Psychiatric Nurse Practitioner – I-SNP 

Company: Avail Health Medical Practice of Florida, P.A. 

Reports to: VP of Care Delivery, Katie Korte 

Location: This position is hybrid/primarily virtual and must be located within Maryland, or within a reasonable commuting distance. 

About Avail Healthcare

Avail Health is a Nurse Practitioner–founded organization dedicated to removing barriers to care, access, and meaningful clinical work for Medicare-age individuals. We combine thoughtful technology, strong operational infrastructure, and deep respect for the patient–provider relationship to enable nurse-led virtual and mobile care models. As a fast-growing organization, we are building durable clinical infrastructure to support innovative care programs across multiple states, with a focus on improving outcomes for complex and underserved senior populations. 
For more information visit www.availhealthcare.co

Role Summary 

The Psychiatric Nurse Practitioner (PMHNP) – I-SNP is a clinically focused, hybrid (virtual-first) role responsible for delivering high-quality psychiatric care to Medicare Advantage Institutional Special Needs Plan (I-SNP) members residing in long-term care skilled nursing settings. 

Our I-SNP population is clinically complex. The ideal candidate brings deep expertise in geriatric psychiatric management, including the behavioral and psychological symptoms of dementia (BPSD), as well as experience with dual-diagnosed adults—including Medicare beneficiaries who qualify on the basis of disability rather than age—who present with co-occurring psychiatric illness and substance use disorders (SUD). This role requires comfort managing both ends of the age and diagnostic spectrum: from long-term custodial elders with advanced dementia and complex behaviors to younger disabled adults with comorbid addiction and serious mental illness.  

This role operates within Avail Health’s integrated, team-based care model, partnering closely with geriatric primary care NPs and interdisciplinary team (IDT) members to manage complex behavioral health needs across a high-acuity population. 

Care is delivered primarily via telehealth, supported by a mobile Community Health Worker (CHW) acting as a virtual extender. In-person mobile visits are conducted as needed when CHW support is unavailable. 

The PMHNP is responsible for comprehensive psychiatric evaluation, diagnosis, and longitudinal management of behavioral health conditions, applying evidence-based, patient-centered approaches within a highly collaborative, technology-enabled care model supported by robust HIE access and ambient AI documentation tools to enhance efficiency and care quality. 

Expectations for this role: 

• Initial evaluations: 60 minutes per patient 

• Follow-up visits: 20–30 minutes per patient 

• Average patient-facing time: 6.5 hours/day, with 1.5 hours reserved for documentation, care coordination, and team collaboration 

• Access to a robust health information exchange (HIE) providing rich, comprehensive patient history and clinical data 

• Ambient AI scribe technology integrated into the workflow, reducing documentation burden by up to 80% 

Location & Work Environment 

The role is hybrid — the vast majority of patient care is delivered virtually, with occasional or as-needed mobile deployment to support program needs. Residence is required within Maryland, with regional coverage spanning 13 skilled nursing facilities from Westminster to Fort Washington for in-person mobile visits when required. Candidates who are centrally located within the coverage area and able to support efficient daily travel are strongly preferred.  

Standard hours are Monday through Friday, 8:00 AM – 5:00 PM EST. Remote work requires a reliable high-speed internet connection and a dedicated, HIPAA-compliant workspace to ensure the security and confidentiality of patient information and organizational communications. 

Key Responsibilities 

Clinical Care & Psychiatric Management 

• Conduct comprehensive psychiatric evaluations for skilled nursing facility residents via telehealth or in-person mobile visit. 

• Provide direct management of psychiatric conditions common in the institutionalized geriatric and disabled adult population, including depression, anxiety, psychosis, agitation, insomnia, and behavioral disturbances. 

• Develop and manage individualized psychiatric treatment plans incorporating psychopharmacology and non-pharmacologic interventions tailored to medically complex, functionally impaired patients. 

• Guide clinical decision-making related to initiating, adjusting, or deprescribing psychotropic medications with rigorous attention to polypharmacy, fall risk, renal and hepatic function, and medical comorbidities. 

• Collaborate closely with the geriatric NP primary care team regarding integrated medical and psychiatric management. 

Dementia & Behavioral Management 

• Evaluate and manage behavioral and psychological symptoms of dementia (BPSD), including agitation, aggression, psychosis, wandering, sundowning, and sleep-wake cycle disturbances. 

• Apply evidence-based, person-centered approaches to dementia care, leading with non-pharmacologic strategies and exercising careful, conservative judgment when pharmacologic intervention is warranted. 

• Provide guidance to facility staff and care teams on behavioral management strategies, environmental modifications, and de-escalation techniques. 

• Navigate the clinical and ethical complexity of psychotropic prescribing in cognitively impaired residents, including CMS antipsychotic reduction initiatives and gradual dose reduction requirements. 

• Communicate with families and legal decision-makers regarding diagnosis, prognosis, care goals, and medication risks and benefits. 

Dual Diagnosis & Substance Use Disorder Management 

• Provide psychiatric evaluation and ongoing management for Medicare beneficiaries who qualify on the basis of disability, including younger adults presenting with co-occurring serious mental illness and substance use disorders. 

• Assess and manages SUD, including opioid use disorder (OUD), alcohol use disorder (AUD), and stimulant use disorder, within a skilled nursing facility setting. 

• Initiate and manage medication-assisted treatment (MAT), including buprenorphine and naltrexone, where clinically appropriate and within applicable regulatory requirements. 

• Apply a trauma-informed, harm-reduction framework to treatment planning for dual-diagnosed residents. 

• Coordinate with facility teams, case managers, and external behavioral health resources to support discharge planning and continuity of SUD care. 

Care Coordination & Collaboration 

• Work collaboratively with: 

• Community health workers (on-site visit facilitation partners) 

• Mobile geriatric nurse practitioners (primary care team) 

• Mobile RN Care Managers 

• Skilled nursing facility staff, including nursing and social services 

• Family members, guardians, and caregivers 

• Provide clinical guidance and psychiatric consultation to the broader care team. 

• Participate in interdisciplinary care conferences, team huddles, and case reviews. 

• Support education and shared decision-making with facility staff and families. 

Quality & Compliance 

• Ensure care delivery aligns with Medicare Advantage I-SNP requirements and applicable state and federal regulations. 

• Document assessments, treatment plans, and clinical encounters accurately and in a timely manner. 

• Participate in quality improvement activities and outcome measurement initiatives. 

What Success Looks Like 

• Delivers high-quality, evidence-based psychiatric care across virtual and mobile settings, maintaining strong clinical outcomes in a medically complex, high-acuity population  

• Effectively stabilizes and manages behavioral health conditions, including BPSD and dual-diagnosis patients, reducing behavioral escalations and avoidable hospitalizations  

• Demonstrates thoughtful, compliant psychotropic prescribing practices, aligned with CMS guidelines and best practices in geriatric psychiatry  

• Partners seamlessly with geriatric NP primary care providers and interdisciplinary team members to deliver coordinated, whole-person care  

• Maintains timely, accurate, and compliant documentation, meeting regulatory and organizational standards  

• Efficiently leverages technology (HIE, ambient AI scribe) to optimize workflow, productivity, and care quality  

• Builds strong, trusted relationships with facility staff, patients, and families, supporting effective communication and care planning  

• Contributes to overall program success through consistent performance, clinical quality, and engagement in team-based care delivery 

Required Qualifications 

• Master’s or Doctoral degree in Nursing (MSN or DNP) from an accredited program 

• Active, unrestricted Maryland Nurse Practitioner (NP) license in good standing. 

• Board certification as a Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) 

• Active Maryland DEA registration with prescriptive authority, or eligibility and willingness to obtain prior to start date. 

• Extensive experience in geriatric psychiatry, particularly with institutionalized older adults in skilled nursing or long-term care settings 

• Demonstrated clinical expertise in: 

• Behavioral and psychological symptoms of dementia (BPSD), including agitation, aggression, psychosis, and sundowning 

• Evidence-based, non-pharmacologic approaches to dementia-related behavioral management 

• CMS antipsychotic stewardship, gradual dose reduction requirements, and psychotropic prescribing regulations in long-term care 

• Psychopharmacology in geriatric and medically complex populations, including management of polypharmacy 

• Fall risk, renal and hepatic dosing adjustments, and drug-drug interactions in frail older adults 

• Dual diagnosis: co-occurring serious mental illness and substance use disorders 

• Substance use disorder evaluation and management, including OUD and AUD, with experience initiating and managing MAT (buprenorphine, naltrexone) 

• Trauma-informed and harm-reduction approaches to care 

• Collaborative, interdisciplinary care models in institutional settings 

• Strong clinical judgment and comfort with complex psychiatric decision-making in medically frail and cognitively impaired patients 

• Excellent communication skills with patients, families, facility staff, and interdisciplinary team members across the age and diagnostic spectrum 

• Comfort with telehealth technology and virtual care delivery 

• Ability to work effectively in a hybrid environment with evolving workflows and processes. 

• Residence in Maryland with ability to travel within the assigned regions as needed 

• Authorization to work in the United States 

Preferred Qualifications 

• Prior experience working with: 

• Medicare Advantage or Institutional Special Needs Plan (I-SNP) populations 

• Skilled nursing facility or long-term care residents 

• Value-based care or CMS innovation models 

• Experience with telehealth-based psychiatric care delivery 

• DATA 2000 waiver (X-waiver) or DEA DATA waiver for buprenorphine prescribing, or willingness to obtain 

• Familiarity with CMS LTC antipsychotic stewardship and F-tag regulatory requirements 

• Familiarity with ambient AI documentation tools and health information exchange platforms 

Compensation & Benefits 

• Total Salary: $140,000– $165,000, commensurate with experience 

• Retirement:  401(k) retirement plan with a 2% employer match, subject to plan terms and eligibility requirements 

• Performance Bonus: Employees may be eligible for a discretionary performance bonus based on individual performance, role-specific metrics, and overall company performance. Bonus structure and targets vary by role and are not guaranteed. Employees must be actively employed on the payout date to receive any bonus. 

• Annual Compensation Review: Compensation is reviewed annually and may be adjusted based on performance, market data, and organizational factors. Adjustments are not guaranteed. 

• Mileage Reimbursement: $0.725 per mile for travel exceeding 30 miles per day, up to $200 per day. 

• Benefits Package: Comprehensive benefits include medical, dental, and vision coverage. The company offers a Direct Primary Care (DPC) model paired with a high-deductible health plan and covers 100% of employee medical premiums, with dependent coverage subsidized. Additional benefits include company-paid life and disability insurance, and employer contributions to a Health Savings Account (HSA). 

• Paid Time Off: Employees accrue 15 days of paid time off annually, increasing with tenure. PTO accrues per pay period. 

• Holidays: 8 paid company holidays plus 1 floating holiday annually. 

• Retirement: 401(k) retirement plan with a 2% employer match, subject to plan terms and eligibility requirements 

Additional Requirements 

• Valid driver’s license, reliable transportation, and active automobile insurance; must be able to travel within the assigned region and provide proof of insurance upon request 

• Ability to meet credentialing, privileging, and background check requirements (engagement contingent upon completion)  

• Compliance with all applicable federal, state, and organizational regulations governing clinical practice  

Support & Resources 

• Avail Health provides all necessary devices for clinical and technology-related activities  

• Professional liability and malpractice insurance coverage ($1M/$3M) provided