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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.   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