Locum Tenens NP/CNM

[sunmoonstars3]

Has anyone had experience working as an independent contractor/locum tenens CNM? I'm thinking of taking this type of job, but not sure what to look out for. Would love to hear anyone's experience! Are there drawbacks to being an independent contractor?

I'd be moving to a different state, and I don't know how the salaries compare. The job is also a 3-4 days of clinic and 1:4 call, with weekend call 8a-8a. The job has asked for my hourly rate--how do you calculate that for clinic vs call hours? And since you pay more in taxes as an independent contractor, what is the ballpark increase in hourly wage for pay?

Is it worth it to take the housing offered, or request a stipend, or...? I have pets and would need a house with a yard.

Any other advice would be greatly appreciated.

[NedRN]

To just maintain parity with ordinary wages, IC pay has to be 10% more to account for employer paid FICA, workers comp, and unemployment. Add another 30 percent or more for missing benefits. Add another 24% for normal agency margin (billing, running payroll, and so on).

I don't know what CNMs make, but an L&D nurse commands a bill rate of 70 to 120 currently depending on area and need. NPs don't make much more than travel nurses, as little as $5 an hour extra. Hope that is not the case for you!

[sunmoonstars3]

Hi Ned, thanks for your reply. Can you explain what you mean by the agency rate and bill rate? I understand requesting extra for the health insurance and Medicare tax, but not the rest of your reply. Thanks again!

[NedRN]

No agency rate mentioned, perhaps you meant margin. A bill rate is an all inclusive hourly rate that an agency charges a client for a traveler. An agency gross profit margin is the percentage of the bill rate they keep for themselves to pay for overhead such as marketing, recruiters, insurance, and offices. For travel nurses, the industry average gross profit margin is 24% (of the bill rate). Advanced practice agencies have a higher margin.

Reading your initial post again, it appears you are taking an agency job. It strikes me as unusual that they want to know your rate, and that you are going to work for them without an offer. Where do you work right now, and what is your compensation package worth? Do you want parity, more, or less? You need to figure out what your current benefits are worth (if your current job has benefits), in part by asking what it would cost to COBRA your insurance.

Tell me more!

Yes, there are drawbacks to working as an IC. There are also benefits. It depends on a variety of things.

[HikingNinja, BSN, MSN, DNP, RN, APRN, NP]

You might have better luck in the NP forum on this website. There are several on there who do nothing but locum tenens. I'm interested in this as well so I searched through the NP forums and came across quite a bit of info. The pay structure is a bit different than regular travel nursing. It's a bit confusing. Per procedure/item billing based on acuity level, productivity incentives, etc. in addition to the hourly. Some assignments are a few days. Others are weeks or months. And then there's the independent practice vs supervised practice to through into the mix. The NPs who travel regularly on the NP forum are very helpful with explaining all the complicated billable that go into a locum tenens contract.