Clinical Social Worker - Home Based Primary Care; HBPC

Overview

The Social Worker serves as a core member of the interdisciplinary Home-Based Primary Care (HBPC) treatment team, a specialized outpatient Patient Aligned Care program. The incumbent works under supervision to provide psychosocial interventions and case management services to veterans with complex medical, social, and behavioral conditions where routine clinic-based care is not effective.

The social worker coordinates a variety of case management responsibilities, including outreach, interdisciplinary activities, psychosocial assessments, treatment planning, consultation/education to other healthcare facility staff, and community-based service providers. Incumbent utilizes entry‑level clinical practice skills, knowledge, and judgment to develop and measure effectiveness of social work practice and services, using outcome evaluations to improve treatment services. Coordination of specialized services and programs is also provided.

Encounters/visits are made in the home‑setting; government cars are available for travel to the patient’s residence. Incumbent must be physically able to maneuver home structures with obstacles, stairs, and pets.