Position Overview

Piedmont Healthcare is seeking an experienced Advanced Practice Provider (Physician Assistant or Nurse Practitioner) to join our Neurosurgery team with a specialized focus on pituitary and skull base disorders.

The APP will work closely with a pituitary neurosurgeon and pituitary endocrinology team to provide coordinated, multidisciplinary care for patients with pituitary tumors and other disorders of the sellar and parasellar region.

This is a highly collaborative role spanning the complete patient journey, including outpatient consultation, preoperative evaluation and optimization, operating room support, inpatient rounding, postoperative management, discharge, and longitudinal follow-up.

The ideal candidate will have a strong interest in developing advanced expertise at the intersection of neurosurgery and pituitary endocrinology and becoming an integral member of a comprehensive pituitary program.

Key Responsibilities

Operating Room & Surgical Support

• Provide operative support for pituitary and skull base neurosurgical procedures.
• Serve as First Assist when appropriate based on training, credentialing, and procedural needs.
• Participate in perioperative management of patients undergoing endoscopic transsphenoidal and other pituitary procedures.
• Coordinate with neurosurgery, anesthesia, ENT/skull base surgery, endocrinology, nursing, and other members of the operative team.
• Support standardized clinical pathways designed to promote safe, efficient surgical care.

Preoperative & Perioperative Care

• Conduct comprehensive histories and physical examinations.
• Coordinate preoperative testing, imaging, specialty consultations, medication management, and medical clearances.
• Review surgical preparedness and identify potential clinical issues requiring physician evaluation before surgery.
• Provide patient and family education regarding the surgical process, anticipated hospitalization, recovery, and follow-up.
• Collaborate with endocrinology regarding preoperative assessment of pituitary hormonal function.

Inpatient & Postoperative Management

• Perform daily inpatient rounds on pituitary neurosurgery patients.
• Complete progress notes, orders, consultations, discharge documentation, and care coordination.
• Monitor neurological and endocrine status following surgery.
• Assist in the recognition and management of postoperative issues associated with pituitary surgery, including:
• Diabetes insipidus and disturbances in sodium/fluid balance
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
• Adrenal insufficiency
• Cortisol and other pituitary hormone abnormalities
• Cerebrospinal fluid leak
• Visual or neurological changes
• Postoperative infection or other surgical complications
• Collaborate closely with the neurosurgeon and endocrinologist when escalation or treatment modification is required.
• Coordinate safe and timely discharge, including medication management, laboratory monitoring, patient education, and follow-up appointments.

Outpatient Responsibilities

• Participate in new and established patient consultations for pituitary and sellar disorders.
• Obtain comprehensive histories, perform physical examinations, and review relevant imaging and laboratory results.
• Participate in postoperative clinic visits and longitudinal surveillance.
• Coordinate laboratory testing, MRI surveillance, specialty referrals, and postoperative follow-up.
• Provide education regarding diagnosis, surgical treatment, recovery, medications, symptoms requiring urgent evaluation, and long-term follow-up.
• Participate in night and weekend call and hospital rounding rotation with other APPs.

Pituitary Endocrinology Support

A distinguishing feature of this position is its close integration with pituitary endocrinology.

The APP will:

• Support coordinated neurosurgery/endocrinology evaluation of pituitary patients.
• Facilitate appropriate pituitary hormone testing and ensure results are available for physician review.
• Assist with coordination of postoperative endocrine surveillance.
• Reinforce medication and hormone-replacement education established by the treating endocrinologist.
• Help coordinate management of cortisol, thyroid, sodium/fluid balance, gonadal and other pituitary-axis abnormalities.
• Facilitate communication between neurosurgery, endocrinology, primary care, and other specialists.
• Help ensure patients do not become lost to follow-up after surgery and receive appropriate long-term endocrine and imaging surveillance.

Multidisciplinary Program Responsibilities

The APP will serve as an important clinical connector within the pituitary program and may participate in:

• Multidisciplinary pituitary or skull base conferences
• Case review and treatment planning
• Patient navigation and care coordination
• Development of standardized clinical pathways
• Patient and referring-provider education
• Quality and outcomes monitoring
• Clinical documentation and program development
• Referral coordination and timely access for new pituitary patients

Qualifications

Required

• Graduate of an accredited Physician Assistant or Nurse Practitioner program.
• Current or eligible Georgia PA or APRN licensure.
• Appropriate national board certification.
• Current BLS certification.
• Ability to obtain appropriate hospital privileges and meet Piedmont credentialing requirements.
• Excellent clinical judgment, communication, organization, and patient-care skills.

Preferred

• 1–2+ years of neurosurgery, endocrinology, neuroendocrinology, ENT/skull base surgery, or other surgical experience.
• Prior operating room or First Assist experience.
• Experience caring for neurosurgical patients in the inpatient setting.
• Experience with pituitary, skull base, neuroendocrine, or endocrine disorders is highly desirable.
• Experience coordinating multidisciplinary patient care.
• Strong interest in developing specialized expertise in pituitary disease.

Ideal Candidate

The ideal candidate is a highly collaborative APP who is comfortable functioning across multiple clinical environments including the OR, inpatient unit, neurosurgery clinic, and endocrinology clinic.

Because pituitary care bridges surgical and medical specialties, the successful candidate should enjoy multidisciplinary practice, complex patient management, detailed care coordination, and developing long-term relationships with patients.

The candidate should also be interested in becoming a pituitary-focused clinical expert, rather than functioning solely as a general neurosurgery APP.