Social Worker (Admissions Coordinator)

Veterans Health Administration • Buffalo, NY

8d • Onsite

About The Position

The Social Worker (Admissions Coordinator) is assigned to the Community Living Center (CLC) at the VA Western New York Health Care System. The role provides direct social work services to Veteran residents and their families and coordinates admissions to the Community Living Centers in Buffalo and Batavia.

The admissions coordinator evaluates whether prospective admissions are appropriate, supports the CLC Medical Director and Nurse Leader in assessing bed availability and admission needs, and helps identify home-based or community-based alternatives when appropriate. The position coordinates respite opportunities, supports application and intake processes, and uses the Bed Management System to track Veterans whose admission is delayed by bed availability. Admissions include discussion with Veterans about the reason for admission, expected length of stay, and discharge goals.

The Social Worker works with interdisciplinary treatment teams and community professionals to coordinate care and help Veterans meet treatment and discharge goals. Services include social work assessment and history, case management, individual, family and group counseling, discharge planning, advocacy, and consultation and education for Veterans, families, staff, and medical residents. The role helps identify safe and appropriate discharge settings, supports adjustment to alternative living arrangements, provides information about community resources and VA benefits, and assists with health care proxy and living will education and documentation. The position communicates with patients, families, and care teams and completes warm handoffs to subsequent social workers as needed.

The work schedule is Monday through Friday, 7:30 a.m. to 4:00 p.m. This is not a virtual position.

Requirements

• Master's degree in social work from a school fully accredited by the Council on Social Work Education (CSWE); a doctoral degree cannot substitute for the master's degree.
• Licensed or certified at the advanced practice level and able to provide supervision for licensure.
• Proficiency in spoken and written English.
• One year of experience equivalent to the GS-11 grade level, demonstrating advanced practice skills, judgment, and progressively greater professional competency.
• Knowledge of program coordination and administration, including consultation, negotiation, and monitoring.
• Knowledge and ability to write program policies, procedures, or practice guidelines.
• Ability to supervise multidisciplinary staff assigned to the program.
• Ability to organize work, set priorities, meet multiple deadlines, and evaluate assigned program areas.
• Ability to provide training, orientation, and guidance within clinical practice.
• U.S. citizenship, subject to the stated limited exception for non-citizens under VA policy.
• Must pass a pre-employment physical evaluation or examination and meet applicable background, onboarding, identification, and application-document requirements.
• Must participate in the Department of Veterans Affairs seasonal influenza vaccination program.
• Must serve a two-year trial period, subject to written certification for continued employment.

Nice To Haves

• Experience working with geriatric or long-term care populations, including knowledge of the aging process, age-related health and functional changes, and the psychosocial needs of older adults and their caregivers.
• Certification or other post-master's degree training from a nationally recognized professional organization or university that includes a defined curriculum or course of study and internship, or equivalent supervised professional experience.

Responsibilities

• Coordinate and evaluate the appropriateness of CLC admissions, including assessing bed availability and considering referrals to home-based or community-based services.
• Serve as a point person for the interdisciplinary treatment team to facilitate Veteran respite opportunities in the community.
• Implement discharge plans developed by the interdisciplinary team and recommend home- and community-based support services.
• Provide guidance on respite application, screening, intake, and discontinuation, and collaborate with team members on appropriateness and acceptance.
• Use the Bed Management System to track Veterans whose admission is denied or delayed because no bed is available.
• Ensure Veterans understand and agree on the reason for admission, expected duration of CLC residency, and discharge goals.
• Coordinate case management with the interdisciplinary team and community professionals to support treatment needs and agreed-upon goals.
• Provide social work services including assessments, case work, individual, family and group counseling, discharge planning, and case management.
• Identify patient discharge disposition and collaborate on post-CLC needs and appropriate living arrangements.
• Provide education and assistance regarding health care proxies and living wills, document completed or revised forms in the electronic medical record, and forward hard copies for scanning.
• Provide information on economic assistance and financial aid, including strategies to increase income through employment, vocational rehabilitation, VA benefits, or disability resources.
• Assist Veterans and families with adjustment to alternative living arrangements, including long-term or subacute nursing home care, assisted living, supportive housing, retirement facilities, group homes, or homeless shelters.
• Participate in discharge planning with Veterans, families, and team members to ensure individualized plans are safe, meet patient needs, and are carried out in a timely and appropriate manner.
• Advocate for patients to obtain services in a timely manner and serve as a liaison between patients, families, and the medical team.
• Provide individual and family counseling to help alleviate distress associated with acute and chronic illness.
• Educate Veterans and families about community resources, advance directives, and VA benefits.
• Consult with and educate team members and medical residents about social work practice and VA policies and procedures.
• Provide case management throughout the continuum of care and make a warm handoff to the next social worker when needed.
• Communicate effectively in oral and written form and perform other duties as assigned.

Benefits

• Competitive salary and regular salary increases.
• 37–50 days of annual paid time off per year, including annual leave, sick leave, and 11 paid Federal holidays.
• Up to 12 weeks of paid parental leave after 12 months of employment, in connection with birth, adoption, or foster care placement of a child.
• Child care subsidy may be available after 60 days for eligible full-time employees and families meeting the stated income and eligibility criteria.
• Traditional federal pension with five-year vesting and federal 401(k) with up to 5% in VA contributions.
• Federal health, vision, dental, term life, and long-term care insurance; many federal insurance programs can be carried into retirement.
• Potential credit toward annual leave accrual based on prior federal or military service, subject to prior request and approval.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior