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Contract Negotiation as a New Grad Nurse Practitioner (Plus 7 Factors to Consider Negotiating)

As a new grad nurse practitioner or one who’s been in practice a while, we may tend to think, the healthcare industry is no place for negotiating. Or we subscribe to the notion that we should just take what we’re offered and be happy with what we have.

Negotiating your worth while showcasing your value can be very intimidating as a nurse practitioner. It’s both a skill and an art that takes practice. Neither of which was very well cultivated during graduate school.

You’re in luck! Here, we’ll be going over all the things served at the negotiation table so you can start your first day happy and satisfied.

The venue for negotiation can take place in different ways. You may experience negotiating with an in-person or virtual meeting. For instance, after an interview or after receiving a letter of intent offering you a position. Other common ways include, by phone conversation or email exchange.

Effective negotiation takes research, preparation, and planning.

One of the main factors nurse practitioners think of negotiating is salary. And rightfully so. Your salary is the entree or main course of your dining experience.

As a nurse practitioner, you are generating revenue.

This is much different from the nurse role in a fiscal sense, as nurses do not bill or get reimbursed for the work they perform. The nurse practitioner role is also different from our physician colleagues as we can perform the same responsibilities and bill the same or close to what physicians bill. So in short, nurse practitioners perform the job for less, which equals more profit for the employer.

Some factors that directly and indirectly affect your salary as an advanced practice provider include:

  • Number of patients you see in a day

  • Reimbursement rate

  • Collection rate

  • Overhead expenses

  • Paid time off

  • Company profit policy

  • Benefit package


Overall, the cost-benefit analysis to hire a nurse practitioner is a no-brainer for many organizations. Knowing that information above, you should feel confident approaching the job offer negotiation and advocating best for yourself.

While salary is the most common element of negotiations, you should consider negotiable factors that translate to more money or time in pocket.

Time is a valuable currency.

Consider these 7 elements when negotiating your nurse practitioner contract:


1. Personal time, sick time, vacation.

If all of your paid time off is grouped together into one bucket, consider a realistic breakdown of how that affects your personal life. Do you have kids and are the flexible parent? Do you like to travel or have family that lives away from you and need additional time off? Is there a policy for leave without pay?


2. Schedule.

Is there flexibility with start and end times? Could you come in earlier or stay later to fill the needs of the clinic while having the flexibility you need? Do they offer telehealth days where you can work from home? Reduce weekends or holidays rotations?


3. CEU time and money.

Many organizations contribute to continuing education as it benefits the both provider and employer. But consider having this learning opportunity be a paid portion of your work. It’s incredibly challenging to participate in an online conference while being scheduled for work. Equally, it may be difficult to use your limited PTO days for a work related function.


4. Tuition reimbursement.

Some employers will help with increasing tuition reimbursement over increasing salary as it can be a tax advantage for companies. Employees benefit as they lessen their school loan amount.


5. Administrative time.

Having an allotted time for responsibilities other than direct patient care is critical for enhanced office efficiency. Getting this in writing to free your time and help reduce after hours charting.


6. Sign on bonus.

This is additional money paid in increments or as a one time distribution for being hired on with the employer. Beware of any repayment terms involved with accepting the bonus.


7. Cost of living increase.

This is a good way to bump up your pay on a yearly, semi-annual, or even quarterly basis to keep up with inflation. You can ask for this to match the term of your contract.


Need more help navigating your job search and NP life, get the support you need.

About the Author

Josie Tate is a successful nurse practitioner, visionary nurse leader, and inspirational career mentor. She is the creator of Clincepts, a professional development resource that helps bridge the gap for nurses transitioning into advanced practice.

Nurse practitioners across the industry get and stay happily hired using strategies from Josie’s proven framework. At its core, Clincepts empowers and equips nurse practitioners to stand out, shine bright, and speak up as the best candidates for the job.

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