firsthand is hiring an

APP (Nurse Practitioner or Physician Assistant)

Nashville, United States
Full-Time
firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians, which focuses on meeting each individual where they are and walking with them side by side as a trusted guide, partner, and first call on their journey to wellness.

firsthand's team members use their lived experience to build trust with these individuals and support them in obtaining socio-economic assistance and in reconnecting to primary and behavioral care. Support like this creates substantial savings for managed care organizations (Medicaid providers) and taxpayers by decreasing inappropriate healthcare utilization. This enables us to build solutions that scale and, as a result, change 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 APPs 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.
HGs lead the medical aspects of team-based care for individuals with serious mental illness that firsthand serves. They are responsible for whole person assessment and management of our vulnerable population, collaborating closely with community primary care and behavioral health providers, as well as an internal team of firsthand Guides (Certified Peer Recovery Specialists) and Community Resources Guides (social services personnel).

As a Health Guide, you will perform a whole-person clinical assessment, including:

  • 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. ,
  •  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 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 Medical Assistants, and 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.

You will be a good fit if you have:

  • Excellent clinical acumen in outpatient chronic disease and behavioral health care
  • Empathy, compassion, and approachability 
  • Excellent listening, communication, and interpersonal skills
  • Desire to help people in need and support their path to wellness
  • Comfort working as part of a multidisciplinary team, and enjoy mixed roles and duties - this is a mix of direct service, teaching, and care management
  • Cultural humility, knowledge of trauma informed care, and social determinants of health
  • Desire to perform data driven care
  • Familiarity with local providers
  • Ability to maintain professional boundaries and engagement skills with a population with challenges and in non-traditional work conditions
  • Intermediate computer and typing proficiency - experience with Electronic Health Records, familiarity with Google Suite a plus
  • Ability to operate a vehicle, including a driver’s license that is active and in good standing; must be eligible to drive under Company insurance policy 

The experience you bring to the role includes:

  • 5+ years clinical care as a Nurse Practitioner or Physician Assistant, ideally in a primary care 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.

Benefits 

For full-time employees, our compensation package includes base, equity (or special incentive program for clinical roles) and a bonus potential. Our benefits include physical and mental health, dental, vision, 401(k) with a match, 16 weeks parental leave for either parent, flexible vacation, and a supportive and inclusive culture.

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

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.
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