The Michael E DeBakey VA Medical Center (MEDVAMC) is seeking a Senior Social Worker. This position will be located at the Conroe Outpatient Clinic (COPC) is located in Conroe, Texas Current permanent VA employees and Federal employees from other federal agency should apply under CBST-11219946-21-LG The incumbent independently will provide clinical psychosocial and case management services at an advanced practice level to eligible active duty service members, Veterans and their family members to meet biological, psychological, social, and environmental needs. The active duty service members and Veterans receiving treatment at the site come from an expansive geographic area. Their health care and psychosocial problems and needs are complex and require a high degree of clinical oversight, coordination and creative problem-solving. Services are provided at the Conroe Community Based Outpatient Clinic, in the community, virtually and via telework. In addition, incumbent may provide virtual coverage to other CBOC locations within the Michael E. DeBakey VA Medical Center (MEDVAMC) catchment area. Incumbent will provide high quality medical social work care and services to Veterans enrolled in outpatient Primary Care. This includes active case management and care coordination, clinical assessment and treatment, advocacy, and coordination of linkages to other appropriate VA or community service providers/agencies as needed by the Veteran and family. This is accomplished in cooperation with members of the Primary Care/PACT treatment team and/or other interdisciplinary teams as appropriate. The incumbent is expected to demonstrate the capacity to work independently in the medical/clinical setting. In this Veteran-centric approach, the incumbent often functions as a care coordinator with a panel of Veterans to ensure that their health care needs are met. The incumbent is uniquely prepared for this role by virtue of their education, training, and experience. The incumbent understands the impact that family and community have on the health-care needs of Veterans. Incumbent incorporates complex multiple causation in differential diagnosis and treatment of Veterans, including psychosocial and psychiatric diagnoses within approved clinical privileges and scope of practice. Incumbent is able to provide individual, group, and family psychotherapy and advanced level case management interventions used in the treatment of Veterans. Specifically, the incumbent also facilitates and/or participates as an interdisciplinary team member in health promotion, behavioral, and psychoeducational groups with a focus on chronic illness (i.e. smoking cessation, diabetes, weight management). Promote and utilize group, individual and phone education to complete Advance Care Planning (ACP) in the PACT clinic. Provides guidance and counseling for Veterans/families with regard to long term care and end of life care/decisions. Incumbent coordinates with outside medical facilities to promote continuity of care to include: creation of a network of social services providers in the local community to enhance services provided by the VA; fill service gaps identified in the Veteran's care and treatment due to limitations in Veteran's services. Functions within the interdisciplinary team to coordinate with medical staff re: home health care and extended care referrals. Collaborates with social work, Rehab and Long Term Care, Primary Care, and nursing service to facilitate acute rehabilitation admission, transfer to a skilled nursing facility, initiation or resumption of skilled or nonskilled homemaker/home health services, respite, and/or referral to other VA and/or community programs. Provides care coordination and consultation with medical, nursing, and social work staff in other care areas to which Veterans are referred, consulted, treated and/or comanaged. Provides assessment, evaluation, treatment, and reporting for cases of suspected or reported abuse, neglect, or financial exploitation. Maintains knowledge of Veteran's benefits and services, community resources, and process for making appropriate referrals to community and other governmental programs or agencies. Work Schedule: Monday through Friday; 8am to 4:30pm; with possible extended hours based on patient need Telework: Not Available Position Title/ Functional Statement # 000000 Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Discloser Report: Not required
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.