Clarification from the agency

Current permanent employees of the VA Boston Healthcare Systems including permanent Veterans Canteen Service employees, current permanent full-time Hybrid Title 38 and permanent full-time Title 38 employees. Past/Current/Upcoming Graduates of VHA Health Trainee Programs (HPT) are eligible to apply (must send proof such as an SF-50 with application), and all U.S. Citizens.

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The PA provides comprehensive wellness care, as well as acute, episodic, and chronic care, of adult clients. The PA is prepared by advanced practice in adult health care across the health continuum. This practice includes independent and interdependent decision making, and direct accountability for clinical judgment. Graduate preparation expands the comprehensiveness of the PAs role, which includes: participating in and use of research; and development and implementation of health policy, leadership, education, case management, and consultation.

Duties include, but are not limited to:

• Manages a panel of patients in coordination with other members of the inter-professional team; provides coverage for other providers' panels when they are out
• Makes home visits for initial consultation and follow up visits as appropriate while patients are admitted to the Choose Home team
• Independently obtains medical histories and performs comprehensive geriatric examinations; ordering and interpreting laboratory studies and other special examinations; performing cognitive and capacity testing when appropriate; making diagnoses; and formulating treatment plans
• In concert with nursing and other professions, manages the patient's care coordination through ensuring needed specialty appointments are made and attended, following up on care plans determined by other specialists, and coordinating with other specialists to provide care in the home
• Lead the formulation of a patient's care plan, and instruct and supervise other members of the inter-professional team in carrying out this plan
• Counsels patients or caregivers on medical problems, medications, expected effects of treatment, diet and other therapeutic health maintenance matters; assess caregiver and potential caregiver capability of providing care and supervision for patients
• Facilitate conversations about goals of care, planning for future moves to higher level of care, and end of life planning
• Formulate a care plan for patients upon discharge from program and coordinate a handoff to PACT and other specialties who will continue to follow
• Identify areas for continuing education and participate in in-service trainings (including staying current with all required education).
• When applicable, instruct medical/nursing students, residents, and other learners that rotate on the Choose Home team

Work Schedule: Monday - Friday, 8:00 a.m. - 4:30 p.m.
Telework: Authorized.
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not authorized.
Permanent Change of Station (PCS): Not authorized.
Financial Disclosure Report: Not required.

Notifications:
This position is an AFGE Bargaining Unit position.
This position is covered by a special rate.
Current and former Federal employees must submit copies of their most recent SF-50 (Notice of Personnel Action). The SF-50 must identify the position title, series, grade, step, tenure and type of service (Competitive or Excepted). In some cases, more than one SF-50 may be required to show a higher grade previously held.
This position is in the Excepted Service.
The salary is based on the grade and step approved for the selected candidate.
The Professional Standards Board (a peer-review group) will recommend the grade and salary for new appointments based on the candidate's education and experience. For internal selectees being promoted, the board will determine grade and HR will determine step in accordance with policy.
Veterans' preference does not apply for other current permanent Federal agency employees.

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.
• You may be required to serve a probationary period.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process.
• Must pass pre-employment physical examination.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.
• May be subject to satisfactory completion of our credentialing process.

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.

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

Preferred Experience:

• Geriatrics and Long Term Care experience preferred

Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade:

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 3. The actual grade at which an applicant may be selected for this vacancy is in the range of 1 to 3.

Physical Requirements: All applicants must be physically able to satisfactorily perform the duties of the position. A pre-placement physical examination shall be completed prior to appointment.

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.