Summary The ISOU Advanced Practice Provider position is tasked with delivering medical care to migrants during U.S. Coast Guard Alien Migrant Interdiction Operations and ICE removal missions. Responsibilities include emergency care, consulting, and supporting IHSC facilities. The role requires advanced clinical expertise, on-call readiness, and adaptability in austere environments, including at sea and in flight. This position is only open to USPHS officers and Call to Active Duty (CAD) candidates. Responsibilities DUTIES AND RESPONSIBILITIES: The incumbent serves as either a Physician Assistant or Nurse Practitioner with responsibility for providing direct patient care to migrants during Alien Migrant Interdiction Operations (AMIO) and to individuals in ICE custody during removal missions. Performs a variety of unusual and complex professional tasks without close supervision. Operates under U.S. Coast Guard medical protocols and must respond within 24 to 48 hours when on call. Provides medical care aboard cutters, small boats, fixed and rotary-wing aircrafts. Ensures official representation of U.S. government health services at sea. Anticipates and responds to medical needs in collaboration with military, federal, state, and civilian partners. Provides medical guidance as Medical Aircrew Member (MAM), plans patient transfers, and delivers care in remote or austere environments. Ensures continuity of care and patient safety while supporting mission objectives domestically and overseas. Acts as specialty consultant to local regional, and national programs. Advises on policy development, program implementation, and evaluation in compliance with regulations and laws. Reviews and analyzes, prepares written reports, and contributes to the development of medical protocols. Independently establishes evaluation criteria, formulates approaches, and participates in conferences or meetings on significant issues affecting mission performance and public health. Supports ICE Enforcement and Removal Operations (ERO) Field Offices by providing medical guidance, patient care, and planning support. Serves as Federal Emergency Response Official credentialed officer and responds to agency-declared emergencies as directed. Serves as an APP at an IHSC facility. Develops and implements care plans, for patients with complex physical, mental, and social health needs. Performs diagnostic procedures, prescribes treatments, and manages medical equipment and nursing techniques. Exercises independent judgment to protect patient safety and achieve mission readiness. Performs additional program duties and responsibilities as directed by the unit and/or agency. Remains flexible and able to adapt to sudden changes in schedules and work requirements, which may mean leave cancellation if it interferes with unanticipated missions or trainings. Requirements Conditions of Employment Qualifications PHYSICAL DEMANDS: Required to perform CPR or emergency care standing and kneeling positions at times in confined spaces. Must have the ability to assist sick, injured, or other during ingress and egress (e.g., may require lifting, dragging, wheeling, or carrying someone who weighs significantly more than oneself). Must be able to lift and carry 50 lbs. of medical equipment 100 yds. without assistance. Incumbent carries equipment when boarding and disembarking the vessels. Must be able to see, hear, and smell with aids if necessary. Must easily alternate between kneeling and standing. Must be able to perform the duties in a stressful and often austere environment with inclement weather and challenging sea states and altitudes without physical limitations. Agency may require incumbent to work extended hours and remain at sea, confined cabin space, or aircraft during inclement weather and ground delays. Must be able to physically able to climb ladders and stairs without impediment. Must be able to tolerate sudden changes in environment, temperature, seasons, altitudes, geographies and weather. Must be able to pass the FAA Class III Flight Physical for Altitude Physiology Chamber orientation. Education REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES: Meet the minimum education, years of experience, and license requirements for either nurse practitioner or physician assistant. Nurse practitioner Master's of science in nursing from a program accredited by the National League for Nursing Accrediting Commission or the Commission on Collegiate Nursing Education; Three years clinical experience as a nurse practitioner; A current, unrestricted, and valid Registered Nurse license from a U.S. State (as defined in 42 USC 201 (f)); and Certification as a Family nurse practitioner (FNP) by the American Academy of Nurse Practitioners, American Nurses Credentialing Center, Pediatric Nursing Certification Board, or National Certification Corporation. Physician assistant Incumbent must possess an accredited master's degree and must have completed a physician assistant training program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) or one of the predecessor organizations Three years clinical experience as physician assistant; and A current, unrestricted, and valid certification as a physician assistant by the National Commission on Certification of Physician Assistants (NCCPA) from a U.S. State (as defined in 42 USC 201 (f)). Incumbent must possess and maintain current CPR/Basic Life Support, ACLS, and PALS certification. Knowledge of and ability to apply professional nursing principles, procedures, and techniques to patient care (for Nurse Practitioner), or medical principles, procedures, and techniques (for Physician Assistants). Alertness and skill in providing care and reacting to emergency situations. Knowledge of training methods and sufficient interpersonal skills to develop a rapport with patients and co-workers during which instructional and educational information is presented. Knowledge of and participation in established clinic and NCCHC requirements on safety, infection control, quality assurance, maintenance of records of patients seen, statistical information gathering, etc. Knowledge of supply requisition procedure and ability to complete requests for equipment repair and maintenance. Must be able to attain and maintain DHS Secret Clearance. Must be able to attain and maintain a U.S. Government Official Passport. Must maintain minimum flight hour per Official Non-Aircrew member flight orders. Must be able to qualify for Sea Pay. Preferred but not required: Experience in IHSC health system. Correctional health care experience. Certification as Correctional Health Care Professional (CCHP). Knowledge and/or experience with IHSC policies, NCCHC and PBNDS requirements. Knowledge of public health preparedness, infection control and tuberculosis management. Advanced Medical Life Support (AMLS), Trauma Nurse Core Course (TNCC), Pre Hospital Trauma Life Support (PHTLS) certification. Prior Patient Transport, Flight Nursing or Aerospace Medicine/Nursing experience. ANCC Certification as National Healthcare Disaster Professional (NHDB-BC). Proficient in Spanish or secondary language Additional Information This position is located within the Department of Homeland Security (DHS), Immigration and Customs Enforcement (ICE), Enforcement and Removal Operations (ERO), ICE Health Service Corps (IHSC); Office of the Deputy Assistant Director (DAD) of Health Systems Support (HSS), IHSC Special Operations Unit (ISOU). Chief of ISOU supervises the incumbent and Deputy Assistant Director of HSS serves as the reviewing official. This is a non-supervisory position. The ISOU Advanced Practice Provider consists of both family nurse practitioners and physician assistants assigned to ISOU. Incumbents provide medical services to migrants rescued or interdicted at sea on U.S. Coast Guard cutters patrolling the seas, in support of their Alien Migrant Interdiction Operations (AMIO). Incumbent provides on call medical assistance for U.S. Coast Guard cutters patrolling U.S. coastal waters. Incumbent works in conjunction with ICE officers interacting with civilian and government organizations, contract staff, U.S. and foreign dignitaries, and domestic and foreign law enforcement agencies to provide continuity of care. IHSC has a multi-sector, multidisciplinary workforce of more than 1100 employees, including U.S. Public Health Service (PHS) commissioned officers, federal civil servants, and contract staff. The IHSC provides on-site direct patient care to ICE detainees at 21 detention facilities throughout the country and manages the provision of off-site medical care for detainees housed in approximately 240 additional Intergovernmental Service Agreement (IGSA) facilities. The ICE detainee population is approximately 34,000 detainees on a daily basis, with an average length of stay of approximately 30 days, and over 400,000 detainees annually. IHSC also provides medical support during ICE enforcement operations in the air, on the ground, and at sea. SUPERVISORY CONTROLS: Incumbent works under the direction of the ISOU Unit Chief. While under the U.S. Coast Guard, the U.S. Coast Guard Flight Surgeon provides clinical oversight for operations. The clinical directors provides clinical oversight at the IHSC facility. The ISOU Unit Chief obtains input from the IHSC clinic director and from the U.S. Coast Guard when conducting performance evaluations. Recurring assignments are not accompanied by instructions; however, objectives, priorities and deadlines are provided on new assignments. The incumbent plans and organizes his/her own work, determines the sequence of assignments, selects, and develops methods, and seeks assistance from experts only rarely. Work is reviewed for feasibility, compatibility with other work, and effectiveness in meeting requirements or expected results. and PHS requirements.