
• Plan appointment scheduling and medication reviews so that clients at both sites receive timely follow-up despite split coverage.

• Participate in treatment team…