Geriatric Nurse Practitioner - (Bellevue Area)

" A New Approach to an Age-Old Need" - Pathway Geriatrics is a nurse practitioner-owned medical practice headquartered in Redmond, WA, currently serving the Greater Seattle area. We provide in-home palliative primary care services for homebound older adults. Said differently, we bring our medical services to our clients, who often can't leave their homes to get the specialized care they need.

We have a uniquely deep background in technology (and tech startups), which heavily influences our workflows and culture. Our vision is to build a new type of medical practice that melds the latest technologies and best practices with the caring hearts of top-tier providers.

The Basics

We are looking for an experienced Geriatric Nurse Practitioner to serve as a palliative primary care provider in our Seattle Eastside region. You will work with high-complexity homebound clients primarily residing in Adult Family Homes (AFHs), assisted living facilities, and appropriately supported private residences.

The position is fully field-based, though we do hold weekly team meetings at our Redmond office.

Typical business hours are 9:00 AM to 5:00 PM, Monday - Friday.

Compensation

Compensation typically ranges from $130,000 to $160,000 base, depending on experience. High performers may also earn very meaningful discretionary bonuses tied to panel stability, quality of care, and team contribution.

The Job Details

You will serve as the PCP for a panel of about 200 homebound older adults in your region. Most of our clients live in Adult Family Homes (AFHs), with some residing in private residences and assisted living facilities. We often have several clients at each home. We aim to visit each location every 5 to 6 weeks, with individual visit frequency driven by medical necessity and provider judgment.

Our providers also facilitate each client's medication and chronic care management between in-person appointments.

We do our best to keep clients out of the emergency room. While we don't yet offer in-home urgent care, we can often manage urgent situations remotely with help from our local network of in-home diagnostic services. These include mobile imaging, ultrasound, phlebotomy, and urinalysis/urine cultures.

Your Clients

The nature of our services means we often work with multiple parties when coordinating patient care. We typically work with at least three stakeholders per patient: the patient, their medical power of attorney, and their caregiver (usually an Adult Family Homeowner).

A typical client is 75+ years old and often in their final years. Most clients are homebound due to advanced dementia, but many also have other chronic diseases like osteoarthritis with contractures and pain, Parkinson's disease, heart failure, and diabetes. That said, we also work with younger adults who are homebound due to traumatic brain injuries, strokes, or mental health conditions.

Our clients' family members and powers of attorney have varying levels of engagement and knowledge. We are transparent and communicative with them and aim to serve as a resource for them and their loved ones.

The Office

The job is 100% field-based. On a given day, you will visit between one and five homes or facilities. Each Adult Family Home is someone's house in a regular neighborhood that the state has licensed to care for around six homebound adults.


Be prepared to pull out your laptop and perform your visits on the family couch, at the dining room table, or perched on a client's bedside. Adult Family Homes are unique settings that genuinely feel like family for these older adults, where they live in a small and compassionate environment, and their caregivers know them well. Their intimate knowledge of each client's habits and expressions often helps us fill in the gaps when clients cannot speak for themselves. We develop a rapport and work together with the caregivers since they have the knowledge that allows us to find the right fit for a client's treatment.

Who Thrives Here

This is not a role for someone who wants a predictable, clock-punching job.

Pathway Geriatrics attracts clinicians who hold themselves to a high standard-often higher than anyone else does. We care deeply about doing this work well, and we expect our providers to do the same.

Our best clinicians are intellectually curious, clinically confident, and comfortable practicing near the top of their scope. They keep learning. They question assumptions. They don't accept "this is just how medicine works" when something can be done better. They take ownership of their panel, their decisions, and their outcomes.

This role requires real engagement. You will build long-term relationships with patients, families, and caregivers. You will think through complex situations that don't have clean answers. You will occasionally think about your patients after hours. Not because you're required to, but because you care and because good care sometimes demands it.

You won't be doing this alone-we operate as a tight clinical team and expect providers to lean on each other as much as they challenge themselves.

We are not a good fit if you're looking for a short-term role, minimal patient interaction, rigid protocols with no room for judgment, or a job where you can fully disengage the moment the day ends.

This role is a great fit if you thrive in longitudinal care, are comfortable with clinical ambiguity, value close collaboration with caregivers, and prefer thoughtful, proactive medicine over high-volume visits. If you're driven to be excellent-and want to work with others who feel the same-this tends to feel less like a job and more like a place you've been looking for.

If you're reading this and feeling a little intimidated, but also energized, that's usually a good sign.

Requirements

Our practice approaches issues from a palliative care perspective. Our primary goal is to improve client comfort and quality of life while reducing unnecessary medications. We monitor disease progression and consider when they should transition to hospice services. We usually continue as the client's attending provider while they are on hospice, managing their end-of-life care.

We see many routine problems day-to-day, but we are also frequently surprised by things we've never seen before.

• We often work with dementia-related behavioral concerns expressed through tearfulness, restlessness, physical aggression, combativeness, and sleep difficulty.

• As our clients grow weaker, they will transition from walkers to wheelchairs to hospital beds and require our assessments and orders to coordinate that equipment.

• We partner with local home health care teams when our client needs skilled nursing, physical and occupational therapy, speech therapy, and psych nursing.

• Adult family homes also have special state regulations, so they need us to provide specific orders and permissions for their inspection requirements.

Typical Medications We Work With

Many dementia behaviors are managed with psychotropic medications. As such, we need you to be comfortable weighing the risks and benefits of applying antidepressants, antipsychotics, anticonvulsants, and others to help our clients with their quality of life.

We also strive to reduce or stop unnecessary medications. Standard "adult" guidelines often don't apply to a geriatric population. You will also need to be comfortable managing specialty medications, including those for cardiac issues and diabetes.

Other Tidbits

Personal Vehicle: You will need one.

On-call: We are available to our clients 24/7 for urgent needs. On-call responsibilities rotate evenly between providers and involve phone triage only-no after-hours facility visits. For context, most nights we receive no calls.

Giving Back: We try to give back to our community in many ways, and we ask all our employees to participate. Contribution examples might include writing an article, precepting a nursing student, or teaching a class at the local senior center.

Software Feedback: We're developing a proprietary healthcare tech platform designed explicitly for in-home patient care. Our engineers will work with you from time to time while designing and testing our software platform to streamline operations (i.e., make your life easier).

Benefits

In addition to your compensation, we provide each provider with:
• Malpractice insurance
• Four weeks PTO (vacation + sick leave)
• Nine paid holidays (six are set, three you get to pick)
• Top-notch low deductible Health Insurance (Medical, Dental, Vision) with an FSA
• 401K with 100% company matching up to 4% of compensation
• Life & Disability Insurance
• Workers Comp