The Triage Nurse is a remote Registered Nurse who provides telephone and electronic triage support to firsthand individuals and staff, while also supporting outpatient care coordination. This is primarily a day-shift role (8 hours/day, 8:30–4:30 PST), with occasional potential for nights or weekends. When not managing acute issues, Triage Nurses focus on care coordination, training, and related administrative tasks.

Responsibilities of a Triage Nurse include:

• Triage and Escalation: Manage inbound clinical issues from firsthand staff and patients via phone; triage appropriately and escalate emergencies immediately.
• Collaboration: Work closely with peer mental health workers, social workers, and APPs to address acute issues comprehensively.
• Coordination: Coordinate care with patients’ other providers to ensure seamless health management.
• Training: Develop and deliver training on basic medical topics for peer mental health workers and social workers.

Triage Nurses should have:

• Strong triage and prioritization skills, with the ability to rapidly assess and determine the appropriate level of care.
• Problem-solving expertise with a creative, patient-centered approach.
• Ability to provide condition-specific patient education and self-management guidance.
• Adaptability to varying team cultures and processes.
• Empathy, compassion, and approachability in patient and team interactions.

Required experience includes:

• Active RN license through a Nurse Licensure Compact (NLC) state and willingness to obtain licensure in non-compact states.
• Bachelor of Science in Nursing (BSN) or Associates of Nursing (ASN)
• At least 3 years clinical care experience in psychiatric inpatient or outpatient settings AND/OR at least 3 years of Emergency Room (ER) experience 
• Experience working with populations facing challenges such as serious mental illness, behavioral health conditions, and/or substance use disorders
• Care management and coordination experience.

Bonus Points for:

• Psychiatric-Mental Health Nursing Certification (PMH-BC)
• Washington state RN license

The Centralized Health Guide is a licensed Nurse Practitioner who leads the medical aspects of virtual care for individuals with serious mental illness that firsthand serves. The Centralized Health Guide is responsible for virtual whole person assessments and management of our vulnerable population, collaborating closely with community primary care and behavioral health providers, as well as an internal team of triage registered nurses and psychiatric nurse practitioners.

As a Centralized Health Guide, you will:

Perform a virtual whole-person clinical assessment, including:

• Assessing both behavioral and physical health conditions with a thorough history and virtual physical examination
• Treating conditions including prescribing medications on an ongoing and short-term basis
• Capturing conditions not yet diagnosed, ordering additional studies where indicated to confirm or rule out the diagnosis
• Collaborating with a team of support including medical records and clinical documentation specialists, certified coders, and medical assistants
• Making individualized recommendations and/or referrals for programs/care provided by firsthand and/or outside providers, based on the assessed need
• Supporting individuals in developing and exercising self management skills and skills skills person-centered care around their individual goals and preferences via motivational interviewing and holistic care planning
• Organizing the information in a manner that supports appropriate clinical documentation and successful disability applications (if appropriate)

Perform virtual unscheduled care assessments and transition of care, including:

• Provide exemplary customer service to individuals with SMI and maintain a NPS score of 90% or higher
• Commitment to reducing ER visits within 7 days of your interaction with individual
• Provide urgent-care treatment for conditions such as COPD exacerbations, uncontrolled diabetes, CHF exacerbations, Cold and Flu Symptoms, UTI, pain, anxiety, depression, and SI.
• Transition of care visits for individuals within 7 days of discharge from ER/hospitalization 

Provide Guidance and Support to In-person Health Guides and firsthand guides including:

• Leads individual progress reviews in partnership with firsthand guides
• Assist with implementing new interventions and work processes

You will be a good fit if you have:

• Passion for serving individuals suffering from mental illness
• Display a positive attitude and team player mentality within team
• Intrinsic motivation to be a top performer 
• Above average comfort with technology 
• Desire to perform data driven care
• Natural ability to adapt to various assignments and moving target goals
• Empathy, compassion, and approachability 
• Excellent listening, communication, and interpersonal skills
• Ability to maintain professional boundaries and engagement skills with a population with challenges and in non-traditional work conditions
• Willingness to become certified in psychiatric nursing (on the RN level)
• Licenses in FL, MI, OH, VA, WA or willingness to get licensed in these states

The experience you bring to this role includes:

• 3+ years clinical care as a Nurse Practitioner, ideally in a primary care setting or emergency department
• Working with and managing a population with challenges such as behavioral health and/or SUD conditions
• Care management and coordination 
• Psych RN cert (optional, willingness to become certified)

firsthand is building a workplace and culture that cares deeply for our team and our communities. Our benefit design is in line with our values of compassion and empathy:

• A range of healthcare benefits offerings for yourself and/or your family
• 401(k) with employer matching program
• Competitive and flexible paid time off policies
• Choice of Mac or PC for laptop or tablet as needed

We firmly believe that great candidates for this role may not meet 100% of the criteria listed in this posting. We encourage you to apply anyway - we look forward to begin getting to know you.

Senior Psychiatric Nurse Practitioner (Remote)

The Psychiatric Nurse Practitioner is a licensed Nurse Practitioner certified in  Psychiatric Mental Health Nursing, who leads the behavioral health aspects of virtual care for individuals with serious mental illness (SMI) that firsthand serves. At firsthand, our NPs are referred to as Health Guides (HGs), as they are dedicated, compassionate advocates, leading our individuals on a journey towards wellbeing and recovery.

The Psychiatric Nurse Practitioner HG is responsible for virtual behavioral health assessments, management of our vulnerable population, and collaborating closely with community providers. The Psychiatric Nurse Practitioner HG serves as a key member of the shared clinical services team which includes triage and care coordination nurses (TCCNs) and nurse practitioners (HG flex).

• As a Psychiatric Nurse Practitioner, you will perform Medical and Behavioral Health assessments, including:
• Provide exemplary customer service to individuals with SMI and maintain a NPS score of 90% or higher
• Commitment to reducing avoidable Psychiatric ER visits through timely evaluation and interaction with individual
• Assess behavioral health and medical conditions with a thorough history and virtual physical examination
• suicide stabilization,  diagnosis and stabilization of bipolar, schizoaffective, and schizophrenia in a fully remote environment with in-person peer recovery support.
• Diagnose psychiatric disorders and mental health conditions
• Document patients’ medical and psychological histories, mental status exams, diagnoses, treatment plans, prescriptions, and outcomes
• Educate patients and family members about mental health, medications, and treatment plans
• Prescribe and monitor prescribed prescriptions for psychotropic medications, abiding by laws and regulations
• Manage and monitoring for metabolic syndrome and/or other comorbidities 
• Collaborate with a team of support including licensed and non-licensed professionals
• Ensure continuity of care,  referring  to community primary and behavioral health providers and specialists based on assessed needs
• Support individuals in developing and exercising self management skills and skills skills person-centered care around their individual goals and preferences via motivational interviewing and holistic care planning

Performs virtual SOAR (SSDI/SSI Outreach Access and Recovery) disability assessments, including:

• Highly detailed intake visit on patient’s behavioral health history and impact on ability to work 
• Organizing the information in a manner that supports appropriate clinical documentation and successful disability applications (if appropriate)

Provide Guidance and Support to Psychiatric Nurse Practitioners

• Lead by example in maintaining above average visit productivity levels
• Display a positive attitude and team player mentality within team
• New hire on-boarding and shadowing, and other responsibilities as assigned by Director of Shared Clinical Services
• May be responsible for player-coach mentorship of Primary Care/Psychiatric Nurse Practitioners or Triage Nurses (Does not include hiring/career decisions, personnel management.)
• Assist with developing and implementing new Primary Care/Psychiatric Nurse Practitioners interventions and work processes
• Assist with training and coaching Health Guides and Flex Health Guides on diagnosis and management of psychiatric disorders

You will be a good fit if you have:

• Intrinsic motivation to be a top performer in visit productivity and patient outcomes
• Tenacious self-starter and independent thinker
• Above average comfort with technology, as this is a 100% remote position
• Desire to perform data driven care
• Natural ability to adapt to various assignments and moving target goals
• Empathy, compassion, and approachability 
• Excellent listening, communication, and interpersonal skills
• Ability to maintain professional boundaries and engagement skills with a population with challenges and in non-traditional work conditions

The experience you bring to this role includes:

• certification as a Family Nurse Practitioner/Psychiatric Mental Health Nurse Practitioner or Adult Health Nurse Practitioner/Psychiatric Mental Health Practitioner.
• 3+ years clinical care as a Psychiatric Mental Health Nurse Practitioner or Adult Health Nurse Practitioner/Psychiatric Mental Health Practitioner.
• Telehealth experience 
• Ability to work collaboratively with a diverse group of licensed and non-licensed professionals
• Strong background in the diagnosis of psychiatric disorders and psychopharmacological treatments and familiarity with non-pharmacological interventions
• Excellent verbal and written communication, organizational, and time management skills

firsthand is building a workplace and culture that cares deeply for our team and our communities. Our benefit design is in line with our values of compassion and empathy:

• A range of healthcare benefits offerings for yourself and/or your family
• 401(k) with employer matching program
• Competitive and flexible paid time off policies
• Choice of Mac or PC for laptop or tablet as needed