Job Listing
Social Worker - Patient Aligned Care Team
Veterans Health Administration · Posted 12 days ago
About the Role
This position is utilized as part of a team that supports Patient Aligned Care Team (PACT)/ Primary Care functions, and is expected to work on site at The Villages on Mulberry Lane. The Clinical Social Worker is able to formulate and implement a treatment plan, identifying the patient's problems, strengths, needs, abilities, and challenges with the patient, family and interdisciplinary treatment team.
What You'll Do
- →This position supports the PACT - Patient Aligned Care Team.
- →The Clinical Social Worker possesses the skills to offer psychosocial interventions including the provision of short-term, solution-focused supportive counseling with Veterans and their family members/significant others/caregivers.
- →Social Worker is responsible for reviewing and coordinating all phases across the continuum of care, this includes primary care, specialty care, mental health care, acute care, extended care, and others.
- →Duties may include, but are not limited to: Knowledgeable of the range of treatment and skills needed for all adult patients including mental health patients related to their physical limitations, psychological needs and age associated illnesses and conditions.
- →Evaluate the need for Veterans to be referred for capacity exams (neuropsycholgical assessments, payee, fiduciary, etc.) through the Primary Care or Mental Health Provider.
- →Identifies family/caregiver stressors and makes referrals to both VA and community resources to reduce caregiver burnout and support families and caregivers in providing care for Veterans.
- →Assesses for any signs or symptoms of abuse, neglect, or exploitation and follows required local policies regarding mandatory reporting and documentation.
- →Must be knowledgeable of various mental health diagnoses and understand the diversification of the mental health within the Veteran population, being sensitive to human growth and development, age-appropriate needs and concerns.
- →Screen and assess for suicide risk to provide vital access to services for Veterans who may be experiencing suicidal ideations and be in need of care.
- →Provides case management and care coordination to facilitate appropriate delivery of health care services, incorporating complex multiple causation in differential diagnosis and treatment of Veterans and making psychosocial and/or mental health diagnoses within approved clinical privileges or scope of practice.
- →Knowledgeable regarding the continuum of care and is able to evaluate required level Properly document and scan records to ensure clear and accurate information regarding the Veterans' wishes are available in the electronic health record.
- →Proactively addresses the goals of care conversations, discussing role of the surrogate, eliciting understanding of diagnosis and prognosis, eliciting patient's values, goals, providing basic information about LSTs & services, and documenting the conversation.
- →Preferred Experience: Experience in independently assesses the psychosocial functions and needs of individuals and families from diverse backgrounds.
- →Able to formulate and implement a treatment plan, identifying the patient's problems, strength's, needs, challenges and coping skills.
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 evaluation/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
Job ID: a382a6b7-6dc6-4e18-a7c1-34de1e68d694
Posted via USAJobs