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Social Worker- Home Based Primary Care (HBPC)

Veterans Health Administration · Posted today

On-site Bath, NY $75K – $97K Apply by Jun 15, 2026 Social Work ENFJESFJINFJINFP
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About the Role

This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Program Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application.

What You'll Do

  • The Clinical Social Worker in this position provides direct services to adult and geriatric veterans enrolled in the Home Based Primary Care (HBPC) Program with high quality case management, clinical treatment, advocacy, and coordinate linkage with appropriate VA and community service providers/agencies as needed by the client.
  • This is in collaboration with other members of the HBPC Team or other interdisciplinary treatment teams as appropriate.
  • This position is responsible for assessment, planning, and provision of case management services in the HBPC Program at the Finger Lakes HCS.
  • The Clinical Social Worker coordinates a variety of activities including outreach, interdisciplinary activities, psychosocial assessments, treatment planning, consultation/education to Medical Center staff and community based service providers, the collection and maintenance of statistical data, program planning evaluation and modification, and the supervision of students as assigned.
  • Major Duties: Screening/Assessment - The Social Worker will develop an assessment of the veteran in collaboration with the interdisciplinary treatment team, the veteran, and family members/significant others, whenever possible.
  • Treatment Planning/Goal Setting - The Social Worker is responsible for contributing to the development of the treatment plan and setting achievable treatment goals with the veteran, family members/significant others and other HBPC clinical staff.
  • Referral to service providers - Throughout the course of treatment, the Social Worker is the subject matter expert on VA and/or community resources.
  • Resource Development - The Social Worker is responsible for using the current Social Work resource file of VA and community social service programs and enhancing the content to the benefit of veterans.
  • Advocacy - The Social worker understands the intimidation of bureaucracy and will act as an advocate when it serves the best interest of the veteran and family members/significant others.
  • Crisis Intervention - The Social Worker is experienced in making rapid assessments and developing crisis management plans.
  • The Social Worker has access to multiple resource directories in addition to previously developed resources to meet the demands of a crisis.
  • Education/Health promotion and prevention - The Social Worker provides education related to VA and community resources, entitlements, Advance Directives/Living Will and will refer veterans and families/significant others to the appropriate interdisciplinary team member for identified health education needs.
  • Coordination of non-institutional and institutional services - The Social Worker is responsible for the coordination of the referrals of non-institutional services such as HBPC, ADHC/CADHC, home hospice and skilled and non-skilled homecare services in collaboration with the interdisciplinary treatment team members.
  • Supportive counseling - The Social Worker will provide the veterans and their caregivers with ongoing supportive counseling.

Requirements

  • 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.
  • 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 identification 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.
  • As a condition of employment for accepting this position, you will be required to serve a 1 or 2-year trial 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 trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.

Personality Fit

This role is commonly a great fit for these MBTI types:

Job ID: 64766ab3-5e80-41ba-b4f9-ed26b3efdd3e

Posted via USAJobs

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