Physician Assistant III

Clarification from the agency

All qualified candidates are encouraged to apply. Area of consideration in order is: current, permanent facility employees; current permanent VHA employees; other current permanent Department of Veterans Affairs employees, and then open to U.S Citizens but non-citizens may be appointed when it is not possible to recruit qualified citizens. Note: The 2-page resume requirement does not apply to this position

FUNCTIONS OR SCOPES OF PRACTICE
Core Elements

• Obtaining medical histories and performing physical examinations.
• Providing and coordinating medical care for assigned patients, including establishing diagnoses, formulating, and implementing care plans, and providing follow-up care, in collaboration with the attending physician.
• Ordering diagnostic studies and other special tests, such as Ultrasound, XRAY, Magnetic Resonance Imaging (MRI), and Computerized Tomography (CT) scans.
• Ordering or obtaining laboratory specimens.
• Ordering VA specialty service consults and initiating requests for non-VA medical care and consults in accordance with VHA and local facility policy and procedures. Ordering patient care supplies and equipment.
• Ordering medical care including, but not limited to, diets, therapies, nursing care, and medications as permitted by VHA directive and local policy.
• Admitting and discharging patients in consultation with, and on behalf of, the collaborating physician, obtaining admission history and performing physical examinations, participating in patient rounds, documenting progress notes and summaries in the patient record, and writing patient orders on assigned patients. The collaborating physician must co-sign admission notes and discharge summaries written by the PA, in accordance with The Joint Commission standards.
• Other patient record entries by PAs, including medical histories, physical examinations, progress notes, service consults and patient orders do not require physician co-signature unless specifically required by Federal law, VA policy, or the standards of applicable external accrediting bodies.
• Providing education and counseling of patients and families in preventive care, medical conditions, and the use of prescribed treatments and drugs.
• Providing end-of-life education and counseling to individual patients and or patients family members.
• Perform Geriatric Medicine, Acute Care for the Elderly (ACE), and Palliative Medicine consultations in the outpatient clinics, telehealth clinics, home environment, emergency department, and inpatient wards.
• Perform other delegated tasks not specifically outlined herein upon the direction of the collaborating physician.
• Assist with data collection and implementation of quality improvement measures.
• Assist with workflow coordination (i.e., updating the team and SharePoint with patient assignments as determined in collaboration with resident, fellows, attending physicians, and GEC leadership.)
• Perform procedure as approved by Service Chief and credentialling body.

Expanded Elements

• Perform cardiopulmonary resuscitation in accordance with VAMC policy.
• Evaluate patients placed in restraints for behavioral purposes;

i. Work with patient and staff to identify ways to help the patient regain control.
ii. Revise the patient's plan for care, treatment, and services as needed.
iii. Provide required written orders as necessary.

Practice Autonomy
Full autonomy is appropriate for an experienced PA in Primary Care, other outpatient, or inpatient settings where enough clinical competence has been demonstrated in carrying out assigned patient care responsibilities. This level may also be used when the PA performs lower risk outpatient therapeutic and diagnostic procedures common to the area of the PA's practice. The PA at this level practices with a high level of autonomy on a day-to-day basis and requires infrequent consultation with the collaborating physician. When consultation with the physician does occur, it must be documented in the patient record by the PA. The physical presence of the collaborating physician at the site of PA practice is not required. The collaborating physician's oversight responsibilities for this level of PA practice include periodic monitoring of the PA's clinical activities through a retrospective review of at least five randomly selected patient encounter notes each quarter to ensure the presence of ongoing competency and medical appropriateness. In addition, the collaborating physician and PA will be in contact at least weekly to discuss any difficult or unusual clinical management. The collaborating physician will concur with continuing this level of autonomy or recommend changes when the PA's Scope of Practice is renewed, or interim changes are requested. This level of autonomy is appropriate for most PA practice settings (e.g. inpatient, outpatient, Community Based Outpatient Clinics (CBOC), Community Living Centers (CLC), Long Term Care, Home Based Primary Care (HBPC), Telemedicine, or remote sites).

Additional Duties

• Perform administrative tasks.
• Teach and provide direction for health care students and residents.
• Act as liaison with outside facilities in coordinating transfers.

VA offers a comprehensive total rewards package.

Work Schedule: Monday-Friday, 8am-430pm
Telework: Ad-hoc
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not authorized

Conditions of employment

• All qualified candidates encouraged to apply. Open to U.S. Citizens but non-citizens may be appointed when it is not possible to recruit qualified citizens.
• All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
• Selective Service Registration is required for males born after 12/31/1959.
• Must be proficient in written and spoken English.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Must pass pre-employment physical evaluation.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• You may be required to serve a probationary period.
• Complete all application requirements detailed in the "Required Documents" section of this announcement.

Qualifications

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.

BASIC REQUIREMENTS.

a. Citizenship. Citizen of the United States [in accordance with section 7402(c) to title 38,United States Code (U.S.C.). Non-citizens may be appointed when it is not possible to recruit qualified candidates in accordance with 38 U.S.C. § 7407(a).

b. 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.

c. 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.)

d. Licensure. PAs must possess an active, current, full, and unrestricted license to practice ina 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.
(1) Impaired Licensure. A PA who has, or has ever had, any license(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status may be appointed only in accordance with the provisions of chapter 3, section B, paragraph 13of this part.

(2) Exceptions for Graduate PAs.
(a) PAs who otherwise meet the basic requirements, but do not possess the required licensure, may be appointed, pending licensure, as a graduate PA on a temporary full-time appointment not-to-exceed two years under the authority of 38 U.S.C. § 7405(c)(2)(B).

(b) Graduate PAs may only be appointed at the entry grade level and may not be promoted/converted until certification is obtained.

(c) Temporary graduate PA appointments may not be extended beyond two years or converted to a new temporary appointment.

NOTE: Individuals who have or have had multiple licenses and had any such license revoked for professional misconduct, professional incompetence or substandard care, or who surrendered such license after receiving written notice of potential termination of such license by the State for professional misconduct, professional incompetence, or substandard care, are not eligible for appointment to the position unless such revoked or surrendered license is fully restored (38 U.S.C. § 7402(f)). This requirement does not apply to licensed PAs currently employed by VA as of November 30, 1999, provided they maintain continuous appointment and are not disqualified for employment by any subsequent revocations or voluntary surrenders of State license, registration or certification.

(3) Loss of Credentials. An employee in this occupation who fails to maintain the required licensure or NCCPA certification when required under paragraph 3a below must be removed from the occupation, which may result in termination of employment (VA Handbook 5005, part II, chapter 3, paragraph 17).

(4) Failure to Obtain Licensure. In all cases, graduate PAs must actively pursue and obtain required licensure from the date of their appointments. The human resource office will provide the unlicensed PA in writing the date by which the license must be acquired and the consequences for not becoming licensed by the deadline. The written notice must be provided prior to the first date of employment. Failure to obtain required credentials by the prescribed date will result in termination of employment.

e. Physical Requirements. See VA Directive and Handbook 5019, Employee Occupational Health Service.

f. English Language Proficiency. Candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. § 7403(f).

Preferred Experience: Geriatric and home health experience preferred. Meets the minimum requirements for the APRN or PA discipline.

Grade Determinations: Physician Assistant-III

• 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
• 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.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

How you will be evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

NOTE: A formal pay-setting process will be used to determine your salary. The salary may be at any point in the range listed for this vacancy.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.

To apply for this position, you must provide a complete Application Package which includes:

• Long-form resume/Curriculum vitae (CV)

The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please ensure you have included all documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), etc.

• Cover Letter
• DD-214/ Statement of Service
• Disability Letter (VA)
• License
• Long-form resume/Curriculum vitae (CV)
• Performance Appraisal
• Professional Certification
• Separation Notice (RIF)
• SF-15
• SF-50/ Notification of Personnel Action
• Transcript

Veterans' Preference Note: Preference eligible candidates and other Veterans will be given preference when qualification of candidates are approximately equal for Title 38 positions in VHA. When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 "Application for 10 Point Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit Feds Hire Vets - Veterans - Job Seekers - Veterans' Preference.

Next steps