Advanced Practice Registered Nurses / Physician Assistants
Internal Number: 740495900
This Physician Assistant (PA) position is located in Primary Care Service within the VA St. Louis Health Care System (VASTLHCS). The PA is a professional who executes position responsibilities that demonstrates leadership, experience, and creative approaches to the management of complex client care. The PA must demonstrate performance and leadership that is broad enough to improve the care for a group of patients. The PA is responsible for the documented outcomes at the program or service. 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 Determinations: In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignment of candidates: 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: i. Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care. ii. Ability to perform patient history and physical. iii. Ability to formulate a plan and provide treatment to the patient. iv. Ability to provide patient care that is abreast of changing concepts and advancements in the profession. 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. 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 Regulations, specifically VA Handbook 5005, Part II, Appendix G-8 Physician Assistant Qualification Standard. This can be found in the local Human Resources Office. The full performance level of this vacancy is Grade 3. The actual grade at which an applicant may be selected for this vacancy is in the range of Grade 1 to Grade 3. Physical Requirements: Applicants must meet physical standards for the position. A physical examination prior to placement is required. This is a designated drug testing position. After appointment, you will be subject to random testing for illegal drug use. Requires lifting 15-44 pounds; pushing (approx. 2 hours); reaching above shoulder; use of fingers and both hands; walking and standing from 3-5 hours and kneeling. Ability for rapid mental and muscular coordination simultaneously. Must have depth perception and ability to distinguish basic colors and shades of colors. Hearing aid is permitted. ["This is an open continuous announcement. Applicants will be reviewed and referred every 21 days. VA offers a comprehensive total rewards package. The PA has advanced clinical knowledge and competency and is able to function in a variety of roles. The PA has a scope of clinical practice in collaboration with a physician. The PA functions as the professional leader of a PACT teamlet or an interdisciplinary health care team with broad-based, clinical expertise in caring for patients with chronic and complex disease. The PA possesses the administrative leadership necessary to promote interdisciplinary cooperation among the various disciplines. The PA demonstrates ability to assess the patient clinically, analyzes needs and coordinates care in an effective and cost-efficient manner to assure total management of the patient's identified needs. The purpose of the work is to provide the full range of assessment of needs, planning for care, teaching, and performance of routine and emergency procedures for primary care patients. The work product directly impacts the successful completion of the clinic's mission by increasing the well-being of substantial numbers of eligible beneficiaries. Routine duties include: Performing initial histories and physical examinations on outpatients. The supervising physician will review and countersign all admitting inpatient history and physical exams. Providing ongoing outpatient for assigned patients. Screening outpatients to determine need for further care. Prescribing medications within defined scope of practice. Ordering diagnostic studies such as laboratory tests, x-rays, electrocardiograms. Duties for Primary Care faculty include providing direct patient care in an outpatient setting. There are also opportunities to engage in population health management and quality improvement projects. Prior training or clinical experience is preferred. Primary Care of a panel of primary care patients (male and female) Provide comprehensive assessment, diagnostic work-up and clinic intervention, including comprehensive patient assessment, health history, physical examination, and patient education to Veterans in the Primary Care team setting; outpatients include both scheduled and unscheduled Veterans. Function as an integral part of a Primary Care multi-disciplinary team to coordinate, facilitate, and provide patient care and services. Discriminate between normal and abnormal findings to establish a diagnosis and initiate appropriate response to emergency health problems. Initiate appropriate referrals and consultations to other clinical services. Order and evaluate diagnostic tests as appropriate, recommend treatment and/or referral. Validate the effectiveness of previously implemented medical treatment. Initiate, evaluate, and change orders for medications. Include patient and family in planning care and establishing realistic measurable goals for health maintenance/improvement. Record/document health appraisal information, clinical assessments, treatment decisions, plan of care, ongoing management and therapeutic outcomes, order medications, diagnostic tests and referral consultations where needed for every patient encounter; recording will be accomplished using the electronic comprehensive patient record system (CPRS), and will be completed on the day of the encounter. Respond to computerized \"alerts\" indicating diagnostic test abnormalities and to health line requests from Veterans/family members on the day of receipt (weekends excepted). Follow Performance Measure guidelines, including completion of clinical reminders in CPRS. Access and timeliness standards; prescription order entry, National VA formulary requirements, and customer service standards. Work effectively with patients, families, members of the multi-disciplinary team, and other staff. Demonstrates flexibility in responding to clinic demands, adhere to personal and professional obligations and responsibilities, practice and maintain ethical standards, and sustain a work environment that is harmonious and customer service oriented. Providers will act as surrogates for the patients of their colleagues when their colleagues are on leave/travel. Work Schedule: Monday-Friday (8:00am-4:30pm) Telework: Available Virtual: This is not a virtual position Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized PCS Appraised Value Offer (AVO): Not Authorized Financial Disclosure Report: Not required"]
The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,298 health care facilities, including 171 medical centers and 1,113 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.