Methadone Mobile Unit - Nursing Supervisor

COWLITZ INDIAN TRIBE•Vancouver, WA

About The Position

The Nursing Supervisor – Methadone Mobile Unit provides leadership and direct patient care oversight aboard a licensed Mobile Medication Unit (MMU) operating as a component of a SAMHSA-certified and accredited Opioid Treatment Program (OTP). Under the general direction of the Medical Director, Director of Nursing and Program Director, this position supervises staff assigned to the mobile unit, ensures safe and compliant medication-assisted treatment (MAT) services—including the preparation, dispensing, and administration of methadone and other FDA-approved medications for opioid use disorder (MOUD)—and maintains full compliance with federal regulations (42 CFR Part 8, 21 CFR Parts 1300/1301/1304), DEA requirements, and applicable state laws. This role is the primary point of accountability on the mobile unit and serves as the liaison between field staff, the Medical Director, Director of Nursing, Program Director and the main OTP site. The Nursing Supervisor fosters a patient-centered, trauma-informed, non-judgmental care environment consistent with harm-reduction principles and shared decision-making frameworks. Regulatory Context: Mobile Medication Units must comply with all OTP rules under 42 CFR Part 8 as updated by SAMHSA's February 2024 final rule. The MMU is considered an extension of the parent OTP's SAMHSA certification and DEA registration. All required services not available on the unit (e.g., counseling, comprehensive assessments) must be coordinated at the main OTP site. This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive.

Requirements

Graduate of an accredited nursing program; ADN required; BSN preferred.
Minimum 2–3 years of nursing experience required.
Current, unencumbered Registered Nurse (RN) license in the state of operation (or valid compact state license).
Must maintain licensure in good standing; no history of license suspension or revocation.
Minimum 1 year of supervisory or charge nurse experience preferred.
Flexibility and willingness to float between the mobile unit and fixed clinic location(s) as operationally needed.
Prior experience in a methadone clinic, OTP, or substance use disorder treatment setting strongly preferred.
Valid state driver's license with clean driving record — Required for operation of the mobile unit; motor vehicle record (MVR) check will be conducted prior to employment.
Experience in behavioral health, psychiatric nursing, infectious disease, or community health is advantageous.
Working knowledge of federal and state laws governing methadone treatment and Schedule II controlled substance dispensing (42 CFR Part 8, 21 CFR Parts 1300–1304, 42 CFR Part 2).
Ability to recognize signs and symptoms of opioid intoxication, withdrawal, overdose, and adverse medication reactions.
Strong assessment skills with attention to patient safety and detail in medication management.
Demonstrated ability to work effectively in a mobile or non-traditional clinical setting with variable environments.
Proficiency with electronic health records (EHR), medication dispensing systems, and controlled substance accountability documentation.
Excellent interpersonal, verbal, and written communication skills; ability to interact compassionately and non-judgmentally with patients in active recovery.
Strong organizational and time management skills; ability to manage multiple priorities in a fast-paced environment.
Commitment to harm reduction, trauma-informed care, and patient-centered treatment philosophies.
Basic Life Support (BLS/CPR) certification required; naloxone administration training required.
Must be able to successfully complete and maintain background check and drug screening requirements as applicable under state and federal law and organizational policy.
Must comply with all HIPAA, 42 CFR Part 2, DEA, SAMHSA, and applicable accreditation body standards.
Must maintain current BLS/CPR certification and any other certifications required for the role throughout employment.
Required to complete all mandatory training including addiction medicine updates, OTP regulatory training, and organizational compliance education.

Nice To Haves

Experience working with or supervising staff in a mobile health unit or community health setting.
Knowledge of ASAM criteria for levels of care in substance use disorder treatment.
Familiarity with SAMHSA OTP Extranet and federal reporting processes.
Bilingual or multilingual language skills aligned with the patient population served.

Responsibilities

Supervise, direct, and evaluate staff assigned to the mobile unit on a daily basis.
Schedule staff to ensure adequate coverage for all operating days
Conduct regular chart reviews, competency assessments, and performance evaluations for staff.
Orient new employees to mobile unit protocols, controlled substance procedures, and patient safety standards.
Serve as a resource and mentor, promoting continuing education in addiction nursing and OTP regulations.
Participate in multidisciplinary team meetings with counselors, physicians, and program leadership.
Oversee and directly participate in the safe preparation, dispensing, and administration of methadone and other MOUDs (buprenorphine, naltrexone, naloxone) per physician or Medical Director orders.
Ensure all patients are assessed prior to each dose —verifying alertness and orientation, and identifying any signs of intoxication or adverse medication reactions before administration.
Administer dosing according to individualized treatment plans; monitor patients for side effects and clinical response.
Oversee the take-home medication program including documentation and safety protocols.
Operate, calibrate, and maintain automated dispensing equipment and ensure functionality of unit systems before and after each operating shift.
Ensure safe handling, storage, and transport of Schedule II controlled substances aboard the mobile unit consistent with DEA regulations.
Complete or supervise initial assessments and medical histories for newly admitted patients, including physical and psychosocial screening.
Monitor patients for comorbid medical conditions (e.g., hypotension, respiratory disorders, infectious disease) that may interact with methadone therapy.
Identify and respond to urgent clinical situations, including overdose, withdrawal, or acute medical emergencies, and coordinate EMS activation when necessary.
Provide patient and family education on methadone therapy, drug interactions, harm reduction strategies, naloxone use, and community resources.
Coordinate referrals for services not available on the unit (counseling, psychiatric care, primary care, social services) with the main OTP site.
Support telehealth-based intake and screening processes per current SAMHSA guidelines where applicable.
Maintain strict accountability for all methadone and controlled substances dispensed during each shift, including daily sight-and-count inventories and reconciliation of all doses administered.
Ensure accurate, timely, and complete documentation in the electronic health record (EHR) for all encounters, medication records, lab results, and patient assessments.
Document Medical Director telephone orders and ensure timely co-signature per OTP protocol.
Review daily, weekly, and monthly dosing reports; report discrepancies to the Medical Director, Director of Nursing and Program Director immediately.
Ensure the unit operates in compliance with SAMHSA, DEA, state OTP authority (SOTA), and accreditation body (Joint Commission/CARF) standards.
Maintain community relations documentation related to mobile unit service locations per licensing requirements.
Support preparation for accreditation surveys, DEA inspections, and state licensing reviews.
Perform or oversee pre-operation and post-operation vehicle and equipment inspections; report and document maintenance needs promptly.
Ensure a clean, organized, and safe clinical environment aboard the unit at all times.
Coordinate patient scheduling and daily clinic flow at mobile unit locations, including management of missed doses and patient intake procedures.
Maintain emergency medications and supplies (including naloxone) in proper inventory on the unit.
Assist with coordination of unit deployment schedules, service location routes, and community outreach efforts.
Operate the mobile unit vehicle as required; must possess and maintain a valid state driver's license with a clean driving record and meet all organizational vehicle insurance eligibility requirements.
Adhere to all applicable motor vehicle laws, DOT regulations, and organizational vehicle operation policies when transporting the unit between deployment sites.
Complete any required organizational driver training, vehicle safety certification, or pre-employment motor vehicle record (MVR) check prior to operating the unit.
As operationally required, float into the main OTP clinic or satellite clinic locations to provide direct nursing coverage, support staffing needs, and ensure continuity of patient care.
Perform all clinical nursing duties within the fixed clinic setting (patient assessment, medication dispensing, documentation, patient education) consistent with clinic protocols and OTP standards.
Maintain familiarity with both mobile unit and fixed clinic workflows, systems, and staffing structures to transition seamlessly between settings.
Provide supervisory coverage at the clinic in the absence of the Director of Nursing or as directed by the Medical Director or Program Director
Collaborate with Director of Nursing to ensure consistent patient care standards, controlled substance accountability, and regulatory compliance across all service settings.
Participate in quality improvement initiatives and provide meaningful input into mobile unit program design and policy development.
Track and report patient outcomes, adverse events, and medication incidents in accordance with organizational and regulatory requirements.
Identify opportunities to expand access to care and improve patient engagement, particularly for underserved and rural populations.
Remain current with evolving SAMHSA regulations, addiction medicine research, and best practices in opioid use disorder treatment.