Senior Social Worker - Home Based Primary Care

Job Title

Job duties include helping with VA Careers - Social Work. Receives and completes consults from interdisciplinary teams and other social workers on complex, difficult cases, using advanced practice skills and expertise. Completes psychosocial assessments; interviews veteran and family members and/or significant others to establish facts about the veteran's unique situation; identifies presenting problems and their causes, and the impact of such problems on the veteran's functioning and health as a part of a comprehensive psychosocial assessment;

assesses high risk factors, acuity and need for services.

Develops an assessment of the veteran in collaboration with the interdisciplinary treatment teams, the veteran, family members and significant others, whenever possible. Develops psychosocial treatment plans in collaboration with the HBPC interdisciplinary team, including goals for psychosocial clinical treatment. Senior Social Worker provides independent consultation and makes recommendations to the interdisciplinary team regarding the course of treatment. Provides the patient, caregivers, and/or family members with ongoing supportive counseling.

Participate in discharge planning with other disciplines and will be responsible for ensuring that discharge plans are executed in a manner that is timely and appropriate.

Provide individual, family and group counseling as appropriate. Provide consultation/education to veterans and families on community resources, advance directives and VA benefits. Act as a consultant to other team/staff members. Provide consultation/education to medical residents on social work practice and VA policy and procedure. Act as liaison between VA and community resources, to include marketing and public relation duties as needed.

Provide case management to veterans and families, as needed, throughout the continuum of care. Provide a full range of social work services within commonly accepted standards of social work practice which includes case work, individual, family and group counseling, discharge planning, case management and other services as appropriate.

Address Advance Directives and Goals of Care Conversations in accordance with the standards of their work area. Provide wellness/prevention education and facilitate Patient/family support groups as appropriate. As appropriate, supervise the practice of social work students, or a less experienced social worker. Coordinate treatment and communicate with the care lines to facilitate continuity of care for veterans. Participate in committee assignments, as deemed necessary by the service manager.

Maintain data and statistical compilations to comply with JCAHO, VA and medical center policy and procedures. Document social work interventions and activities in patients clinical record utilizing CPRS and ensure appropriate hand off when transferring of patient care. Completes Suicide Risk assessments and assists Veterans with developing Suicide Safety Plans, consults with and keeps the Suicide prevention Office informed as appropriate for Veterans considered at risk for Suicide.

Advocate for the VA and identifies the need for services in specific geographical areas. Experienced in making rapid assessments and developing crisis management plans to maintain the veteran in a medical foster home. Ensures the interdisciplinary team is kept informed of any concerns with the patient and/or caregiver.

Work Schedule:

M-F, 7:30am-4:00pm. Compressed/Flexible:
Yes. 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 leave, 11 paid Federal holidays per year) Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. Parental Leave:
After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child. Child Care Subsidy:
After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66. Retirement:
Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA. Insurance:
Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement). Telework:
Not Available. Virtual:
This is not a virtual position. Functional Statement #: 59360A. Permanent Change of Station (PCS):
Not Authorized