firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking with them side by side as a trusted guide and partner on their journey to better health.

firsthand's team members use their lived experience to build trust with these individuals and support them in reconnecting to the healthcare they need, while minimizing inappropriate healthcare utilization. Together with our health plan partners, we are changing the way our society supports those most impacted by SMI.

We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job—it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun.

At firsthand, our Nurse Practitioners are referred to as Health Guides (HGs). Our HGs are dedicated and compassionate advocates leading the individuals we serve on a journey towards wellbeing and recovery.

In each of firsthand’s markets, a Health Guide (licensed Nurse Practitioner or Physician Assistant) leads the medical aspects of team-based care for individuals with serious mental illness that firsthand serves. The Health Guide (HG) is responsible for whole person assessment and management of our vulnerable population, collaborating closely with external primary care and behavioral health providers, as well as an internal team of firsthand Guides (peers) and Community Resources Guides (social workers).

As a HG, you will make significant impact by:

Assessing both behavioral and physical health conditions with a thorough history and physical examination
Verifying previously diagnosed conditions and capturing conditions not yet diagnosed based on review of medical records, evidence-based practice, clinical judgment and diagnostic studies.
Completing timely and high quality urgent care visits
Overseeing transitions of care by conducting post-hospital discharge visits to ensure a stabilizing plan is in place to avoid unnecessary rehospitalizations.
Conducting visits in the office, virtually, in the field, or in an individual’s home when needed
Ensuring continuity of care, referring to community primary and behavioral health providers and specialists based on assessed needs
Supporting individuals in developing and exercising self management skills and person-centered care around their individual goals and preferences via motivational interviewing and holistic care planning
Organizing clinical information in a manner that supports appropriate clinical documentation criteria for successful disability applications (if appropriate)
Collaborating with a team of clinical documentation specialists, certified coders, and medical assistants

As a HG, you will lead the medical component of the team-based care provided by firsthand, including:

Training and advising roles like Health Guide Associates (Medical Assistants), and firsthand Guides (Peer Recovery Specialists) on behavioral, clinical, and social health priorities
Supporting care coordination
Leading care and disease management and identifying actionable care gaps
Communicating and coordinating with individuals’ care providers, primarily at CMHCs, FQHCs, and hospitals
Providing direct patient care when unscheduled care needs cannot be met by existing community providers

As a HG, you will collaborate with other team members to provide integrated care:

Assist firsthand Guides (Peer Specialists) with engagement and recovery support
Work with the firsthand Care Team and the Community Resources Guide in supporting individuals’, SDOH needs and with medical eligibility assessments for disability applications

HG's have:

Motivation & Productivity: Intrinsic drive to excel in visit productivity and deliver top-tier performance.
Empathy & Compassion: Approachability, active listening, and excellent interpersonal skills, combined with the ability to establish and maintain professional boundaries, even in challenging situations.
Technological Proficiency: Strong comfort with technology, including familiarity with Electronic Health Records (EHR) and tools like Google Suite (preferred).
Clinical Expertise: Robust clinical acumen in managing chronic disease and behavioral health within outpatient settings.
Data-Driven Mindset: Eagerness to utilize data to inform care decisions and perform data-driven care.
Adaptability: Natural ability to adapt to diverse assignments and dynamic goals in non-traditional work conditions.
Commitment to Wellness: Genuine desire to help individuals on their journey toward improved health.
Cultural Competence: Cultural humility, trauma-informed care practices, and an understanding of social determinants of health.
Team Collaboration: Strong teamwork skills, comfortable working within multidisciplinary teams and balancing roles such as direct service, teaching, and care management.
Local Knowledge: Familiarity with local providers and community resources.
Communication & Organizational Skills: Exceptional verbal and written communication, attention to detail, and the ability to thrive in a fast-paced environment.
Reliable Connectivity: Access to high-speed internet for effective remote work.

Required experience includes:

3+ years clinical care as a Nurse Practitioner or Physician Assistant, in a primary care or emergency room setting
Working with and managing a population with challenges such as behavioral health and/or SUD conditions
Developing and delivering educational programs to nurses and affiliated medical staff
Care management and coordination experience.
Valid driver’s license in good standing, with the ability to operate a vehicle and eligibility to drive under the company’s insurance policy.
High proficiency in Spanish

Benefits

For full-time employees, our compensation package includes base, equity (or a special incentive program for clinical roles) and performance bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, 15 days/year vacation in your first year (this increases to 20 days/year in your second year and beyond), and a supportive and inclusive culture.

Vaccination Policy

Employment with firsthand is contingent upon attesting to medical clearance requirements, which include, but may not be limited to: evidence of vaccination for/immunity to COVID-19, Hepatitis B, Influenza, MMR, Chickenpox, Tetanus and Diphtheria. All employees of firsthand are required to receive these vaccinations on a cadence/frequency as advised by the CDC, whereas not otherwise prohibited by state law.

New hires may submit for consideration a request to be exempted from these requirements (based on a valid religious or medical reason) via forms provided by firsthand. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed.

Unfortunately, we are not able to offer sponsorship at this time.