Senior Social Worker/Patient Aligned Care Team (PACT)

Summary

The Patient Aligned Care Team (PACT) is a comprehensive team which delivers primary care to veteran patients in a longitudinal rather than episodic fashion and which has as its focus: prevention; health promotion, coordination, and chronic disease management. The social worker functions as a PACT teamlette member with a panel of veterans to ensure that health care meets their needs, as defined by the veteran.

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This job is open to

The public

U.S. Citizens, Nationals or those who owe allegiance to the U.S.

Internal to an agency

Current federal employees of the hiring agency that posted the job announcement.

Clarification from the agency

NOTE: The 2-page Resume requirement does not apply to this position. For more information, refer to Required Documents below.

Duties

VA Careers - Social Work: https://youtube.com/embed/enRhz\_ua\_UU

Total Rewards of a Allied Health Professional

Duties of the position include, but are not limited to:

• Independently works with veterans and their families who are experiencing a wide range of complicated medical, psychiatric, emotional, behavioral, and psychosocial problems.
• Frequently offers consultation to colleagues and students on the psychosocial treatment and care coordination of complex patients as incumbent is seen as an expert and leader among peers in the psychosocial care of medically complex patients.
• Possesses a working knowledge of medical and mental health diagnoses, disabilities, and treatment procedures, including acute, chronic, and traumatic illnesses, substance abuse disorders, bereavement, common medications, and general medical terminology. Medical conditions include but are not limited to dementia (including Alzheimer's and Lewy-Body's), CVA (cardiovascular accident, aka "stroke"), DM Type I (diabetes mellitus), COPD (chronic obstructive pulmonary disease), TBI (traumatic brain injury), CHF (congestive heart failure), AKA and BKA (leg amputation), CKD and ESRD (kidney disease), and cancer. Mental health conditions include but are not limited to depressive disorders, anxiety disorders (including PTSD), substance abuse disorders, personality disorders, and psychotic disorders (including bipolar I and schizophrenia). Most prescribed medications for these stated conditions include but are not limited to benzodiazepines (for anxiety), SSRI's and SNRI's (for depression and anxiety), anti-psychotic medications, potassium-sparing diuretics (for heart issues), chemotherapy and radiation (for cancer), and cholinesterase inhibitors (for dementia).
• Possesses a high level of skill and expertise to establish and maintain effective therapeutic relationships with, and in assessing and treating the complicated psychosocial problems of, veterans and their families/significant others.
• Actively participates as a member of the interdisciplinary treatment team through collaboration with veterans and family as well as interdisciplinary treatment team members to formulate and implement a treatment plan, identifying the patient's problems, strengths, weaknesses, coping skills and assistance needed.
• Accepts referrals originating from any member of the interdisciplinary team, from Veterans and/or their families who call or walk-in for assistance, and from community professionals.
• Conducts thorough assessments to determine psychosocial problems that cause distress, often impacting the health condition and creating barriers to care needs of veterans and family members, the underlying causes of the presenting problem, the interpersonal and environmental factors impacting the problem, and its effect on the patient's ability and desire to comply with the treatment recommendations by the multidisciplinary team. These stressors can include adjustment to the current medical condition, untreated or under-treated mental health or substance abuse conditions, economic instability, legal problems, and inadequate housing and transportation.

Work Schedule: Full Time; Varying Schedule; Subject to change to meet the needs of the Agency

Telework: Not Eligible

Virtual: This is not a virtual position.

Functional Statement #: 612-07673-F

Recruitment Incentive (Sign-on Bonus): Not Authorized

Permanent Change of Station (Relocation Assistance): Not Authorized

EDRP Authorized: Former EDRP participants ineligible to apply for incentive. Contact V21CCOEEDRP@va.gov, the EDRP Coordina