The Permanente Medical Group, Inc. (Kaiser Permanente Northern California)
Fresno & Modesto, California
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The Nocturnist Physician Assistant (PA) - Inpatient Medicine is a licensed, certified, non-physician healthcare provider who delivers high-quality, direct patient care during overnight hours in a hospital setting. This role includes delegated prescriptive authority, credentialing, and privileging, with services billed as an independent provider in accordance with Medicare, Medicaid, and applicable regulatory standards.
Working collaboratively with supervising physicians and interdisciplinary teams, the Nocturnist PA manages acutely ill and hospitalized patients, focusing on admissions, cross-coverage, and overnight clinical care. The provider practices within the scope defined by state regulations, institutional policies, and clinical protocols.
Schedule & Role Focus
Night shift / nocturnist schedule (e.g., 9 PM - 7 AM or similar)
Primary responsibility for overnight admissions, cross-coverage, and urgent patient needs
Collaboration with hospitalists, specialists, nursing staff, and ancillary services
May include weekend and holiday rotations
Essential Functions of the Role
Perform comprehensive or focused histories and physical examinations to assess patient conditions
Order, interpret, and evaluate laboratory and diagnostic studies
Diagnose and manage acute and chronic medical conditions in hospitalized patients
Initiate and manage treatment plans using evidence-based practices and clinical guidelines
Prescribe medications and therapeutic interventions in accordance with approved protocols
Respond to overnight clinical changes, rapid responses, and urgent patient needs
Conduct hospital rounds, admissions, and discharges as needed
Perform procedures within scope of practice and demonstrated competency
Collaborate with physicians and interdisciplinary teams to optimize patient outcomes
Educate patients and families on diagnoses, treatment plans, medications, and health promotion
Document all patient care activities accurately and in a timely manner
Initiate consultations and referrals when cases exceed scope or expertise
Key Success Factors
Advanced knowledge of inpatient medicine, disease processes, and treatment modalities
Strong clinical judgment and critical thinking, especially in high-acuity situations
Ability to work independently during overnight hours while maintaining collaboration
Excellent verbal and written communication skills
Strong interpersonal skills and team-based approach to care
Proficiency in electronic medical records and clinical software systems
Ability to develop and implement outcomes-based treatment plans
Skill in interpreting diagnostic tests and responding to clinical changes
Minimum Qualifications
Graduate of an accredited Physician Assistant program
Current licensure as a Physician Assistant in the state of Texas
Certification by the National Commission on Certification of Physician Assistants (NCCPA)
Prescriptive authority and DEA (as applicable)
Basic Life Support (BLS) certification
Advanced Cardiovascular Life Support (ACLS) certification within 30 days of hire
Preferred Qualifications
Experience in inpatient medicine, hospitalist, or acute care settings
Prior nocturnist or night shift experience
Benefits
Baylor University Medical Center offers a comprehensive and competitive benefits package, including:
Immediate eligibility for health and welfare benefits
401(k) savings plan with dollar-for-dollar match up to 5%
Tuition reimbursement programs
Paid Time Off (PTO) starting on Day 1
Note: Benefits may vary based on position type and employment status.
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!