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Veterans Affairs, Veterans Health Administration Dietitian in Worcester, Massachusetts

Summary This Clinical Dietitian position is located within the Nutrition and Food Service (NFS) at the VA Medical Center in Worcester serving as a medical nutrition expert. Responsibilities This position will be involved in the professional practice of dietetics in accordance with the guidance set forth in NFS directives, policies and procedures, and VA regulations governing the practice of dietetics. The clinical dietitian may be scheduled and assigned to any nutrition practice area. Duties include, but are not limited to: Nutritional Care: 1. Conducts a comprehensive nutrition assessment utilizing the Nutrition Care Process (NCP) for assigned patients. 2. Develops and implements an individualized plan for MNT in accordance with the patient's medical program goals and objectives. 3. Performs a Nutrition Focused Physical Exam (NFPE) during assessments to determine risk and/or degree of malnutrition. 4. Calculates nutrient requirements (calories, protein, carbohydrates, lipids, vitamins, electrolytes and fluids) and necessary diet restrictions or food and drug interactions. 5. Evaluates patterns and relationships among data obtained and possible root causes for nutrition problems. 6. Tailors diet prescription to each individual patient according to physical and metabolic needs. With an understanding of the patient's health condition, designs the nutritional treatment plan with consideration for psychosocial, behavioral, physical activity, ethnic and cultural factors to obtain desirable outcomes and promote long term adherence to a medical nutrition care plan. 7. Prioritizes the importance of nutrition problems for optimal health, recovery from illness, management of chronic disease or disease prevention. 8. Utilizes evidenced-based Nutrition Practice Guidelines and Whole Health Principles to develop shared goals with the patient and formulates a plan of care that is focused on the etiology of the nutrition problem. 9. Actively supports veteran centric food service operations, with a food forward approach through knowledge of computer software programs related to food service systems; and through interfacing with the food service section to ensure patient satisfaction with meals, assisting in implementation of new initiatives, and acting as a liaison between clinical units/wards and the food service section. 10. Works cooperatively with foodservice staff to assure conformance to diet prescriptions. 11. Identifies patients in need of nutritional support and recommends the appropriate mode of support, including suitable route, formula, and rate of administration. Provides initial and on-going nutritional assessment of patients receiving enteral and/or parenteral nutrition. 12. Recommends labs, diets, and consults. Evaluates and monitors the effectiveness and outcome of MNT interventions. Evaluates the patient's response to care based on identified, measurable outcomes and reviews the plan, as appropriate. Nutrition Education and Coordination of Care: 1. Assesses educational needs and provides nutrition education or counseling for individuals and groups, incorporating a learning approach that considers the cultural, religious, educational and medical situation of the patient. Includes information regarding budgeting, menu planning, food purchasing and preparation, food storage and sanitation. 2. Utilizes motivational interviewing techniques to evaluate patient and/or caregiver's readiness to learn and potential for changing behaviors. 3. Evaluates achievement of learning objectives by the patient and/or family. Adapts nutrition education materials and counseling techniques to the patient's level of understanding, which frequently involves simplifying complex dietary restrictions. 4. Identifies drug-nutrient interactions and drug-drug incompatibilities and counsels/ communicates with the patient regarding the impact on nutrition status and/or nutrient utilization. 5. Utilizes virtual care technology such as VA Video Connect (VVC) and Secure Messaging (SM) to improve access to nutrition care. 6. Provides follow-up nutrition education/counseling in accordance with the patient's treatment goals and determines when a problem requires consultation or referral to another provider or service. 7. Participates in planning and education of home nutrition support. 8. Develops, prepares and facilitates Healthy Teaching Kitchen presentations. 9. Completes MDS/Care plans timely, as applicable. 10. Participates in community projects and education. Serves on Health Education committees and workgroups as needed / assigned. 11. Other duties as assigned Work Schedule: Full Time; Monday - Friday, 8:00 AM - 4:30 PM Telework: If approved, will be on an ad-hoc basis Virtual: This is not a virtual position. Position Description/PD#: Dietitian/PDF02237 Financial Disclosure Report: Not required Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Requirements Conditions of Employment 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: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency: Dietitians must be proficient in spoken and written English as required by 38 U.S.C. 7402(d). Education and Supervised Practice: (1) The individual must have earned a bachelor's degree from a U.S. regionally accredited college or university or foreign equivalent and fulfilled each of the following criteria: (a) Completed a didactic program in dietetics accredited by the Accreditation Council for Education in Nutrition and Dietetics (ACEND), formerly known as the Commission on Accreditation for Dietetic Education (CADE). (b) Completed an ACEND accredited or approved supervised practice program. Supervised practice programs are post-baccalaureate degree programs that provide supervised practice experiences which meet the eligibility requirements and accreditation standards of ACEND, formally known as CADE. Completion of a coordinated program in dietetics fulfills the requirements of a supervised practice program. Time spent in a dietetic internship or supervised practice program does not qualify as creditable experience. Registration/Certification: All applicants must be registered with the Commission on Dietetic Registration (CDR) the credentialing branch of the Academy of Nutrition and Dietetics formerly known as the American Dietetic Association (ADA). Advanced Level Practice Dietitians must possess a minimum of one advanced practice credential relevant to the area of practice, (e.g. Certified Nutrition Support Clinician (CNSC), Board Certified Specialist in Renal Nutrition (CSR), Board Certified Specialist in Gerontological Nutrition (CSG), Certified Diabetes Educator (CDE), or Board Certified Specialist in Oncology Nutrition (CSO)). See exception in Education section: May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). See below in Education section. Grade Determinations: In addition to the basic requirements for employment, the following criteria must be met when determining the grade of candidates. GS-7 Dietitian (Entry Level): (a) Experience or Education. None beyond the basic requirements. (b)Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, the candidate must demonstrate the following KSAs: 1. Basic knowledge of principles and practices of dietetics and Medical Nutrition Therapy (MNT). 2. Ability to provide nutrition care utilizing the Nutrition Care Process (NCP) to patients, family members and/or caregivers considering psycho-social issues and age-appropriate, evidence-based nutrition practice guidelines. 3. Ability to communicate effectively orally and in writing with patients, family and/or caregiver, and other professional healthcare providers (e.g., tailoring to audience and use of medical terminology). 4. Ability to plan and organize work consisting of multiple tasks and priorities under direct supervision. 5. Basic knowledge of, and ability to use, current information technology operations, software, hardware, terminology, security requirements, and capabilities. 6. Knowledge of basic food production and service for various populations which incorporates principles of sanitation, safety, and menu planning within a healthcare environment. 7. Knowledge of educational concepts, methods, and the ability to execute existing education and training activities for Nutrition and Food Services (NFS) employees. GS-9 Dietitian (Developmental Level): (a) Experience or Education. At least 1 year of experience equivalent to the next lower grade level or education equivalent to 2 full years of progressively higher level graduate education, or master's degree from an accredited university or college in the field of dietetics or closely related field. (b) Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, the candidate must demonstrate the following KSAs: 1. Ability to plan and organize work of considerable difficulty and responsibility, under general supervision. 2. Knowledge of various food preparation and delivery systems within a healthcare environment. 3. Knowledge of educational concepts, methods, training materials, and resources and the ability to develop and conduct education and training programs for NFS employees. 4. Ability to participate in research studies and conduct performance improvement studies and document findings to evaluate staff, food, supplies, equipment, and service, in order to improve the efficiency of the operation. 5. Knowledge of the principles and practices of clinical dietetics including NCP and MNT in order to plan, develop, and coordinate nutrition interventions, including enteral and parenteral nutrition, interdisciplinary care plans, and nutrition education activities that promote Veteran health, wellness and lifestyle management. GS-11 Dietitian (Full Performance Level): (a) Experience or Education. At least 1 year of experience as a registered dietitian equivalent to the next lower grade level, or education equivalent to 3 full years of progressively higher level graduate education, or a Ph.D. or equivalent doctoral degree from an accredited university or college in the field of dietetics or closely related field. (b)Demonstrated Knowledge, Skills, and Abilities 1. In addition to the experience above, the candidate must demonstrate the following KSAs: a. Knowledge of best practices in the dietetics profession and in scientific literature, including knowledge of research methods, study design, data collection, interpretation of findings, and translation of results into nutrition practice. b. Ability to comply with various accrediting, regulatory, and agency authorities. c. Ability to develop and maintain a system of internal reviews and direct quality control and performance improvement studies. d. Knowledge of computer software programs relative to food service systems. 2. In addition to the KSAs identified in subparagraph 1 above, candidates for clinical nutrition positions must demonstrate the following KSAs: a. Knowledge of the principles and practices of nutrition care and the treatment of complex cases in clinical settings in order to develop, implement and coordinate best practices in the dietetics profession (e.g. assessment, diagnosis, intervention, monitoring and evaluation). b. Knowledge of best practices in areas of clinical nutrition and the ability to apply nutrition interventions to patients with multiple co-morbidities. c. Ability to act as a consultant for health care providers including registered dietetic technicians, dietetic interns, nurses, physicians, medical students, and allied health professionals. References: VA Handbook 5005/80 Part II Appendix G20 Dated September 5, 2014 The full performance level of this vacancy is GS-11. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-7 to GS-11. Physical Requirements: The essential duties of a Clinical Dietitian works efficiently and without hazard to themselves and others and include use of fingers, walking (1-2 hours), hearing (aid permitted); mental and emotional stability, working closely with others, exposure to TB and other diseases. Education IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: Grandfathering Provision. All persons employed in VHA as a dietitian on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series and grade held, including positive education and registration requirements or board certification, if applicable. For employees who do not meet all the basic requirements in this standard, but who met the qualifications applicable to the position at the time they were appointed to it, the following apply: Such employees may be reassigned, promoted up to and including the full performance (journeyman) level, or changed to lower grade within the occupation, but may not be promoted beyond the journeyman level or placed in supervisory or managerial positions. Dietitians who are appointed on a temporary basis prior to the effective date of the qualification standard may not have their temporary appointment extended or be reappointed, on a temporary or permanent basis until they fully meet the basic requirements of the standard. Dietitians initially grandfathered into this occupation who subsequently obtain additional education and/or registration that meet all of the basic requirements of this qualification standard must maintain the required credentials as a condition of employment in the occupation. Employees who are retained as a dietitian under this provision and subsequently leave the occupation lose protected status and must meet the full VA qualification standard requirements in effect at the time of reentry as a dietitian. Additional Information Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. VA may offer newly-appointed Federal employee's credit for their job-related non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. This job opportunity announcement may be used to fill additional vacancies. It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. 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. If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application.