Social Worker- Primary Care Team

Veterans Health Administration • Lansing, MI

14h

About The Position

The Social Worker provides social work services within assigned segments of the Patient Aligned Care Team (PACT), a comprehensive team that delivers longitudinal primary care to Veterans with a focus on prevention, health promotion, coordination, and chronic disease management. In this Veteran-centric role, the Social Worker often functions as a care coordinator.

The position includes assessing psychosocial concerns and needs, coordinating case management with outpatient interdisciplinary teams, supporting Veterans and their families in understanding problems and considering solutions, and coordinating services to meet treatment goals. Services may include referrals and assistance with access to care, transportation, advance directives, financial needs, housing, functional decline, and community placements. The Social Worker establishes therapeutic relationships, uses telehealth as appropriate, provides education about community resources and VA programs, and collaborates with Veterans, families, community professionals, and treatment teams.

The role also includes participation in team huddles, staff meetings, committees, work groups, and task forces; assisting with orientation and learning for less experienced social workers; and performing other duties as assigned. The work schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m. The full-performance level is GS-11, with selection at GS-09 to GS-11.

Requirements

• Master's degree in social work from a school fully accredited by the Council on Social Work Education (CSWE); a doctoral degree does not substitute for the master's degree.
• State licensure or certification to independently practice social work at the master's degree level. An exception may apply at GS-9 while completing state prerequisites; GS-11 requires licensure or certification.
• Proficiency in spoken and written English.
• For 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 licensure or certification; alternatively, a doctoral degree in social work may substitute for the experience requirement.
• Ability to work with Veterans and family members from diverse backgrounds using counseling skills.
• Ability to assess psychosocial functioning and needs and formulate and implement treatment plans.
• Ability to implement treatment modalities with individuals, families, and groups, using supportive, problem-solving, or crisis-intervention techniques as appropriate.
• Ability to establish and maintain effective working relationships and communicate with clients, staff, and community agency representatives.
• Knowledge of medical and mental health diagnoses, disabilities, treatment procedures, common medications and their effects or side effects, and medical terminology.
• For GS-11, knowledge of community resources and ability to make appropriate referrals and coordinate services.
• For GS-11, skill in independently conducting psychosocial assessments and treatment interventions for people from diverse backgrounds.
• For GS-11, skill in independently implementing treatment modalities with individuals, families, and groups experiencing psychiatric, medical, and social problems.
• For GS-11, ability to consult with 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 adherence.
• Must be a U.S. citizen, subject to the stated exception for non-citizen appointments when qualified citizens cannot be recruited under VA policy.
• Must meet applicable Selective Service registration requirements for males born after December 31, 1959.
• Must complete a background/security investigation, online onboarding, pre-employment physical evaluation, and applicable application requirements.
• Must participate in the seasonal influenza vaccination program.
• Must serve a one- or two-year trial period.
• Must be in overall good health and able to perform the stated physical activities.

Nice To Haves

• Experience working in a primary care setting.
• Case management experience.

Responsibilities

• Assess psychosocial problems, including presenting concerns, in-home factors, obstacles to treatment, and barriers to following recommended care.
• Provide case management in collaboration with members of the outpatient interdisciplinary team.
• Participate in scheduled interdisciplinary team huddles to identify Veterans at risk and determine whether psychosocial intervention is needed.
• Help Veterans and families understand factors contributing to problems and discuss potential short- and long-term solutions.
• Coordinate collaborative efforts to meet agreed-upon treatment goals, including liaison with community professionals.
• Arrange or refer Veterans and families to services such as access-to-care support, transportation, advance directives, financial assistance, housing, and services for functional decline.
• Establish and maintain effective therapeutic relationships with Veterans and their families in the Primary Care Clinic.
• Complete psychosocial assessments to determine Veterans' and families' functioning and needs.
• Coordinate community placements with Veterans, families, and interdisciplinary treatment team members, including nursing homes, Community Living Centers, residential care homes, and hospice services.
• Use telehealth modalities to meet Veteran needs.
• Provide consultation and education about community resources, VA benefits and specialty programs, and advance directives.
• Serve on facility committees, work groups, and task forces as assigned.
• Attend appropriate staff meetings, including interdisciplinary team, Social Work team, and Social Work supervision meetings.
• Assist with the orientation and learning of less experienced social workers.
• Perform other duties as assigned by the direct supervisor, Chief of Social Work Service, or Executive Leadership Team.

Benefits

• 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 experience, subject to approval.
• Up to 12 weeks of paid parental leave after 12 months of employment in connection with the birth, adoption, or foster placement of a child.
• Eligible full-time employees may receive a childcare subsidy after 60 days of employment, subject to income and other eligibility requirements.
• 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