Most "wilderness medic" positions tend to be either additional (part time, as needed) duties for someone with another job, like a park ranger, or else volunteer (unpaid) positions with a Search and Rescue group. From what I have seen, there are very few (if any) people paid to be a full time wilderness medic.
There are, however, paid positions with many ski patrols. Some EMS agencies in rural areas respond to calls off the road network. For example, in my part of the world, the Girdwood FD responds to calls in the adjacent backcountry. However, that only amounts to a small portion of their calls, most are on the highway. Also, as far as I know Girdwood has only one paid medic position (assistant chief for EMS), the rest are volunteer.
I can't speak to the tactical side of things.
