Social Worker - Patient Aligned Care Team (Geriatric PACT)

Veterans Health Administration • Coatesville, PA

3d

About The Position

The Social Worker is assigned to the Primary Care Clinic and serves as a member of a multidisciplinary Patient Aligned Care Team (PACT), with a focus on the geriatric population of Veterans. The role provides clinical and psychosocial assessment, intervention, short-term solution-focused counseling, and case management for Veterans and, when appropriate, their families. The incumbent assesses presenting problems, in-home factors, treatment barriers, psychosocial functioning, strengths, coping skills, and service needs, including during crises.

The Social Worker coordinates care with outpatient interdisciplinary team members and community professionals to support agreed-upon treatment goals and facilitate timely access to services. Areas of support include homelessness, hospice services, nursing home care, home health services, financial resources, VA benefits, and transportation. The role also contributes to facility committees and work groups, supports the orientation and learning of less experienced social workers, and may serve as a preceptor for social work students. The position requires knowledge of medical and mental health conditions and treatments, as well as proficiency with software and VHA computer systems.

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 this master's degree requirement.
• Licensure or certification by a state to independently practice social work at the master's degree level, subject to the stated GS-9 exception for pending licensure or certification prerequisites.
• For appointment at GS-11, at least one year of post-MSW experience equivalent to GS-9 in health care or another social work-related setting, plus independent-practice state licensure or certification; alternatively, a doctoral degree in social work may substitute for the one year of professional clinical social work experience.
• Demonstrate a Veteran-centric approach to interventions and counseling for Veterans, family members, caregivers, and survivors.
• Be able to assess psychosocial functioning and needs and formulate and implement treatment plans that identify problems, strengths, weaknesses, coping skills, and needed assistance.
• Be able to implement treatment modalities with individuals, families, and groups, using supportive, problem-solving, or crisis-intervention techniques as appropriate.
• Be able to establish and maintain effective working relationships and communicate with clients, staff, and community agency representatives.
• Have knowledge of medical and mental health diagnoses, disabilities, treatment procedures, acute, chronic, and traumatic illnesses or injuries, common medications and their effects or side effects, and medical terminology.
• For GS-11, know community resources and appropriate referral processes, and be able to coordinate services.
• For GS-11, be skilled in independently conducting psychosocial assessments and treatment interventions for people from diverse socioeconomic, cultural, ethnic, and educational backgrounds.
• For GS-11, be skilled in independently implementing treatment modalities with individuals, families, and groups experiencing psychiatric, medical, and social problems.
• For GS-11, be able to provide consultation to new social workers, social work graduate students, and other staff about patients' psychosocial needs and the effects of psychosocial problems on health care and treatment compliance.
• Be a U.S. citizen, subject to the stated exception for non-citizens when qualified citizens cannot be recruited under VA policy.
• Be proficient in written and spoken English.
• Meet applicable selective service registration requirements for males born after December 31, 1959.
• Complete background/security investigation, online onboarding, required identification and application documentation, and a pre-employment physical evaluation.
• Participate in the seasonal influenza vaccination program.
• May be required to serve a one- or two-year trial period.

Nice To Haves

• Experience in geriatric, hospital, hospice, and medical social work.

Responsibilities

• Assess psychosocial problems and needs, including when Veterans are experiencing a crisis.
• Provide short-term, solution-focused counseling to Veterans and/or their families.
• Conduct thorough psychosocial assessments, including assessment of in-home factors and obstacles to treatment or follow-through.
• Establish and maintain effective therapeutic relationships with Veterans and/or their families in the Primary Care Clinic.
• Collaborate with Veterans, families, and interdisciplinary team members to develop and implement treatment goals and interventions.
• Provide case management with the outpatient interdisciplinary team to coordinate care and meet agreed-upon treatment needs.
• Facilitate access to community resources and services, including homelessness assistance, hospice, nursing home care, home health services, financial resources, VA benefits, and transportation.
• Serve as a liaison between Veterans and/or their families and VA and community resources.
• Participate in facility committees, work groups, and task forces as assigned by the supervisor and Chief of Social Work Services.
• Assist with the orientation and learning of less experienced social workers and, if interested, serve as a preceptor for social work students.
• Use software applications for document drafting and data management, as well as other VHA computer systems.
• Complete other duties as assigned.

Benefits

• Competitive salary and regular salary increases.
• 37–50 days of annual paid time off per year, including 13–26 days of annual leave, 13 days of sick leave, and 11 paid federal holidays.
• Potential credit toward annual leave accrual based on prior work or military service, subject to approval.
• Up to 12 weeks of paid parental leave after 12 months of employment, in connection with the birth, adoption, or foster care placement of a child.
• Potential childcare subsidy for eligible full-time employees after 60 days of employment, subject to family income and program limits.
• Traditional federal pension with five-year vesting.
• 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.

What This Job Offers

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