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At Avera Heart Hospital, you’re not just joining a workplace – you’re becoming part of a family. With more than 700 dedicated employee, we deliver care that truly makes a difference. Our commitment to excellence has earned us the distinction of being one of only a handful of hospitals nationwide – out of more than 4,000 – to achieve a double 5-star rating from the Centers for Medicare and Medicaid Services.

Position Highlights

Position Summary:

The Vascular First Assist Advanced Practice Provider (APP) functions as both a skilled surgical first assistant to the vascular surgery team and an independent/collaborative clinician in the outpatient vascular clinic.

This dual-role position requires advanced clinical judgment, technical proficiency in the operating room, and strong diagnostic and management skills in the clinic setting. The Vascular First Assist APP plays a critical role in ensuring safe, efficient, and high-quality surgical and ambulatory care while supporting optimal patient outcomes across the continuum of care.

Responsibilities:

Surgical First Assist Responsibilities (OR)

Act as first assistant in vascular surgical procedures, including open and endovascular cases.

Provide expert tissue handling, exposure, retraction, hemostasis, and suturing under surgeon direction.

Assist with vessel exposure, anastomosis preparation, and graft placement

Participate in wound closure, dressing application, and intraoperative decision-making as appropriate.

Maintain sterile technique and anticipate surgical needs throughout the procedure.

Assist with intraoperative troubleshooting and complication management in collaboration with the surgeon.

Outpatient Vascular Clinic Responsibilities

Independently or collaboratively evaluate new and established vascular patients.

Perform focused history and physical examinations related to vascular disease.

Order, interpret, and act on appropriate diagnostic testing (e.g., duplex ultrasound, ABI, CTA, labs) in collaboration with supervising physicians.

Develop and implement evidence-based treatment plans for conditions including:

- Peripheral arterial disease

- Carotid disease

- Venous insufficiency and varicose veins

- Wound care related to vascular disease

- Postoperative follow-up care

Provide preoperative evaluations and surgical clearance coordination

Conduct postoperative clinic visits including:

-Wound assessment and management

-Suture/staple removal when appropriate

-Complication recognition and triage

-Medication management and patient education

Counsel patients on:

- Risk factor modification (smoking cessation, exercise, medication adherence).

- Surgical vs. non-surgical treatment options.

- Expectations for recovery and long-term vascular health.

- Collaborate closely with vascular surgeons, vascular sonographers, and nursing staff.

- Document thoroughly and accurately in the electronic medical record.

Education:

Graduate of an accredited Physician Assistant program or Nurse Practitioner programs (MSN/DNP). ​

Current, unrestricted PA license (state) with NCCPA certification or NP license (state) with national board certification (AANP/ANCC as applicable).

Current DEA license for prescribing.

BLS required; ACLS required or obtained within a defined onboarding period.

Experience:

Minimum 1-2 years clinical experience as an APP in an inpatient and/or procedural setting or strong surgical rotation background with readiness to function in perioperative workflows.

Prior APP experience in Vascular Surgery preferred.

Prior first assist experience with vein harvest/endovascular preferred.