Clarification from the agency

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. NOTE: The 2-page Resume requirement does not apply to this position. For more information, refer to Required Documents below.

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The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being.

Specific practice setting is at Hot Springs CLC with plans to expand the Home-Based Primary Care (HBPC) Program and start a Home-Based Memory Care (HBMC) Team specializing in care of Veterans with dementia. The PA will collaborate with physician and interdisciplinary health team members to identify, implement, test, and export novel approaches to optimizing quality of life of older Veterans and Veterans with neurocognitive disorders/dementia.

Scope of Assigned Duties include, but are not limited to:

• Obtains medical histories and performs physical examinations, at admission to CLC and annually.
• Documents Discharge Note and Discharge Summaries at the time of discharge.
• Provides and coordinates medical care for assigned patients, including establishing diagnoses, formulating, and implementing care plans, and providing follow-up care.

• Orders and interprets diagnostic testing results and therapeutic modalities, including but not limited to laboratory tests, ECG, radiological studies, hemodynamic monitoring, treatments, limited IV fluids/electrolytes, oxygen, etc., based on the current CLC treatment guidelines of stable patients.
• Orders ancillary services, including but not limited to, pharmacy, social services, physical medicine and rehabilitation therapies, prosthetic services, etc. and attend CLC Interdisciplinary Team to coordinate care for CLC Veterans.
• Orders VA specialty service consults and initiating requests for non-VA medical care and consults in accordance with VHA and local facility policy and procedures. Orders interfacility transfers and other transportation for CLC Veterans.
• Orders or prescribes devices, supplies, and durable medical equipment.
• Orders or prescribes medications for patients under their care consistent with privileges.
• Obtains and documents informed consent for treatments and procedures for which the PA is responsible according to the BHHCS Medical Bylaws.
• Provides education and counsels patients and families in preventive care, medical conditions, and the use of prescribed treatments and drugs.
• Conducts Goals of Care Conversations with high-risk patients regarding any desired limitation in life-sustaining treatments and choice of surrogate as well as enter the Life-Sustaining Treatment Decisions (LST) progress note and corresponding orders when Veteran is under their care or if delegated by the attending physician.
• Telehealth Modalities may be utilized for the provision of care by an authorized provider pursuant to Service level guidance, required training and instruction, and in collaboration with the Facility Telehealth Coordinator (FTC).
• Provides clinical oversight and participate in peer review of other Rehabilitation and Extended Care (REC) providers through periodic chart reviews.
• Acts as a surrogate for absent CLC providers as needed, to include review of EMR view alerts and other duties as assigned.
• Regularly attends all provider meetings, departmental meetings and medical staff meetings as requested.
• Conducts home visits to assess needs of patients and their caregivers enrolled in home-based primary care and the home-based memory care team.
• Performs comprehensive medical assessments/ evaluations in the patients' home setting with consultation with Medical Director, as needed.
• Performs medication reconciliation in home setting.
• Manages and treats medical conditions in the home setting, involving Medical Director as needed.
• Formulates multi-disciplinary treatment plans.
• Provides health education to patients and their caregivers.
• Responds to telephone calls from patients and caregivers regarding their health care.
• Coordinates with community nursing home program liaison and CLC admissions team, and at times the state veterans home and community nursing homes for continuity of care of veterans with neurocognitive disorder as the disease progresses and they need skilled nursing home care.
• Refers patients to appropriate community or VA programs.

Work Schedule: Monday - Friday, 7:30am - 4:00pm; additional information may be provided at interview.
Telework: Ad-hoc Only
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized

Conditions of employment

• U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• 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.
• English Language Proficiency. In accordance with 38 U.S.C. 7402(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
• Selective Service Registration is required for males born after 12/31/1959.
• 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 dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• 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).
• Complete all application requirements detailed in the "Required Documents" section of this announcement.
• You may be required to serve a probationary period.

As a condition of employment for accepting this position, you will be required to serve a 2-year probationary period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:

• your performance and conduct;
• the needs and interests of the agency;
• whether your continued employment would advance organizational goals of the agency or the Government; and
• whether your continued employment would advance the efficiency of the Federal service.

Upon completion of your probationary period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

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.

Preferred Experience:

• 2 or more years of experience
• Experience in Memory Care or Dementia
• Additional experience in Long-term Care

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) Experience and Education. None beyond the basic requirements. This is the entry level for PAs.

Demonstrated Knowledge, Skills, and Abilities (KSAs).

• 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) 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.

Demonstrated Knowledge, Skills, and Abilities (KSAs).

• 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) 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.

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-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/.

The full performance level of this vacancy is PA-III. The actual grade at which an applicant may be selected for this vacancy is in the range of PA-I to PA-III.

Physical Requirements: This position includes a level of physicality normally associated with duties performed by physician assistants such as physical assessment, and potentially long periods of walking, standing, sitting, moderate lifting, repeated bending, or kneeling.

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.