Summary Employees in this assignment serve in a Dietitian (Clinical) developmental position within the Clinical Section of NFS. They perform increasingly complex tasks as they continue to develop skills in clinical nutrition to apply evidenced-based nutrition practice guidelines. Clinical Dietitians coordinate nutritional care of Veterans with other health care providers, the Veteran, the Veteran's caregiver, and the community. Responsibilities Full performance Dietitian Clinical Home Based Primary Care duties include, but aren't limited to following: Nutritional Care Conducts comprehensive nutrition assessment utilizing Nutrition Care Process, NCP Develops/implements individualized plan for Medical Nutrition Therapy, MNT to address nutrition diagnosis according to medical program goals & objectives Documents MNT in medical record using Assessment, Diagnosis, Intervention, Monitoring, Evaluation, ADIME format Performs Nutrition Focused Physical Exam, NFPE during assessments to determine risk &/or degree of malnutrition Calculates nutrient requirements, calories, protein, carbohydrates, lipids, vitamins, electrolytes & fluids & necessary diet restrictions or food/drug interactions for patient Tailors diet prescription for patient according to physical & metabolic needs; understanding patient's health condition, designs nutritional treatment plan, considering psychosocial, behavioral, physical activity, ethnic & cultural factors to obtain desired outcomes & promote long term adherence to medical nutrition care plan Orders labs, diets & consults per Scope of Practice/Clinical privileges Documents nutrition care plan in patient's medical record, including nutrition assessment data, MNT initiated &recommendations, nutrition counseling results, patient consents & discharge planning Measures outcomes by selecting indicators relevant to nutrition diagnosis Evaluates effectiveness & measures progress toward outcomes of nutrition interventions by comparing current findings w/ previous goals &/or reference standards Documentation supports interdisciplinary approach & continuity of care Nutrition Education & Coordination of Care Assesses educational needs & provides nutrition education/counseling for individuals & groups, including information regarding budgeting, menu planning, food purchasing & preparation, food storage & sanitation Identifies drug-nutrient interactions & drug-drug incompatibilities & counsels/communicates w/ patient regarding impact on nutrition status &/or nutrient utilization Utilizes virtual care technology such as VA Video Connect, VVC & Secure Messaging, SM to improve access to nutrition care Provides follow-up nutrition education/counseling according to treatment goals & determines when problems requires consultation or referral to another provider or service Serves as clinical preceptor for dietetic internship program & in teaching role for other health care professionals, patients & community Assists w/ educating & providing oversight for dietetic students & interns Assists w/ planning learning experiences, teaching & evaluating performance Develops & prepares Healthy Teaching Kitchen presentations Completes MDS/Care plans timely Participates in community projects & education Serves on Health Education committees & workgroups Business Functions Maintains productivity standards Practices effective time management & prioritizes tasks to ensure efficient workflow Maintains accurate record keeping of daily clinical activities & completes patient encounters using Event Capture System Achieves compliance w/ The Joint Commission & other accrediting agency standards to continuously improve safety & quality of care Quality Improvement/Research Leads Performance Improvement activities by participating in development of nutritional care indicators, evaluation criteria, collecting performance improvement data, monitoring outcomes & initiating corrective actions Contributes to culture of safety by entering patient safety concerns in Joint Patient Safety Reporting System Participation as Member of Health Care Team Communicates & influences treatment interventions determined by medical team via interdisciplinary meetings, team rounds, medical conferences & nutrition-related in-services Coordinates care w/ colleagues in variety of medical & home settings to ensure appropriate transitions of care are addressed to meet patient's needs Assists in patient discharge planning to ensure provision of appropriate services & equipment for enteral feeding Serves as member of VAMC inspection team for state homes, homeless shelters & community nursing homes Professional Development Maintains Registered Dietitian Nutritionist registration & completes continuing education requirements Complies w/ all documentation procedures, including timeliness standards according to policies Demonstrates positive, effective communication skills & professional behavior to promote cooperation & teamwork Practices customer service & demonstrates VA I-CARE values Perform other duties as assigned Work Schedule: Monday-Friday, 8:00am-4:30pm Duty location: Benjamin Charles Steel VA Clinic, 1766 Majestic Lane, Billings, MT 59102 Compressed/Flexible: Not Available Telework: Ad hoc, per VA policy Virtual: This is not a virtual position. Functional Statement #: 56609, 56610, 5611-A Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job. 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 trial period. 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). 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: Citizenship Must be a US citizen. Non-citizens may be appointed when it's not possible to recruit qualified US citizens English Language Proficiency RDNs must be proficient in spoken & written English Registration All applicants must hold the RDN credential from the Commission on Dietetic Registration (CDR) the credentialing agency of the Academy of Nutrition and Dietetics. Note: Applicants who hold the RDN credential have met the education requirement (e.g. bachelor's degree or higher) of CDR, as such this occupation is considered professional and scientific with a positive education requirement and the procedures in Part I, Chapter 4 of this Handbook will be followed when applying Veteran's preference. Exception for Dietitians who do not possess the RDN credential. Non-credentialed Dietitians who meet the basic qualification requirements and have fulfilled the requirements below, but do not possess the RDN credential, may be given a temporary full-time appointment not to exceed one year under the authority of 38 U.S.C. § 7405(c)(2) Non-credentialed Dietitians must have fulfilled each of the following: Earned a bachelor's or higher degree from a U.S. regionally accredited college, university or foreign equivalent (refer to ii below) Completed an ACEND® accredited experiential or supervised practice program and provide a verification statement from the program director that conveys eligibility to take the CDR registration exam as a prospective RDN. A list of ACEND® accredited programs is located on the ACEND® website or at ACEND Accredited Programs Directory Foreign Education. To be creditable, college and/or university degrees earned outside the U.S and its territories must be evaluated by ACEND® and meet ACEND®'s International Dietitian Education standards which are designed to provide graduates with the knowledge and competencies to sit for the CDR credentialing exam. Non-credentialed Dietitians may only be appointed at the GS-07 or GS-09 grade level and may not be promoted/converted until they obtain their RDN credential. Non-credentialed Dietitians must provide care under the supervision of a RDN at or above the full performance level. Temporary appointments of non-credentialed Dietitian will not be extended beyond one year or converted to a new temporary appointment Failure to Obtain Registration. In all cases, Dietitians must actively pursue meeting registration requirements starting from their appointment date. At the time of appointment, servicing Human Resources (HR) staff in collaboration with the supervisor, will provide non-registered Dietitians the written requirement to obtain registration, the date by which they must acquire it and the consequences for not doing so by the deadline. Failure to obtain registration within one year from the date of appointment will result in removal from the Dietitian, GS-0630 occupation and may result in termination of employment. Loss of Credential. In collaboration with HR Office staff, management officials must immediately relieve employees who fail to maintain the required registration/certification of duties and responsibilities associated with the occupation and/or assignment, which may also result in separation from employment. Grade Determinations: The following criteria must be met in addition to the Basic Requirements for employment listed above when determining the candidate's grade. GS-07 Experience or Education. None beyond the basic requirements. GS-09 Experience. At least one year of experience equivalent to the next lower grade level. OR Education. Master's degree from a regionally accredited university or college. Demonstrated Knowledge, Skills & Abilities, KSAs Candidates must demonstrate all following KSAs in addition to experience above 1) Knowledge of various accrediting and regulatory requirements. 2) Knowledge of virtual technology to provide nutrition care. 3) Ability to deliver patient care using the NCP (e.g., assessment, diagnosis, intervention, monitoring and evaluation). 4) Ability to apply evidence-based nutrition practices to improve patient outcomes. 5) Ability to develop patient-centered goals. 6) Ability to collect data for performance improvement studies. 7) Ability to collaborate with stakeholders. GS-11 Experience. At least one year of experience as an RDN equivalent to the next lower grade. Demonstrated KSAs Candidates must demonstrate all following KSAs in addition to experience above. 1) Skill in delivering patient care using the NCP (e.g., assessment, diagnosis, intervention, monitoring and evaluation). 2) Skill in interpreting research to apply evidence-based nutrition practices to improve patient outcomes. 3) Skill in developing patient-centered goals. 4) Skill in analyzing data for performance improvement studies. 5) Skill in collaborating with stakeholders.6) Ability to comply with various accrediting, regulatory and agency authorities. Preferred Experience: More than one year home care experience and 1 + years experience in primary care. Also credentialed as a Registered Dietitian Nutritionist. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is a GS-11. The actual grade at which an applicant may be selected for this vacancy is in the range of a GS-7 to a GS-11. Physical Requirements: Must be able to exercise patience, control emotions & manage stressful situations Must be able to prepare, transcribe & analyze data & figures Often lift/carry
