Medical, Dental, and Behavioral Health Recruitment and Incentives

Placement Services Team

The shortage of primary health care providers including Advanced Practice Providers in North Carolina is significant, particularly in the state’s rural and underserved areas. There is also a severe shortage of behavioral health providers and dental professionals who serve Medicaid, uninsured and low-income patients. In response to this shortage, the state has pioneered innovative approaches for placing health professionals in rural and underserved areas. One approach has been to utilize the knowledge and expertise of the Placement Services Team at the Office of Rural Health (ORH) for placing these health professionals. The Placement Services Team consists of three dynamic recruiters and a program manager. The recruiters are assigned to different service regions across the state. The recruiters actively recruit medical, dental and behavioral health providers who can provide primary care in rural and underserved areas. This includes matching providers with open job opportunities.
Please visit Provider Recruitment and Placement for more information including: What We Do, Why Practice in Rural NC and Health Professional Shortage Area (HPSA) maps.

Practice Incentives
Another approach to North Carolina’s significant shortage of primary health care and behavioral health providers in rural and underserved areas is offering practice incentives for primary care providers. If you are a primary health care or behavioral health professional who is interested in providing health care to the state’s rural and underserved areas, please review the practice incentives listed below:

National Health Service Corps
The first layer of practice incentives is at the federal level. The National Health Service Corps (NHSC) Loan Repayment Program (LRP) is administered by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). Applicants should consider NHSC as a long-term option for incentive awards.

  • The NHSC LRP seeks primary care physicians, nurse practitioners, certified nurse-midwives, physician assistants, dentists, dental hygienists, and behavioral/ mental health providers (psychiatrists, health service psychologists, licensed clinical social workers, marriage and family therapists, psychiatric nurse specialists, and licensed professional counselors) to provide culturally competent, interdisciplinary primary health care services to underserved populations located in designated Health Professional Shortage Areas (HPSAs) identified by the Secretary of HHS. HPSAs can be found in rural and urban communities across the nation. In return, the NHSC LRP assists clinicians in their repayment of outstanding qualifying educational loans. In order for you to qualify for Loan Repayment Incentives, both you and the practice site must apply and be approved by the National Health Service Corps (NHSC).
  • NHSC offers up to $50,000 towards outstanding qualifying educational loans in exchange for a 2-year service commitment at approved NHSC sites (with optional one-year extensions after the current NHSC LRP contract is completed).
  • NC ORH is designated as the state’s Primary Care Office (PCO); therefore, the Placement Services Team provides technical assistance for NHSC’s application process.

For more information including application cycles, visit the National Health Service Corps (NHSC) website.

Incentive Programs administered by ORH
The second layer of practice incentives is at the state level and administered by ORH. The incentive programs are modeled after NHSC.

1 – North Carolina Primary Care Physicians Initiative (NC PCPI)
The NC PCPI offers qualifying physicians repayment for student (educational) loans in exchange for providing comprehensive primary care services in independent private practices in Tier 1 and Tier 2 of the North Carolina’s County Distress Rankings (Tiers).

  • Offers up to $100,000 (non-taxable) towards outstanding qualifying educational loans in exchange for an up to 4-year service commitment for physicians.

Prior to 2025, independent private practices located in rural, medically underserved areas of the State were not deemed automatically eligible practice sites for the state funded North Carolina Loan Repayment Program (NC LRP).  In State Fiscal Year 2024, ORH received one-time funding to launch the Primary Care Physicians Initiative (NC PCPI).  The Primary Care Physicians Initiative creates a loan repayment program that automatically qualifies independent private practices in Tier 1 and Tier 2 of the North Carolina’s County Distress Rankings (Tiers) as eligible practice sites; provided that such independent private practices meet all of the following criteria:

a. Are wholly-owned and operated by physicians rather than by a hospital, health system, or other entity.
b. Have at least one provider enrolled in the North Carolina Medicaid program and accept patients who are Medicaid recipients
c. Recruitment and retention of licensed allopathic or osteopathic primary care physicians in rural, underserved areas of the State who specialize in Family Medicine, General Internal Medicine, General Surgery (within critical access hospitals only), General Pediatrics, Obstetrics/Gynecology, or Psychiatry.

Please review the NC PCPI Guidelines here: NC PCPI Guidelines

After eligible physicians have reviewed the guidelines and gathered the required documentation, they may use the application link below to apply. A link to access the on-line application will be posted on April 21, 2025, at 8:00 a.m.

2 - North Carolina Loan Repayment Program (NC LRP)
NC LRP offers qualifying providers repayment for student (educational) loans in exchange for providing comprehensive primary care services in eligible facilities serving those in rural and underserved communities with high needs.

  • Offers up to $100,000 (non-taxable) towards outstanding qualifying educational loans in exchange for an up to 4-year service commitment for physicians and dentists.
  • Offers up to $60,000 (non-taxable) towards outstanding qualifying educational loans in exchange for an up to 4-year service commitment for nurse practitioners including psychiatric, nurse midwives, physician assistants and dental hygienists.

Prior to March 25, 2022, NC LRP required that providers first access National Health Service Corps Loan Repayment Program (NHSC LRP) and sites become NHSC certified to access federal funds. This requirement allowed ORH to be better stewards of very limited state funds. In State Budget Fiscal Year 2022, ORH received a temporary budget increase for incentives. This increase prompted revisions to the guidelines. One major revision to the guidelines include ORH is temporarily removing the requirement for providers and sites to access NHSC prior to NC LRP. Accessing NHSC LRP continues to be a better long-term option for both providers and sites, especially since ORH anticipates that these temporary revisions will be removed once the temporary funds have been exhausted. Other updated revisions are noted as “NEW” throughout the guidelines. Both providers and sites must meet eligibility criteria; therefore, it is strongly recommended that the updated NC LRP Guidelines are reviewed in its entirety.

Please review the updated NC LRP Guidelines here: NC LRP Guidelines

After eligible providers have reviewed the guidelines and gathered the required documentation, they may use the application link below to apply.

Only electronic applications will be accepted.  You can apply by using this link: NC LRP Application

3 - High Needs Service Bonus (HNSB)
HNSB offers qualifying providers without educational (student) loan debt taxable service bonuses in exchange for providing comprehensive primary care services in eligible facilities serving those in rural and underserved communities with high needs. 

  • Offers up to $100,000 (taxable) in exchange for an up to 4-year service commitment for physicians and dentists.
  • Offers up to $60,000 (taxable) in exchange for an up to 4-year service commitment for nurse practitioners including psychiatric, nurse midwives, physician assistants and dental hygienists.

Prior to March 25, 2022, HNSB required that sites first become National Health Service Corps (NHSC) certified to access federal resources before applying for HNSB. In addition, sites needed to be located within counties with a HPSA score of 16 or above. These requirements allowed ORH to be better stewards of very limited state funds. In State Budget Fiscal Year 2022, ORH received a temporary budget increase for incentives. This increase prompted revisions to the guidelines. Three major temporary revisions to the HNSB guidelines include:  1). Removing the requirement for sites to become NHSC certified prior to providers applying for HNSB; 2). Decreasing the required minimum HPSA score from 16 to 10; and 3). Increasing the award amounts to match those offered by the North Carolina Loan Repayment Program. Becoming NHSC certified continues to be a better long-term option for sites, especially since ORH anticipates that these temporary revisions will be removed once the funds have been exhausted. Other updated revisions are noted as “NEW” throughout the guidelines. Both providers and sites must meet eligibility criteria; therefore, it is strongly recommended that the HNSB guidelines are reviewed in its entirety. Guidelines are subject to change at any time, at the discretion of ORH.  Incentive programs are contingent upon funding.

Please review the updated HNSB Guidelines here: HNSB Guidelines

After eligible providers have reviewed the guidelines and gathered the required documentation, they may use the application link below to apply.

Only electronic applications will be accepted and you can apply by using this link: HNSB Application

4 - J-1 Visa Waiver Program
The North Carolina Office of Rural Health is the interested government agency designated to implement the J-1 Visa Waiver provision for foreign medical graduates provided by Section 220 of Public Law 103-416. ORH does not work directly with physician candidates to locate an eligible site. J-1 Visa Waiver applications must come directly from the hiring entity, not the applicant, along with a signed contract.

  • The J-1 Visa Waiver program does not offer a financial incentive; however, it does offer an opportunity for foreign medical professionals to provide health care services in rural and underserved areas in North Carolina.

J-1 Visa Waiver Program Profile

FFY 2024-2025 (October 1, 2024-September 30, 2025)

FFY 2024-2025 J-1 Visa Waiver Guidelines

  • NEW: The U.S. Department of State (DOS) Waiver Review Division (WRD) has transitioned to an electronic submission process and now requires that ALL applications be submitted electronically.
  • NEW: Please submit the complete application as a PDF in the order outlined in the Application Checklist to karen.gliarmis@dhhs.nc.gov Hard copies are no longer required.

Applications are not accepted prior to October 1.
If you have any questions, please contact karen.gliarmis@dhhs.nc.gov We look forward to assisting you.

5 - National Interest Waiver (NIW) Program
A national interest waiver is for foreign physicians, who are seeking an exemption from the labor certification process and job offer requirement. The NIW application is to request an attestation letter from ORH.

  • The NIW program does not offer a financial incentive; however, it does offer an opportunity for foreign medical professionals to provide health care services in rural and underserved areas in North Carolina.
  • We do not provide the contact information to the communities, hospitals, or Health Professional Shortage Areas.
  • All J-1 visa waiver recipients must have a minimum of 1 year of service before applying for NIW and must be in compliance with all J-1 visa waiver requirements.

Please review the NIW guidelines and application here: National Interest Waiver Guidelines Document

Please submit a PDF of National Interest Waiver applications to:
Karen Gliarmis,  Karen.gliarmis@dhhs.nc.gov 

Hard copies are not required.

Placement Services Team Contact

Mailing Address:
North Carolina Placement Services Program
Office of Rural Health
2009 Mail Service Center
Raleigh, NC 27699

Rachel Lane, Recruiter
919-527-6498
Rachel.Lane@dhhs.nc.gov 

Karen Gliarmis, Recruiter
919-527-6452
Karen.Gliarmis@dhhs.nc.gov

Maya Sanders, Recruiter
919-527-6476
Maya.Sanders@dhhs.nc.gov

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