Senior Social Worker (PACT

Job Title

Major duties include but not limited to:

• Represent the VA with professionalism and respect to both internal and external stakeholders.
• Act as a subject matter expert on VA and/or community resources.
• Collaborate with other service providers in assessing the Veteran's needs as appropriate.
• Work closely and coordinate with other PACT Social Workers in the health care system along with providing consultation and education to VA staff and community-based service providers including medical residents and social work students.
• Educate Veterans and/or caregiver of the available services and assisting them in establishing the appropriate referrals based on the Veteran's preference or that of their authorized surrogate decision maker.
• Utilize current VA and community social service programs and enhancing the content to the benefit of Veterans.
• Serve as a liaison with community agencies, assist Veterans (or caregivers) with referrals for services from community and government agencies, and help coordinate these services, when appropriate.
• Coordinate with other VA staff and community agencies to assist in problem solving as needed.
• Run psycho educational groups for Veterans, caregivers and/or family members.
• Function as an independent provider within the PACT.
• Act as a care coordinator and case manager for psychosocial concerns related to psychosocial determinants of health for Veterans assigned to their panel.
• Conduct psychosocial assessments in collaboration with the interdisciplinary treatment team, the Veteran patient, family members and significant others; interviewing Veterans and family members/significant others and writing the psychosocial assessment.
• Ensure biopsychosocial assessments highlight Veterans' strengths, limitations, and internal/external supports and service needs to optimize their functional status.
• Assess and treat the complicated psychosocial and behavioral health problems of Veterans, caregivers and their families/significant others.
• Assess, treat, and appropriately refer for the psychosocial problems that cause distress, which often impact the health condition and create barriers to care. These stressors can include adjustment to the current medical condition, untreated or under-treated mental health or substance abuse condition, economic instability, legal problems, and inadequate housing and transportation.
• Accept referrals from any member of the interdisciplinary team, Veterans, caregivers and/or family members who call or walk-in for assistance, and from community professionals.
• Complete comprehensive psychosocial assessments for patients to help determine what psychosocial and mental health services are needed and make appropriate referrals as outlined by medical center policy.
• Develop treatment plans in collaboration with the Veteran/family/caregiver, interdisciplinary treatment team, and appropriate community partners. Incumbent provides psychosocial interventions and measures outcomes to interventions.
• Provide therapeutic services to individuals, families, and groups covering a wide variety of psychosocial issues.
• Work closely with Primary Care Mental Health Integration (PCMHI) clinicians to facilitate assessments and referrals and will defer to specialty Mental Health psychotherapists when brief psychotherapy is not clinically indicated or when it is more clinically appropriate to refer to specialty Mental Health psychotherapists.
• Coordinate with PCMHI and/or specialty Mental Health clinicians after these referrals are made to ensure a continuity of care between the PACT and the Mental Health teams.
• Conduct psychosocial and behavioral health assessments in collaboration with the interdisciplinary treatment team, the Veteran, family members and significant others (as appropriate).
• Utilize a range of psychoeducation and psychotherapeutic treatment options based on Veteran needs and clinical appropriateness to address issues related to physical limitations, psychological needs and age associated illnesses and conditions.
• Conduct applicable clinical reminders within their approved scope of practice or clinical privileges.

Work Schedule:

8:00am - 4:30pm Monday - Friday Telework:
This position is eligible for telework on an Ad-Hoc Basis

Functional Statement #: 08200-F