This is a Fee Basis Provider position. Fee basis appointments are temporary, excepted appointments of persons in professional and technical occupations under the authority of Title 38 of the United States Code, specifically section 7405(a)(2). Fee basis appointments provide services on a facility's premises when health services are otherwise readily available, cost effective, based on services provided rather than on an hour or tour basis, and when determined to be cost effective to the agency. While fee basis providers are paid on a per service basis and not on a GS grade scale, they must still meet basic qualification requirements. Below are the qualification requirements of a developmental through full performance Diagnostic Radiologic Tech with a specialty in vascular care. Specialty: Ultrasound Diagnostic/Vascular Sonography. Positions should be assigned to the DRT, GS-0647 series, when both ultrasound and other modalities which require the delivery of ionizing radiation are performed. Positions in which ultrasound duties are performed exclusively (no other modalities are performed), should be assigned to the medical instrument technician, GS-0649 series, since ultrasound duties solely do not require the delivery of ionizing radiation. Diagnostic ultrasound uses high frequency sound waves and other diagnostic techniques for medical purposes. The practitioner must be competent in the production, use, recognition, and analysis of ultrasound images and patterns used for patient diagnosis and treatment. The sonographer is regarded as the expert source of all ultrasound imaging, and the interpreting radiologist relies heavily on the skills, knowledge, and abilities of the sonographers in providing a final interpretation. Within this specialization, there is a diverse range of ultrasound imaging sub-specialties. These include: 1) diagnostic medical sonography - abdominal, neurologic, obstetrical/gynecologic, musculoskeletal (MSK), a breast; and 2) vascular sonography-arterial and venous doppler, spectral analysis, and calculating ankle brachial index (ABI). Diagnostic Radiologic Technologist (GS6): Experience or Education. At least one year of experience equivalent to the next lower grade level or the successful completion of one full academic year of graduate education leading to a degree in radiography or other directly related field to diagnostic radiology/imaging. Assignment. Employees at this grade level serve as developmental DRTs, performing examinations which are routine and standardized in nature. They explain exams to patients in terms they can understand as well as potential hazards. They must also troubleshoot equipment used for diagnostic radiology and exercise extreme caution in the handling and safeguarding of all radiation producing equipment. DRTs must report major equipment malfunctions within a timely manner to service representatives and assist higher graded technologists in performing more complicated examinations. Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, the candidate must demonstrate all of the following KSAs: Knowledge of basic technique standards for minimum radiographic exposure. Knowledge of anatomy and positioning. Knowledge of all patient safety procedures. Knowledge of radiographic producing equipment. Ability to learn basic computer functions. Diagnostic Radiologic Technologist (GS7): Experience or Education. At least one year of experience equivalent to the next lower grade level that demonstrates the clinical competencies described at that level; or the successful completion of one full academic year of graduate education leading to a degree in radiography or other directly related field to diagnostic radiology/imaging; or successful completion of an advanced registry program, with certification, in addition to a 4-year baccalaureate degree program in radiography or other directly related field to diagnostic radiology/imaging. Education may relate to the duties of a specific position or to the occupation but must be appropriate for the position being filled. Assignment. DRTs at this level perform a full range of duties but receive guidance and directions regarding unfamiliar or unusual situations for more complex patient issues. Candidates at this grade level may be qualified to provide services in specialized areas of radiologic technology and/or general radiologic technology services. Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, the candidate must demonstrate all of the following KSAs: Knowledge of the technical adequacy of the digital image, including the ability to adjust the image quality in the digital system. Knowledge of different contrast material required for the requested study. Knowledge of radiation protection standards, minimum radiographic exposure techniques, appropriate beam limitation to anatomical area, and employing lead shielding when performing standard radiographic and fluoroscopic procedures. Knowledge of computed radiography, CR readers and Digital Imaging systems. Knowledge of PACS and basic computer skills. Diagnostic Radiologic Technologist (GS8): Experience. At least one year of experience equivalent to the next lower grade level that demonstrates the clinical competencies described at that level. Assignments. Employees at this grade level serve as staff DRTs at the full performance level. Candidates at this grade level must be qualified to independently provide services in specialized areas of radiologic technology and/or general radiologic technology services with only occasional oversight or direction for highly complex issues. Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, the candidate must demonstrate all of the following KSAs: Ability to check system for operation and assess acceptable performance based on established guidelines. Knowledge of calibration parameters and the ability to make adjustments as needed. Knowledge of patient's clinical record, diagnosis, and laboratory results. Ability to monitor patient's physiologic changes during the procedure and keep the radiologist informed. Skill in using tact, diplomacy, and courtesy in dealings with the customer base, patients, staff, family, visitors, and volunteers. Knowledge of anatomy and physiology, and cross-sectional anatomy, recognizing unusual images, and determining proper positioning to best demonstrate areas of interest. ["The Albany Stratton VA Medical Center, Surgical Service is seeking to recruit a highly skilled individual to fill the role of a Vascular Sonographer. This individual will be responsible for providing vascular ultrasound services 1-2 days per week, which is vital to the operation and expansion of our newly reacquired Vascular Service. The Vascular Sonographer independently performs a variety of non-invasive studies using ultrasound and related diagnostic technology as appropriate and records the results and clinical preliminary impressions as indicated. The results of these exams are used to direct the course of patient care. This position is a full performance Vascular Sonographer with knowledge of peripheral vascular anatomy, physiology, and pathology. All examinations are performed within standard protocols on adults and geriatric patients in both the clinic and hospital settings using both stationary and portable equipment. The sonographer communicates preliminary impressions of examination results to referring physicians timely and effectively. Major responsibilities: Perform diagnostic vascular examinations according to standardized laboratory protocols; deviating from normal techniques when necessary to provide the best possible results. Perform diagnostic vascular examinations, recognizing the significance of all structures that are visualized, differentiating artifacts from appropriate structures, while recognizing the limitations of equipment and utilizing knowledge of anatomy and physiology. Perform non-invasive arterial Doppler studies utilizing segmental pressures, volume pulse recordings and Doppler waveform patterns at various levels in the arms and legs Perform venous examinations of arms and legs with Doppler and color duplex scanning using compression maneuvers and imaging, for detection of deep vein thrombosis, superficial thrombophlebitis and/or valvular incompetence, which may include mapping of the superficial veins for size and depth. Perform carotid duplex examinations to evaluate blood flow and plaque characteristics in the carotid and vertebral arteries Perform other vascular examinations using color duplex and Doppler to help the physicians assess, diagnose and treat aortic aneurysms, thoracic outlet syndrome, popliteal entrapment, Raynaud's syndrome, renal artery stenosis, bypass graft patency, dialysis fistula/graft patency and post-operative angioplasties and stentings. Identify pseudoaneurysms and arterial-venous fistulas with duplex scanning Payment for services will be based on the following possible services and are paid per service: CPT 93880 Duplex scan of Extracranial Arteries; Complete Bilateral Study = $144.46 CPT 93923 Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels = $103.08 CPT 93978 Duplex scan of Aorta, Inferior Vena Cava, Iliac Vasculature, or bypass grafts; complete study = $135.30 CPT 93975 Duplex scan or arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs = $199.04 CPT 93970 Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study = $146.36 CPT 93971 Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study = $93.05 CPT 93926 Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study = $114.77 CPT 93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study = $192.41 CPT 93990 Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow) = $117.30 CPT 93882 Duplex scan of extracranial arteries, unilateral or limited study = $95.89 CPT 93985 Duplex scan hemodialysis, complete bilateral study = $199.36 CPT 93986 Duplex scan hemodialysis complete unilateral study = $116.03 CPT 93930 Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study = $152.05 CPT 93931 Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study = $95.26 CPT 93976 Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs limited study = $114.84 CPT 93979 Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts, unilateral or limited study = $89.57 CPT 93981 Duplex scan of arterial inflow and venous outflow of penile vessels, follow-up or limited study = $47.31 The maximum amount a provider can receive in any given calendar year for a combination of any of the above services is a total of $236,000."]

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