High Intensity Peer Counselor (RISE Guide)
firsthand Health · Spokane, WA
📍 Spokane, Washingtonvia greenhousePosted 2026-06-24
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firsthand supports individuals living with SMI (serious mental illness). Our holistic approach includes a team of peer recovery specialists, benefits specialists and clinicians. Our teams focus on meeting each individual where they are and walking with them side by side as a trusted guide and partner on their journey to better health.
firsthand's team members use their lived experience to build trust with these individuals and support them in reconnecting to the healthcare they need, while minimizing inappropriate healthcare utilization. Together with our health plan partners, we are changing the way our society supports those most impacted by SMI.
We are cultivating a team of deeply passionate problem-solvers to tackle significant and complex healthcare challenges with us. This is more than a job—it's a calling. Every day, you will engage in work that resonates with purpose, gain wisdom from motivated colleagues, and thrive in an environment that celebrates continuous learning, creativity, and fun.
We named our company firsthand because we believe that lived, or “firsthand,” experience is invaluable for gaining trust and building meaningful relationships. Because of that, we have many Peer Recovery Specialists that play a critical role in both outreach and long term engagement, supporting individuals living with SMI to achieve and maintain both behavioral and physical wellness. Internally, we refer to this important role as a firsthand Guide (fG). Some of our individuals will benefit from a higher intensity level of care than others, and to support those individuals, we have another Peer Recovery Specialist role: our RISE Population Guides ( RISE guides).
Our RISE Guides carry much of the same expertise as a Peer Recovery Specialist, however they will focus uniquely on supporting our individuals who need the highest level of care we provide at firsthand, often engaging and supporting them multiple times a week (or a day!). This is a role that will be performed in Community, working alongside our CORE firsthand guides, but serving a different panel of individuals than our core Community team.
As a RISE Guide, you will:
Support a small, high-touch panel of individuals, providing comprehensive hybrid support (in-person and virtual) tailored to complex acuity levels to::
Provide intensive post-discharge management and transitions of care, ensuring stability post psychiatric hospitalization and supporting them, ideally with in-hospital engagement and discharge planning
Coordinate and support their Substance Use Disorder treatment plan, if applicable
Support individuals in navigating their relationship with medications, including identifying and addressing barriers to adherence and facilitating communication with their prescribing team
Develop a deep understanding of the individual’s supports and triggers for deterioration, and be able to quickly develop safety & action planning to support them
Co-navigate systemic barriers alongside individuals to ensure they are able to access care, including appointments, transportation, enrollment into care services, and more
Actively problem solve and own to resolve social challenges, such as housing, food, transportation
Participate in daily huddles and regularIPRs to ensure a coordinated approach for RISE individuals
Potentially participate in (Post-Pilot) after-hours rotation to support individuals experiencing a crisis or urgent need outside of standard business hours.
Maintain engagement and build a trusting relationship with their individual, supporting them with empathy and assistance with problem solving
Support our individual, and our broader RISE care team, with ensuring our individuals avoid any sentinel, traumatic events – leading to better clinical outcomes and quality of life
RISE guides should have:
Empathy, compassion, and approachability
Excellent listening, communication, and interpersonal skills
Personal knowledge of recovery and/or behavioral health
Patience, persistence and a desire to help individuals experiencing SMI and/or SUD on their wellness journey
Comfort working collaboratively within multidisciplinary teams, including clinicians
Comfort or willingness to be an advocate for individuals in acute healthcare settings such as ERs and hospitals.
Strong personal boundaries and the ability to navigate high-stress situations while maintaining a calm, grounded presence
Demonstrated mastery with technical tools like smart phones, email, messaging services, and apps
Openness to receiving feedback and a commitment to professional growth
The required experience you bring to this role includes:
Lived experience with SMI and/or SUD and recovery
Two (2) years demonstrated recovery time from a mental health and/or substance abuse disorder at the date of application
State Peer Recovery certification, or eligibility and willingness to obtain certification within six (6) months of employment
Agreement to complete a paid training period prior to serving individuals and pass assessments to move forward.
Interest in gaining a Community Health Worker (CHW) Credential after hire, or already holds certification
Training or experience in de-escalation techniques (e.g., CPI, Mental Health First Aid) or a willingness to be trained in these methods
Bonus points for:
Experience with direct in-person engagement for individuals with SMI and SUD
Expertise in recovery education and coaching
Understanding of whole health and trauma-informed approaches to peer support
Familiarity with local community resources, behavioral health systems, and the criminal justice system (e.g., mental health and drug courts)
Ability to thrive in a mobile environment, spending 80%+ of your time in the community (homes, hospitals, streets) rather than an office
Eagerness to expand knowledge about a broad range of health conditions
Valid driver’s license in good standing, with the abi
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