We named our company firsthand because we believe that lived, or “firsthand,” experience is invaluable for gaining trust and building meaningful relationships. While we are listing this role externally as Peer Recovery Specialist—a widely recognized term—internally we refer to this important role as firsthand Guide (fG), or a Core Guide. In our peer-led model, fGs play a critical role in outreach and engagement, supporting individuals living with SMI to achieve and maintain both behavioral and physical wellness. Trust is at the heart of everything we do, and fGs are uniquely empowered to connect with people who have disengaged from—or never accessed—the services and supports that can improve their quality of life. This role carries the expertise of a Peer Recovery Specialist, but with our distinctive approach and mission woven into every interaction.

The Core Guide partners closely with other members of the firsthand Care Team to drive whole health wellness. This includes working closely with clinicians and other support team members to ensure individuals get the support they need. fGs act as the point of contact for individuals, helping them schedule appointments, advocate for their needs and set and achieve goals.

As a Core Guide, you will:

• Conduct community outreach to individuals with SMI in homes, community locations, and care settings like shelters, hospitals, and emergency departments
• Support individuals health needs by scheduling appointments, taking vitals, ensuring clinical visits are attended and completed, and assisting with telehealth access
• Build trust and relationships by addressing immediate needs and empowering individuals to identify and pursue personal recovery goals
• Serve as the primary point-of-contact, using advanced engagement techniques to facilitate ongoing connection and engagement in supportive services
• Help  address social determinants of health, facilitating access to benefits, resources, and transportation
• Assist with care coordination, advocating for individual goals, accompanying individuals to appointments, and addressing post-discharge needs
• Provide timely and thorough documentation of encounters and participate in case reviews and team collaboration
• Perform initial and ongoing telephonic outreach
• Participate in ongoing training and professional development
• Understand that as firsthand learns and grows, your role will constantly evolve. This job description represents many key elements of this role, but they are subject to change

Core Guides should have:

• Empathy, compassion, and approachability 
• Excellent listening, communication, and interpersonal skills
• Personal knowledge of recovery
• Patience, persistence and a desire to help individuals experiencing SMI and/or SUD on their wellness journey
• Comfort working collaboratively within multidisciplinary team
• Basic proficiency with smartphone and computer technology 
• Openness to receiving feedback and a commitment to professional growth

The required experience you bring to this role includes:

Lived experience with SMI and/or SUD

• State Peer Recovery certification, or eligibility and willingness to obtain certification within six (6) months of employment
• Valid driver’s license in good standing, with the ability to operate a vehicle (company vehicle may be provided) and eligibility to drive under the company’s insurance policy
• Demonstrated proficiency with technical tools like email, messaging services, and apps
• Two (2) years demonstrated recovery time from a mental health and/or substance abuse disorder at the date of application
• Team members will complete a paid training period prior to serving individuals and must pass assessments to move forward. 
• Ability to work Monday - Friday 8:30 am - 4:30 pm

Bonus points for:

• Experience with direct in-person outreach and engagement for individuals with SMI and SUD
• Expertise in recovery education and coaching
• Understanding of whole health and trauma-informed approaches to peer support
• Familiarity with local community resources, behavioral health systems, and the criminal justice system (e.g., mental health and drug courts)
• Eagerness to expand knowledge about a broad range of health conditions
• Interest in gaining a Community Health Worker (CHW) Credential after hire, or already holds one

The Executive Director (ED) is a high-impact, mission-driven General Manager responsible for driving the P&L, operational, and clinical performance of the firsthand model across their state. The ED fosters a culture of firsthand Values-driven innovation, collaboration, and deep community engagement to achieve the firsthand mission of delivering life-changing outcomes to individuals with serious mental and physical illness. The ED is tasked with the management and strategic execution of the entire business unit, overseeing the integration and success of our care team and clinical practice. This includes both community outreach and clinical care delivery teams – ensuring a consistent, scalable, individual-centered approach to care is embraced by all. The ED will ensure firsthand’s teams are effective in their outreach, trust-building, engagement, benefits navigation, and activation of the entire fH care model, as well as its clinical and financial outcomes long term. Furthermore, the ED will lead the expansion of care model operations across the state and in doing so ensure best practices are adopted and implemented across all teams. 

Job Specifics

As ED, you will:

• Serve as the General Manager and own the complete Profit and Loss (P&L) for the entire state. This includes full accountability for medical cost management, revenue optimization, opex management – and broadly driving profitability.
• Report directly to the COO and partner meaningfully with the VP Care Model Performance, Senior Director of Central Clinical Programs, and other EDs to lead, motivate, and inspire community and care model teams deeply dedicated to firsthand’s mission.
• Consistently exceed a rigorous set of high-value care model process (i.e. fidelity to core model activities)and value outcomes (e.g: utilization, HEDIS metrics), individual engagement and activation goals, and financial targets (e.g: medical cost, revenue, membership growth).
• Provide decisive leadership and supervision across all integrated state-level functions, overseeing both Clinical Managers (CMs) and Managers of Community Operations (MCOs). 
• Lead, mentor, and actively develop all market leadership and care team members, fostering a culture of continuous improvement, high accountability, and mission-driven work to ensure long-term team engagement and operational excellence.
• Galvanize and foster a high-performing, inclusive, and supportive employee culture, driven by and visibly embodying the firsthand values
• Manage, analyze, and optimize the state key performance indicators (KPIs), effectively coaching market leadership and care teams to exceed financial, clinical, and operational targets. 
• Ensure the seamless execution of firsthand’s operational and strategic plans, including adapting practices as the business evolves.
• Build key state-level relationships with local healthcare providers, community partners, and health plan clients to drive engagement and improve outcomes.
• Lead the successful execution and launch of new firsthand clinic locations within the state, including the recruitment of community-based and care model staff in collaboration with the People team.

The experience you bring to this role includes:

• Significant experience (7-10+ years) in healthcare leadership roles, preferably in a high-growth, high-complexity operational environment leading integrated community-based and clinical teams.
• Experience leading in a clinical-operational dyad model
• Proven track record of owning and successfully managing a large P&L and delivering results in a value-based care or capitated environment.
• Deep understanding of the healthcare landscape, particularly value-based care, Medicaid, and the behavioral health ecosystem (SMI/SUD).
• Exceptional leadership presence, executive communication skills, and the ability to inspire and manage large, cross-functional teams including market leaders and clinicians.
• Ability to travel regularly across the state to visit communities and meet with partners; proficiency in communicating a “win-win” value proposition to external partners.
• A passion for serving and direct community and care team experience working with individuals living with SMI.
• Preferred experience in an early-stage or growth company with the ability to be flexible and adaptable to changing strategies.

The Executive Director (ED) is a high-impact, mission-driven General Manager responsible for driving the P&L, operational, and clinical performance of the firsthand model across their state. The ED fosters a culture of firsthand Values-driven innovation, collaboration, and deep community engagement to achieve the firsthand mission of delivering life-changing outcomes to individuals with serious mental and physical illness. The ED is tasked with the management and strategic execution of the entire business unit, overseeing the integration and success of our care team and clinical practice. This includes both community outreach and clinical care delivery teams – ensuring a consistent, scalable, individual-centered approach to care is embraced by all. The ED will ensure firsthand’s teams are effective in their outreach, trust-building, engagement, benefits navigation, and activation of the entire fH care model, as well as its clinical and financial outcomes long term. Furthermore, the ED will lead the expansion of care model operations across the state and in doing so ensure best practices are adopted and implemented across all teams. 

Job Specifics

As ED, you will:

• Serve as the General Manager and own the complete Profit and Loss (P&L) for the entire state. This includes full accountability for medical cost management, revenue optimization, opex management – and broadly driving profitability.
• Report directly to the COO and partner meaningfully with the VP Care Model Performance, Senior Director of Central Clinical Programs, and other EDs to lead, motivate, and inspire community and care model teams deeply dedicated to firsthand’s mission.
• Consistently exceed a rigorous set of high-value care model process (i.e. fidelity to core model activities)and value outcomes (e.g: utilization, HEDIS metrics), individual engagement and activation goals, and financial targets (e.g: medical cost, revenue, membership growth).
• Provide decisive leadership and supervision across all integrated state-level functions, overseeing both Clinical Managers (CMs) and Managers of Community Operations (MCOs). 
• Lead, mentor, and actively develop all market leadership and care team members, fostering a culture of continuous improvement, high accountability, and mission-driven work to ensure long-term team engagement and operational excellence.
• Galvanize and foster a high-performing, inclusive, and supportive employee culture, driven by and visibly embodying the firsthand values
• Manage, analyze, and optimize the state key performance indicators (KPIs), effectively coaching market leadership and care teams to exceed financial, clinical, and operational targets. 
• Ensure the seamless execution of firsthand’s operational and strategic plans, including adapting practices as the business evolves.
• Build key state-level relationships with local healthcare providers, community partners, and health plan clients to drive engagement and improve outcomes.
• Lead the successful execution and launch of new firsthand clinic locations within the state, including the recruitment of community-based and care model staff in collaboration with the People team.

The experience you bring to this role includes:

• Significant experience (7-10+ years) in healthcare leadership roles, preferably in a high-growth, high-complexity operational environment leading integrated community-based and clinical teams.
• Experience leading in a clinical-operational dyad model
• Proven track record of owning and successfully managing a large P&L and delivering results in a value-based care or capitated environment.
• Deep understanding of the healthcare landscape, particularly value-based care, Medicaid, and the behavioral health ecosystem (SMI/SUD).
• Exceptional leadership presence, executive communication skills, and the ability to inspire and manage large, cross-functional teams including market leaders and clinicians.
• Ability to travel regularly across the state to visit communities and meet with partners; proficiency in communicating a “win-win” value proposition to external partners.
• A passion for serving and direct community and care team experience working with individuals living with SMI.
• Preferred experience in an early-stage or growth company with the ability to be flexible and adaptable to changing strategies.

The Executive Director (ED) is a high-impact, mission-driven General Manager responsible for driving the P&L, operational, and clinical performance of the firsthand model across their state. The ED fosters a culture of firsthand Values-driven innovation, collaboration, and deep community engagement to achieve the firsthand mission of delivering life-changing outcomes to individuals with serious mental and physical illness. The ED is tasked with the management and strategic execution of the entire business unit, overseeing the integration and success of our care team and clinical practice. This includes both community outreach and clinical care delivery teams – ensuring a consistent, scalable, individual-centered approach to care is embraced by all. The ED will ensure firsthand’s teams are effective in their outreach, trust-building, engagement, benefits navigation, and activation of the entire fH care model, as well as its clinical and financial outcomes long term. Furthermore, the ED will lead the expansion of care model operations across the state and in doing so ensure best practices are adopted and implemented across all teams. 

Job Specifics

As ED, you will:

• Serve as the General Manager and own the complete Profit and Loss (P&L) for the entire state. This includes full accountability for medical cost management, revenue optimization, opex management – and broadly driving profitability.
• Report directly to the COO and partner meaningfully with the VP Care Model Performance, Senior Director of Central Clinical Programs, and other EDs to lead, motivate, and inspire community and care model teams deeply dedicated to firsthand’s mission.
• Consistently exceed a rigorous set of high-value care model process (i.e. fidelity to core model activities)and value outcomes (e.g: utilization, HEDIS metrics), individual engagement and activation goals, and financial targets (e.g: medical cost, revenue, membership growth).
• Provide decisive leadership and supervision across all integrated state-level functions, overseeing both Clinical Managers (CMs) and Managers of Community Operations (MCOs). 
• Lead, mentor, and actively develop all market leadership and care team members, fostering a culture of continuous improvement, high accountability, and mission-driven work to ensure long-term team engagement and operational excellence.
• Galvanize and foster a high-performing, inclusive, and supportive employee culture, driven by and visibly embodying the firsthand values
• Manage, analyze, and optimize the state key performance indicators (KPIs), effectively coaching market leadership and care teams to exceed financial, clinical, and operational targets. 
• Ensure the seamless execution of firsthand’s operational and strategic plans, including adapting practices as the business evolves.
• Build key state-level relationships with local healthcare providers, community partners, and health plan clients to drive engagement and improve outcomes.
• Lead the successful execution and launch of new firsthand clinic locations within the state, including the recruitment of community-based and care model staff in collaboration with the People team.

The experience you bring to this role includes:

• Significant experience (7-10+ years) in healthcare leadership roles, preferably in a high-growth, high-complexity operational environment leading integrated community-based and clinical teams.
• Experience leading in a clinical-operational dyad model
• Proven track record of owning and successfully managing a large P&L and delivering results in a value-based care or capitated environment.
• Deep understanding of the healthcare landscape, particularly value-based care, Medicaid, and the behavioral health ecosystem (SMI/SUD).
• Exceptional leadership presence, executive communication skills, and the ability to inspire and manage large, cross-functional teams including market leaders and clinicians.
• Ability to travel regularly across the state to visit communities and meet with partners; proficiency in communicating a “win-win” value proposition to external partners.
• A passion for serving and direct community and care team experience working with individuals living with SMI.
• Preferred experience in an early-stage or growth company with the ability to be flexible and adaptable to changing strategies.

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.