Nurse Practitioner — Tickortreat
Telehealth tick-bite prophylaxis · Vermont-based · Launching summer 2026
That's the whole clinical scope. No active Lyme treatment, no chronic Lyme management, no antibiotic stewardship debates, no anything-walks-through-the-door diagnostic ambiguity. The protocol is built on IDSA/AAN/ACR 2020 and AAP Red Book 2024. It's currently under specialist review at the UVM Vaccine Testing Center.
Who we are
Tickortreat is a small Vermont-based telehealth service launching this summer in six New England states. We're a family operation in southern Vermont — our founder is a goat farmer (yes, really) who got tired of watching his daughters miss the 72-hour prophylaxis window because primary care couldn't see them in time. He builds the company; his wife (an artist with an MFA from CalArts) designed the brand. 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.