Nurse Practitioner, Concierge Metabolic Health (Remote/Telehealth)

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.

What you’ll do

• 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

Patient volume

• At launch: 5–15 patients, approximately 3–5 hours/week
• Q2–Q4: 25–40 patients, approximately 10–15 hours/week
• Hard cap: 40+ patients, quality over volume

Compensation

Phase 1: Retainer (Launch through 15 active patients)

• $3,000/month guaranteed retainer
• Covers: Clinical availability, protocol development, Cerbo EHR configuration support, patient consultations
• Estimated time commitment: 5–10 hours/week
• CME allowance: $1,000/year

Phase 2: Retainer + Per‑Patient (15+ active patients)

• $3,000/month base retainer continues
• Per‑patient compensation added (structure TBD based on patient volume and complexity)
• Performance bonus tied to patient outcomes, retention rates, and practice growth

Phase 3: Full Employment (40+ active patients or mutual agreement)

• Transition to W‑2 employment + benefits package
• Competitive base salary ($110,000‑$140,000 range depending on experience and volume)
• Potential equity or profit‑sharing for the right long‑term clinical partner

Required qualifications

• Hands‑on experience prescribing and managing GLP‑1 medications (semaglutide, tirzepatide) for weight loss. Candidates without this will not be considered.
• Active Texas APRN license, FNP‑BC or AGPCNP‑BC
• 3+ years of NP practice experience
• Strong foundation in metabolic health, you understand obesity as a chronic, multi‑system disease
• Comfortable interpreting comprehensive panels beyond standard CMP/CBC: hormones, inflammatory markers, advanced lipids including NMR LipoProfile, thyroid depth, kidney markers
• Familiarity with ASCVD risk assessment and cardiovascular risk communication
• DEA registration (or ability to obtain before launch)
• Clean professional record, no board actions or disciplinary history
• Telehealth‑confident, you can build clinical rapport through a screen

Bonus qualifications

• Experience in a cash‑pay, direct‑pay, or concierge practice setting
• Background in endocrinology, internal medicine, or obesity medicine
• Certification or coursework through the Obesity Medicine Association (OMA)
• Familiarity with peptide therapies, hormone optimization, or regenerative medicine
• Multi‑state NP licensure (AZ, FL) or willingness to obtain
• Familiarity with Cerbo EHR or similar modern clinical platforms
• Experience in a startup or early‑stage clinical environment

Who you are

Confident without ego. You can hold your own with a CEO and explain a complex treatment plan without talking down to anyone. Efficient and direct. Our clients value their time. You get to the point, answer the question, and lay out the plan. Discrete. You treat every interaction with the privacy a high‑profile clientele deserves. A builder. This is a ground‑floor opportunity. You don’t wait for a playbook; you help write it. Genuinely curious. You stay current on GLP‑1 research, peptide science, and metabolic health because you want to.