Social Worker-Patient Aligned Care Team

The Patient Aligned Care Team (PACT) is a comprehensive team which delivers primary care to Veteran patients in a longitudinal rather than episodic fashion and which has as its focus: prevention; health promotion, coordination, and chronic disease management. The social worker in this Veteran-centric approach often functions as a care coordinator with a panel(s) of veterans to ensure that health care meets the needs, as defined by the Veteran.

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VA Careers - Licensed Clinical Social Worker:

Total Rewards of a Allied Health Professional

* Able to maintain effective therapeutic relationships with Veterans in the Primary Care Clinic &/or their families.

* Independently works with Veterans & their families who are experiencing a wide range of complicated medical, psychiatric, emotional, behavioral, financial, legal & psychosocial problems.

* Independently complete thorough psychosocial assessments to determine the psychosocial functioning & needs of Veterans &/or their families.

* Participates as a member of the interdisciplinary treatment team & actively participate through collaboration with Veterans & family as well as interdisciplinary treatment team members in the development & implementation of treatment goals & interventions.

* Has experience in medical & mental health diagnoses, disabilities, & treatment procedures, including acute, chronic & traumatic illnesses, substance abuse disorders, common medications & their effects/side effects, & medical terminology.

* Facilitates action for community placements through collaboration with Veterans & their families as well as interdisciplinary treatment team members to ensure that appropriate community placements are completed in a timely manner.

* Serves as a liaison between Veterans &/or their families & VA & community resources in order to ensure thorough delivery of services.

* Works independently to implement treatment modalities, provide educational classes, &/or supportive groups for Veterans & families, including shared medical appointments. The social worker must be able to use & teach Veterans in the effective use of the My Healthe Vet system.

* Coordinates with staff at each of the assigned CBOC's as well as telehealth coordinators to provide clinical telehealth services.

* Must be up to date on all trainings & requirements, so that they may provide ongoing telehealth services without interruption to patient care.

* Provides consultation & education to Veterans & their families regarding community resources, VA benefits & specialty programs, & advance directives.

* Ability to understand the process for accessing &/or coordinating community-based services, including information & referral for additional services from other VA programs, other government programs, & community programs.

* Must be available to provide consultation to other treatment team & staff members regarding psychosocial needs of Veterans &/or their families & the impact of the identified psychosocial problems on the Veteran's health care planning & compliance with treatment.

* Maintains up-to-date knowledge of Veteran's benefits & services, community resources, & process for making appropriate referrals to community & other governmental programs or agencies.

* Provides case management services to Veterans & their families throughout the continuum of care. The incumbent will be able to appropriately utilize principles of human growth & development over the life span & will be able to assist Veterans in coping with the loss & grief experiences from disability & terminal illness.

* Communicates effectively, both orally & in writing with people from varied backgrounds.

* Able to provide brief psychotherapy & support therapy to Veterans & their families.

Work Schedule:

Monday-Friday 8am-4:30pm

Compressed/Flexible:

May be available

Recruitment Incentive (Sign-on Bonus):
Not Authorized

Permanent Change of Station (Relocation Assistance):
Not Authorized

Pay:
Competitive salary and regular salary increases.

Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick…