Nurse Practitioner — Tickortreat
Telehealth tick-bite prophylaxis · Vermont-based · Launching summer 2026
That's the whole clinical scope. Tickortreat operates entirely within the prevention window — the 72-hour period after a tick bite when IDSA-aligned single-dose doxycycline prophylaxis is evidence-based and effective. Active Lyme disease, chronic Lyme management, and diagnostic workup all live outside our scope. Those are real and important clinical concerns, but they need expertise and clinical settings beyond what a focused prophylaxis service should attempt. The protocol is built on IDSA/AAN/ACR 2020 and AAP Red Book 2024, and is currently under specialist review.
Who we are
Tickortreat is a small Vermont-based telehealth service launching this summer in six New England states, founded by Lucas Farrell and Louisa Conrad — a husband-and-wife team who have run Big Picture Farm in southern Vermont together for sixteen years. Big Picture is an Animal Welfare Approved goat dairy that makes award-winning farmstead confections, sold across the country. We started Tickortreat for the same reason we started the farm: we wanted something to exist that didn't yet, and we figured we'd build it ourselves.
The medical director is a practicing physician. The clinical protocol is under review by infectious disease specialists at UVM.
The whole operation runs on the conviction that tick-bite prophylaxis is a real, evidence-based intervention that's currently inaccessible to most people in tick country, and that a tightly scoped, IDSA-aligned telehealth service can change that.
We're not VC-funded, we're not trying to be a hundred things, and we're not going to ask you to operate in clinical gray areas. We're trying to close a specific access gap, do it well, and build something durable in our community.
What you'd do
- Review asynchronous tick-bite cases routed to you through our clinical platform. Most reviews take 5–15 minutes per case.
- Apply IDSA criteria for tick-bite prophylaxis to each case. Prescribe single-dose doxycycline (via DoseSpot e-prescribing) when indicated. When prophylaxis is not indicated, document the clinical reasoning and deliver a personalized monitoring plan.
- Communicate with patients through structured intake review and brief follow-up messages. No video visits required.
- Participate in QA review — periodic chart review, protocol feedback, occasional check-ins with the medical director. We want NPs who care about doing this right, not NPs who just want to bang out visits.
- Optional: contribute to protocol evolution as the service matures. We welcome clinical input from experienced NPs on the protocol and operations — formal input that gets compensated separately from per-visit work.
What you'd bring
Required
- FNP credential (FNP-BC or FNP-C)
- Active, unrestricted nursing license with prescriptive authority in at least one of: VT, NH, ME, MA, NY, CT
- Clean credentialing history (no adverse NPDB findings, no exclusion list matches)
- Active malpractice coverage (or willingness to be covered under our policy)
- Comfort with asynchronous clinical practice
- Solid clinical judgment and willingness to document reasoning thoroughly — our chart standard is "a different clinician could reproduce your reasoning from the chart alone"
Strongly preferred
- Multi-state licensure in our launch footprint (or willingness to add states as we grow — we'll cover the costs)
- Prior telehealth experience (Hims, Ro, Teladoc, MDLive, or similar)
- Experience with tick-borne illness or infectious disease prevention
- Pediatric comfort (about 30% of our expected volume is pediatric)
- Vermont, New Hampshire, or Maine residence (helpful but not required)
Nice to have
- DNP
- Lyme/tick-borne disease coursework or research background
- Bilingual English/Spanish (significant Spanish-speaking populations in our MA/NY/CT patient base)
Engagement model
We're flexible on how you engage with us, and the right structure depends on what you're looking for:
- Per-diem: Pure per-visit compensation. Take cases when you're available. Most flexible.
- Part-time with minimum guarantee: Per-visit compensation plus a minimum monthly commitment. More predictable for you, more reliable capacity for us.
Both are 1099 contractor arrangements. This is moonlighting/gig work — you'll likely have a primary clinical role elsewhere, and Tickortreat fits around it on your schedule.
Compensation
Most reviews take 5–15 minutes per case. Senior NPs taking on clinical-lead responsibilities (chart review, protocol input, training newer clinicians) earn a base retainer in addition to per-visit comp.
Visit volume scales with tick season — high May through October, lower November through April. We're transparent about that with everyone we engage.
Why this might be a good fit
✓ You'll like this role if…
- You want a narrow, well-defined clinical scope where the right answer is usually clear
- You like evidence-based medicine and you respect IDSA guidelines
- You want flexible asynchronous work that fits around your day job, your kids, your other clinical practice
- You care about a real public health gap and want to be part of closing it
- You think doxycycline-for-tick-bite-prophylaxis is exactly the kind of intervention that should be widely accessible
- You're comfortable with a small, founder-led operation that's just getting started
✗ You might not love this role if…
- You want a broad, varied clinical scope
- You're looking for your primary clinical role with benefits (this is moonlighting / gig work designed to fit alongside a primary job)
- You're uncomfortable with cash-pay telehealth (we don't take insurance)
- You want guaranteed steady volume year-round (visit volume scales with tick season)
What credentialing looks like
We take credentialing seriously. The process for any NP joining us:
- Initial conversation (20–30 min)
- Conditional offer
- Document collection: state licenses, board certifications, DEA registration, education records, work history, references, malpractice declarations
- License verifications direct with state boards
- NPDB query
- OIG/SAM/state Medicaid exclusion checks (ongoing monthly thereafter)
- Reference checks
- Clinical protocol training and competency check
- Activation
The full cycle typically takes 4–6 weeks. We do the work to get it right.
Apply
If this is interesting to you, send us a brief application. We respond to every inquiry personally.
Thanks for reaching out.
We'll review your application and respond personally within a few business days. If you'd like to send a CV separately, email it to lucas@tickortreat.com.