Advanced Practice Registered Nurses / Physician Assistants
Internal Number: 633974600
The Nebraska-Western Iowa VA-Grand Island, NE VA Primary Care Service line is hiring a intermittent, temporary, Primary Care Physician Assistant. Throughout the duration of this vacancy announcement, applications that are received will be referred to the selecting official on a bi-weekly basis until position is filled. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education. [Graduate of a training program which is accredited by the Accreditation Review Commission on Education of PA (ARC-PA) or one of its predecessor organizations. Additionally, candidates must meet one of the following:(1) Master's degree in any discipline; OR(2) Bachelor's degree in any discipline with one year of experience as a PA. Certification. Must have successfully passed the PA National Certifying Exam (PANCE).NOTE: Current and continuous certification by the National Commission on Certification of Physician Assistants (NCCPA) is no longer required for employment in VHA. (See paragraph 3a in this standard for additional information regarding the certification requirement for employees grandfathered into the occupation.) Licensure. PAs must possess an active, current, full, and unrestricted license to practice in a State, Territory, or Commonwealth of the United States, or in the District of Columbia. PAs must maintain current registration in the State of licensure if this is a requirement for continuing active and current licensure in that State. Grade Determinations: (1) Physician Assistant-I (PA-I) (a) Experience and Education. None beyond the basic requirements. This is the entry level for PAs. (b) Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills, and abilities (KSA) present the minimum skill set expected of an Entry Level PA. This practice may include, but is not limited to: Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care. Ability to perform patient history and physical. Ability to formulate a plan and provide treatment to the patient. Ability to provide patient care that is abreast of changing concepts and advancements in the profession. (2) Physician Assistant-II (PA-II) (a) Experience and Education. The PA at this grade is at the intermediate grade level and has had progressively increasing responsibility and experiences as indicated in the KSAs listed below. Individuals will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving. Individuals demonstrate the KSAs of PA-II intermediate level by: i. Two years of successful practice as a PA. OR ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency. OR iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education. (b) Demonstrated Knowledge, Skills, and Abilities (KSAs). PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-II: i. Skills to analyze and solve complex medical problems. ii. Ability to function autonomously and make independent medical decisions. iii. Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care. iv. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. v. Ability to practice with colleagues and peers collaboratively. (3) Physician Assistant-III (PA-III) (a) Experience and Education. PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multi-disciplinary teams, and coordinate all aspects of patient care across the health care system. They utilize advanced clinical knowledge and judgment in decision-making and evaluating outcomes. They function as experts in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students. Individuals can demonstrate the KSAs for the full performance level by: i. Three years of successful practice as a PA.OR ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency and one year of professional practice as a PA. OR iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education and one year of professional practice as a PA. (b) Demonstrated Knowledge, Skills, and Abilities. PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-III: i. Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care. ii. Skill to consistently demonstrate an elevated level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE). iii. Ability to present clinical findings and recommendations to appropriate management officials. iv. Ability to clinically facilitate the delivery of patient care in collaboration with health professionals, health managers, and other health care personnel. v. Ability to implement and initiate clinical changes to established treatment protocols based upon new medical literature research findings to enhance patient delivery care for improved patient outcomes.vi. Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records. References: VA Handbook 5005/134 Part II Appendix G8 Preferred Experience: Primary Care Experience preferred. A physician assistant must be a graduated or graduating from a primary care training program approved by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) and have been certified by the entrance exam of the National Board of Medical Examiners Physical Requirements: The work is generally sedentary in nature with some daily intermittent walking, standing, bending, stooping, reaching, and carrying of lightweight items required. Rigid deadlines and need for high degree of accuracy periodically becomes stressful. The full performance level of this vacancy is PA-3. The actual grade at which an applicant may be selected for this vacancy is in the range of PA-1 to PA-3. ["Additional duties may be assigned by the Primary Supervising Physician, appropriate Chief of Service or Chief of Staff, which may include provisions for special training to assure proficiency. Additional duties may be assigned by the Primary Supervising Physician, appropriate Chief of Service or Chief of Staff, which may include provisions for special training to assure proficiency. Obtain pertinent medical and psycho-social history including patient profile, chief complaint, history of present illness, past medical history, social history and review of body systems. Perform a physical examination as pertinent, modifying the examination for the nature of the complaint or problem, age/sex of patient and physical condition of patient. Determine patient's mental status (i.e., level of consciousness, orientation, mood, etc.). Order and interpret laboratory, x-ray, diagnostic and/or treatment studies appropriate for complaint, age, race, sex and physical condition of the patient. Obtain the following specimens for laboratory evaluation Record and transmit findings from data base Complete insurance forms Complete medical evaluation forms Differentiate between normal and abnormal (including variations of normal) information obtained from history, physical, and screening examination of the patients. Preliminary interpretation of diagnostic tests with consultation as necessary (such as routine x-rays of chest and extremities, lab studies, EKG, etc.). Develop initial impression as to severity, etiology and immediacy of patient's problem based on analysis of data obtained from history, physical, laboratory and x-ray studies. Establish diagnosis of common problems with physician consultation and guidance as appropriate. Develop/Formulate Health Management Plan - Develop a management plan considering patient's problem, age, sex, race and condition, conferring with the patient, supervising physician, patient's family and other health professionals as appropriate. Implement and Monitor Health Management Plan Apply established therapeutic practices to patient's problem. Prescribe medications from the open hospital formulary based upon following guideline: If the PA has a current, full, unrestricted, and active NE license, the PA will be eligible t prescribed medications and controlled substances (CII-CV) as agreed upon through collaborative physician agreement as well as in accordance with state and federal laws. If the PA has a current, full, unrestricted and active license frm a state other than NE (i.e. from a state other than that in which the facility is located) the license must allow for prescribing, and must be observed for the limits of that prescribing (that is, the PA can only prescribe drugs from those schedules (to include controlled substances) the state of licensure allows for PAs in that state, not the state where the facility is located) and in accordance with a collaborative physician agreement and state/federal laws. All PAs will be required t maintain an active DEA number. Perform cardiovascular therapies Perform gastrointestinal therapies Perform genitourinary therapies Perform gynecological therapies and pap smear Perform minor surgical therapies/procedures Initiate appropriate management for emergency situations until physician is available. Patient Education - Provide patient education services Identify mental health problems through accepted techniques such as interviewing, observation for behavioral/mood changes, identification of outside factors influencing psychological state and relating physical condition/problems to mental health disorders. Counsel patient concerning non-referral type mental health problems such as anxiety reactions, non-psychotic depression, adjustments to aging, adjustment to chronic disease/terminal illness and psychological influences on physical condition. Support and counsel family in dealing with patient's condition. AD HOC: May be authorized ( Employee who Telework on an occasional, episodic, or short-term, and have completed required telework training and telework agreement)\nVirtual: This is not a virtual position.\nFinancial Disclosure Report: Not required\nWork Schedule: Typical work hours are Monday to Friday 8:00 a.m. - 4:30 p.m., Hours will reflect the need as intermittent position. Additional information may be provided during the interview process. Duties may include evening and weekend working hours."]
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.