Must demonstrate competency in routinely performing at least TEN of the following Echocardiography and/or Vascular ultrasound exams pertinent to department: 3-D, Strain, Exercise Stress Echocardiography, Dobutamine Stress Echocardiography, TAVR, Mitral Clip, Complex Valve, Watchman, Post Processing, Contrast Studies, Agitated Saline Studies, Transesophageal (TEE), Surgical TEE, Complex Cardiac Shunts, Pericardiocentesis, Single Ventricle, TOF, AVC, TGA, ECMO Cannula Position, Complex Heterotaxy, ASD Septostomy, PDA Closure Cath, Venous Insufficiency, Visceral, Segmental Physiology Upper Extremity, Access Grafts, Hemodialysis Access, Venous Ablation Procedures, Ultrasound Guidance, Thoracic Outlet Syndrome, Temporal Artery, Transcranial Imaging, Transcranial PFO Evaluation, Transcranial Emboli Detection, Transcranial Vasomotor Reactivity or Thoracic Bow Hunter’s Syndrome. Participates in supervising student sonographers, training, and orienting new sonographers, directing daily workflow, participates in quality and safety initiatives, acting as a department super user, participates in committees related to modality, department, or facility, participates in educational in-services, and complex care programs.