Job Overview
Freedmen's Medicine is launching a mobile long-acting injectable (LAI) medication service that delivers medication for opioid use disorder (MOUD) and medication for alcohol use disorder (MAUD) directly to patients where they live. The Licensed Practical Nurse (LPN) is the clinician who makes that promise real — traveling to homes, group residences, and supportive housing sites across the District of Columbia and Prince George's County to administer Brixadi® (buprenorphine extended-release injection) and Vivitrol® (naltrexone for extended-release injectable suspension) under the direction of the supervising prescribing provider.
This is not a task-based injection role. Our patients are homebound or functionally homebound adults living with multiple chronic conditions alongside opioid or alcohol use disorder — a population that is routinely lost to follow-up in clinic-based care. The LPN is an integral member of an interdisciplinary care team and participates in case management rounds and collaborative care management (CoCM) reviews, contributing direct clinical observation that shapes the treatment plan. Retention in treatment is the outcome we are hired to produce, and the LPN is the team member closest to it.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Mobile LAI Medication Administration
▪ Travel to assigned patient residences to administer Brixadi® (subcutaneous) and Vivitrol® (intramuscular gluteal, Z-track technique) in accordance with manufacturer instructions for use, prescriber orders, and Freedmen's Medicine clinical protocols.
▪ Verify patient identity, active order, dose, formulation, injection site rotation schedule, and administration interval prior to every injection; confirm program eligibility and REMS/dispensing requirements are satisfied before the visit.
▪ Maintain product integrity in the field, including manufacturer-specified storage, temperature-controlled transport, chain-of-custody documentation, and secure handling of controlled substances consistent with DEA, DC, and Maryland requirements.
▪ Confirm required pre-administration criteria are met and documented — including the prescriber-verified opioid-free interval and negative screening prior to naltrexone administration — and escalate to the supervising RN or prescriber when criteria are not met.
▪ Perform post-administration observation, injection-site assessment, and vital sign monitoring; recognize and respond to adverse reactions, injection-site complications, precipitated withdrawal, and hypersensitivity events, including initiation of emergency response protocols.
▪ Carry, maintain, and administer naloxone where indicated, and deliver overdose recognition and response education to patients, family members, and residence staff.
▪ Manage supplies, sharps, and biohazardous waste in compliance with OSHA bloodborne pathogen standards and applicable jurisdictional regulations.
Clinical Assessment and Patient Monitoring
▪ Obtain and document vital signs, symptom review, medication reconciliation, and adherence history at each encounter within the scope of LPN practice in the District of Columbia and Maryland.
▪ Administer or assist with standardized screening and monitoring instruments as directed, including opioid and alcohol withdrawal assessments, PHQ-9, GAD-7, and craving or functional status measures.
▪ Observe and report changes in clinical status, mental status, housing stability, cognition, mobility, wound status, and social circumstances that may affect treatment adherence or safety.
▪ Perform point-of-care testing and specimen collection as ordered, including toxicology specimen collection following chain-of-custody procedures.
▪ Reinforce prescriber-directed education on medication effects, side effects, next-dose scheduling, and the risks of missed or delayed doses.
Care Team Collaboration and Care Management
▪ Participate in scheduled interdisciplinary case management rounds, presenting concise clinical updates on assigned patients and contributing to disposition and follow-up decisions.
▪ Participate in collaborative care management (CoCM) registry reviews alongside the behavioral health care manager, consulting psychiatric provider, and primary care team; support systematic caseload review and treatment-to-target adjustments.
▪ Coordinate closely with community health workers, care coordinators, social workers, and embedded staff at partner treatment and shelter sites to resolve access barriers and prevent missed doses.
▪ Escalate clinical concerns, missed appointments, and signs of disengagement in real time so the team can intervene before a patient falls out of treatment.
▪ Support warm hand-offs from hospital, emergency department, stabilization center, and shelter-based referral partners.
Documentation, Compliance, and Quality
▪ Document all encounters accurately and contemporaneously in the AthenaOne electronic health record, including administration records, observation findings, patient education, and care coordination activity.
▪ Complete documentation to the standard required to support Medicare, Medicaid, and commercial billing for medication administration and care management services.
▪ Maintain strict confidentiality in accordance with HIPAA and 42 CFR Part 2, which governs the confidentiality of substance use disorder patient records.
▪ Adhere to all federal, District of Columbia, and Maryland regulations governing controlled substance handling, nursing practice, infection control, and mobile clinical services.
▪ Participate in quality improvement activities, chart audits, competency validation, incident reporting, and program performance review.
Patient Engagement and Field Safety
▪ Build trusting, non-judgmental, trauma-informed therapeutic relationships with patients whose experience of the health system has often been marked by stigma and discontinuity.
▪ Apply harm reduction principles and motivational interviewing techniques to support engagement and retention in treatment.
▪ Plan efficient daily routes, communicate proactively regarding schedule changes, and follow field safety protocols including check-in/check-out procedures and situational risk assessment.
MINIMUM QUALIFICATIONS
▪ Graduate of an accredited practical nursing program.
▪ Active, unencumbered Licensed Practical Nurse license in BOTH the District of Columbia and the State of Maryland at the time of hire. Maryland multistate (Nurse Licensure Compact) privilege is accepted where applicable; separate District of Columbia licensure is required.
▪ Minimum of two (2) years of applicable nursing experience. Directly applicable experience includes substance use disorder treatment, opioid treatment programs, behavioral health, home health, hospice, correctional health, community health, or care of medically complex adults.
▪ Demonstrated competency in intramuscular and subcutaneous injection administration.
▪ Current Basic Life Support (BLS) certification from the American Heart Association or equivalent.
▪ Reliable personal transportation, a valid driver's license, and automobile liability insurance meeting practice minimums; satisfactory motor vehicle record.
▪ Proficiency with electronic health records and mobile documentation on tablet or laptop devices.
▪ Ability to work independently in unsupervised community settings while maintaining clear communication with the supervising RN.
▪ Successful completion of criminal background check, drug screen, sanctions and exclusion screening, tuberculosis screening, and immunization requirements.
PREFERRED QUALIFICATIONS
▪ Direct experience administering long-acting injectable medications, including Vivitrol®, Sublocade®, Brixadi®, or long-acting injectable antipsychotics.
▪ Experience in medication-assisted treatment, office-based opioid treatment, or opioid treatment program settings.
▪ Prior home-based or field-based nursing experience serving homebound or unstably housed populations.
▪ Familiarity with AthenaOne or comparable ambulatory EHR platforms.
▪ Training in motivational interviewing, trauma-informed care, or harm reduction.
▪ Working knowledge of DC and Maryland Medicaid behavioral health service delivery.
▪ Bilingual English/Spanish or English/Amharic capability.
CORE COMPETENCIES
▪ Clinical judgment in the field. Sound assessment and escalation decisions without a colleague in the next room.
▪ Reliability. Patients on an injection interval depend on the visit occurring on schedule.
▪ Therapeutic presence. Consistency and respect, particularly with patients experiencing relapse or ambivalence.
▪ Team communication. Concise, clinically useful reporting in rounds and registry review.
▪ Documentation discipline. Complete, timely, audit-ready records.
▪ Cultural humility. Effective, respectful care across the communities we serve.
PHYSICAL AND ENVIRONMENTAL REQUIREMENTS
▪ Ability to travel independently to multiple patient residences daily in varying weather and traffic conditions.
▪ Ability to enter homes and buildings that may lack elevator access, climb stairs, and navigate variable and sometimes cluttered environments.
▪ Ability to lift and carry clinical supply bags and portable equipment weighing up to 25 pounds.
▪ Ability to sit, stand, walk, bend, and perform fine motor tasks required for injection administration.
▪ Potential exposure to bloodborne pathogens, communicable disease, tobacco smoke, pets, and unregulated home environments; personal protective equipment is provided.
SCHEDULE
Primary coverage is Monday through Friday during standard business hours.
Pay: $30.12 - $36.27 per hour
Work Location: In person
