PA) - Day Shift, ORCA POD

DESC•Seattle, WA

About The Position

DESC (Downtown Emergency Service Center) is a nonprofit organization working to help people with the complex needs of homelessness, substance use disorders, and serious mental illness achieve their highest potential for health and well-being through comprehensive services, treatment, and housing. Our vision is a community where no person is abandoned, ignored, or experiencing homelessness. As the region's leading provider of services to multiply disabled adults who have experienced chronic homelessness, DESC serves almost 3,000 people each day. Our integrated service model is designed to help people secure and maintain appropriate, safe and affordable housing. DESC is recognized nationally and regionally as an innovator in developing solutions to homelessness. DESC’s ORCA program provides compassionate, low-barrier, and evidence-based care to individuals who are recovering from opioid overdose and those seeking treatment for opioid use disorder (OUD). The ORCA Center, our brick-and-mortar location, provides post-overdose subacute stabilization services and provides walk-in access to medications for opioid use disorder (MOUD). The ORCA Patient Outreach Division (POD) delivers field-based MOUD care – meeting people where they literally are in the community. The POD Provider delivers flexible, trauma-informed clinical care in the field and supports rapid initiation and continuation of medications for OUD (MOUD). This role works closely with DESC’s Mobile Integrated Health (MIH) partners at the Seattle Fire Department (SFD) to coordinate targeted outreach, create pop-up MOUD access points, and conduct follow-up with individuals after overdose or acute events. The POD Provider may also support the DESC ORCA Center, which operates 24/7 offering rapid MOUD access and post-overdose care. This is a clinical, non-supervisory position.

Requirements

Fully licensed as a Physician, Nurse Practitioner (Family or Adult NP), or Physician Assistant in the State of Washington.
If physician, board certification, or ability to obtain within 12 months of hire, in emergency medicine, family medicine, or internal medicine.
Current registration with the Drug Enforcement Agency (DEA).
Experience or training in addiction medicine, harm reduction, or caring for individuals with OUD.
Proficiency with clinical documentation and electronic health records.
Desire to serve people with complex needs who are or have been experiencing homelessness and are living with serious and persistent mental illness, substance use disorder, and other complex medical conditions.
Able to work effectively with clients displaying a wide range of challenging behaviors .
Adaptable to changing priorities, processes, or workflows as the program grows and evolves.
Able to give and receive constructive feedback.
Familiar with trauma-informed care, harm reduction, and equity and social justice principles.
Possess cultural humility and able to work effectively with individuals of diverse backgrounds and identities.
Willing to travel across the greater Seattle area.

Nice To Haves

Doctoral degree.
Experience in low-barrier buprenorphine programs or Opioid Treatment Programs.
Background in acute settings (e.g., ED, EMS, crisis response).
Training or experience in caring for co-occurring mental health conditions.
Experience with field-based medical outreach.
Bilingual in Spanish/English
Ability to drive an agency or personal vehicle to conduct agency related business, which requires a current Washington State driver's license and insurable driving record.

Responsibilities

Provide evidence-based MOUD treatment (buprenorphine, including LAI formulations; methadone under the 72-hour rule) in a variety of community settings.
Provide telemedicine care to patients and remote consultation for nurses in the field.
Deliver low-barrier clinical assessments, MOUD initiations, acute follow-up, and ongoing management for individuals engaged in outreach.
Conduct harm reduction counseling, including safer-use strategies and overdose prevention planning.
Manage common conditions such as skin and soft tissue infections and connect individuals to primary care or mental health services as needed.
Participate in Seattle Fire Department Mobile Integrated Health joint outreach operations, pop-up MOUD access points, and targeted “hot spot” engagement based on real-time overdose and EMS data.
Support field-based follow-up after overdose, SFD encounters, or ORCA Center visits to ensure MOUD continuation and reduce treatment drop-off.
Work closely with POD nurses and peers to deliver holistic, relationship-centered care.
Coordinate care and warm handoffs with the ORCA Center, DESC outpatient clinics, community MOUD programs, hospitals, and outreach partners.
Establish and maintain strong partnerships with SFD MIH, PSH and shelter staff, and other community organizations to expand access to low-barrier addiction care.
Ensure continuity for individuals transitioning between field engagement, ORCA Center care, and community providers.
Complete timely documentation meeting DESC, regulatory, and payer requirements.
Utilize electronic health records effectively and maintain accurate clinical and outreach notes.
Participate in ongoing training on addiction medicine, harm reduction, trauma-informed practice, race and social equity frameworks, and emerging best practices.
Join case reviews, interdisciplinary meetings, and POD team huddles.
Engage in reflective practice, welcome feedback, and support a culture of curiosity, collaboration, and equity.