North Central Section of the AUA, Inc.

The Portland VA Transplant Nephrology Service provides consultative and direct patient care for patients referred for issues of care across the spectrum of chronic kidney disease: pre-dialysis, hemodialysis and post-renal transplantation. The Transplant Nephrology PA will play a crucial role in all aspects of this care including consultation in person and via telemedicine, and performing evaluations of patients referred for transplant and post transplant. Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Physician Assistant Basic Requirements Master's degree in any discipline or a bachelor's degree in any discipline with one year of experience as a Physician Assistant ~AND~ Successfully passed the PA National Certifying Exam (PANCE) (or are you in the process to taking the exam) ~AND~ Currently hold, or will hold, a full and unrestricted license to practice in a State, Territory, or Commonwealth of the United States or in the District of Columbia. Grade Determination. In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignment of candidates: (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: Two years of successful practice as a PA ,OR, 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 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: Skills to analyze and solve complex medical problems. Ability to function autonomously and make independent medical decisions. Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. 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: Three years of successful practice as a PA, OR, 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, 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: Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care. 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). Ability to present clinical findings and recommendations to appropriate management officials. Ability to clinically facilitate the delivery of patient care in collaboration with health professionals, health managers, and other health care personnel. 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. Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records. Preferred Experience: Experience in Adult Internal Medicine preferred. References: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-8 Physician Assistant Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: Light lifting and carrying, under 15 pounds; Reaching above shoulder; Use of fingers; Both hands required; Near vision correctable at 13"-16" to jaeger 1 to 4; Ability to distinguish basic color and shades of color; Hearing (aid may be permitted); Mental and emotional stability required. ["The PA duties include performing histories and physicals, ordering and interpreting diagnostic and therapeutic tests/studies, writing dialysis orders, initiating consults and referrals, prescribing medications and supplies in accordance with VA policy, VA formulary and State regulations and formulating, initiating and evaluating health care teaching for patients and their families. The PA will serve as a consultant to medical and nursing staff and VISN 20 clinical leadership on the care of renal transplant patients throughout the medical center. The PA is a member of the interdisciplinary teaching team with responsibility for providing continuing education for a variety of health care professionals at VA and in the community. Specific Duties: Outpatient renal consultations: The Transplant Nephrology PA will provide care for patients in the PRE (transplant evaluation) and POST Transplant clinics. The incumbent of this position will be responsible for coordinating PRE and POST transplant care with transplant nephrology physicians and their patients. Obtain a health and medical history, perform a disease focused physical exam as well as formulate appropriate secondary diagnoses based on history, physical examination and clinical findings. Implement and evaluate appropriate plans of care for waitlist evaluations and post transplant care. Manage symptoms related to treatments, including pharmacologic and non-pharmacologic interventions, according to VA policy, VA formulary and State regulations. Assist with patient/family education and telephone triage within the transplant nephrology service. Refer and coordinate with primary care providers, other health professionals and community agencies to manage patient needs. An attending physician will not always be in clinic with the incumbent, but will always be available to come and consult as needed. The Transplant Nephrology PA will formulate a plan for each patient that the incumbent will implement through patient education, communication with the referring provider, electronic health record (EHR) orders, and as needed communication with the transplant service facilitator to schedule procedures. The incumbent will document the visit in the EHR. These clinics will occur both in person and via telemedicine. The Transplant Nephrology PA will participate in the care of outpatient hemodialysis patients at VAPOR when they are visiting for pre-transplantation evaluations, or requiring ongoing dialytic support in the post transplant period. The PA will obtain a health and medical history, perform a disease focused physical exam as well as formulate appropriate secondary diagnoses based on history, physical examination and clinical findings. Implement and evaluate appropriate plans of care for dialysis patients. Manage symptoms related to treatments, including pharmacologic and non-pharmacologic interventions, according to VA policy, VA formulary and State regulations. Assist with patient/family education and telephone triage within the nephrology service. An attending physician will not always be in the dialysis unit with the incumbent, but will always be available to come and consult as needed. The Transplant Nephrology PA will formulate a plan for each patient that the incumbent will implement through patient education, communication with the referring provider, electronic health record (EHR) orders, and as needed communication with the nephrology service facilitator to schedule procedures. The incumbent will document the visit in the EHR. Dialysis patient care will occur in person. The Transplant Nephrology PA will work closely with the transplant nursing coordinators to ensure appropriate care for kidney transplant recipients. The follow up may involve phone calls, and may require the arrangement of urgent or scheduled clinic follow up. The incumbent will document all these interactions into the EHR. The Transplant Nephrology PA is expected to participate in ongoing educational activities related to clinical knowledge and professional issues. The incumbent will seek experiences that reflect current clinical practice in order to maintain clinical skills and competence. The incumbent will participate in the shared coverage of night and weekend call, cross coverage, and other clinical responsibilities of the Nephrology Section. Work Schedule: Monday through Friday, Tours between 7:00am to 5:00pm\nCompressed/Flexible: Available\nTelework: Available\nVirtual: This is not a virtual position."]