Nurse Practitioner, Concierge Metabolic Health (Telehealth)

1836 Wellness is a concierge telehealth practice built for high-performing executives who want more than standard care. Our clinical model centers on a 123-marker diagnostic panel across 12 health domains, more comprehensive than Function Health or Empirical Health, combined with three biological age algorithms, 10-Year and Lifetime ASCVD cardiovascular risk scoring, GLP-1 and peptide protocols, and fully personalized treatment plans. Every patient gets genuine clinical depth, real time with their provider, and a treatment experience that matches how seriously they take their health. We are building this practice from the ground up. The Nurse Practitioner (NP) we hire will have a direct hand in shaping clinical protocols, patient workflows, and the standard of care we deliver, not inheriting a system someone else built.

Location: Remote, 100% Telehealth (Houston, TX base preferred but not required for TX-licensed NPs) Type: Contract (1099), transitioning to W-2 at scale Compensation: $3,000/month retainer + per-patient compensation at volume. Equivalent to $36,000-$60,000+ annually depending on patient load. Performance bonus tied to patient outcomes and retention. Start Date: May 2026 (targeting June 2026 clinical launch) Reports To: Medical Director (physician oversight) and CEO (operations) THE ROLE You will be the primary clinical provider at 1836 Wellness. Working under a collaborative practice agreement with a board-certified Medical Director, you'll manage the full patient lifecycle: intake assessment, comprehensive lab interpretation, treatment planning, medication management, and ongoing monitoring, entirely via secure telehealth through Cerbo EHR. Mobile phlebotomy partners handle all blood draws at the patient's home or office.

Conduct comprehensive telehealth assessments, medical history, contraindication screening, baseline lab review Interpret the 123-Marker Executive Panel covering metabolic health, cardiovascular risk, hormonal balance, organ function, inflammation, advanced lipids (NMR LipoProfile), thyroid depth, and complete urinalysis Review biological age scores (PhenoAge, KDM, 1836 Functional Bio Age) with patients and translate results into actionable clinical recommendations Calculate and communicate ASCVD 10-Year and Lifetime cardiovascular risk scores Prescribe and manage GLP-1 therapies (compounded semaglutide, tirzepatide) with individualized dosing and titration Develop personalized protocols including peptide therapies (BPC-157, CJC/Ipamorelin, Thymosin Alpha-1), hormone optimization, and metabolic support Provide ongoing monitoring through bi-weekly check-ins, medication adjustments, and side effect management Order and interpret follow-up labs at program milestones (Week 6, Week 12) Contribute to building clinical operations, intake workflows, documentation templates, and patient experience standards in Cerbo EHR