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The Patient-Aligned Care Team (PACT) is an interdisciplinary team which delivers primary care services to Veteran patients in a longitudinal, rather than episodic fashion. The focus of PACT is health promotion and wellness, disease prevention, care coordination, and chronic disease management. The role of the PACT Social Worker in this model is that of care coordinator to a panel of Veterans ensuring their health care needs are met, based upon identified goals defined by the Veteran. Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education. Have a master's degree in social work from a school of social work fully accredited by the Council on Social Work Education (CSWE). Graduates of schools of social work that are in candidacy status do not meet this requirement until the School of Social Work is fully accredited. A doctoral degree in social work may not be substituted for the master's degree in social work. Verification of the degree can be made by going to http://www.cswe.org/Accreditation to verify that the social work degree meets the accreditation standards for a masters of social work. Licensure. Persons hired or reassigned to social worker positions in the GS-0185 series in VHA must be licensed or certified by a state to independently practice social work at the master's degree level. Current state requirements may be found by going to http://vaww.va.gov/OHRM/T38Hybrid/. English Language Proficiency. Candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. § 7403(f). May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: GS-9: Experience, Education, and Licensure. None beyond the basic requirements. Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, the candidate must demonstrate all of the following KSAs: (a) Ability to work with Veterans and family members from various socioeconomic, cultural, ethnic, educational, and other diversified backgrounds utilizing counseling skills. (b) Ability to assess the psychosocial functioning and needs of Veterans and their family members, and to formulate and implement a treatment plan, identifying the Veterans problems, strengths, weaknesses, coping skills, and assistance needed. (c) Ability to implement treatment modalities in working with individuals, families, and groups to achieve treatment goals. This requires judgment and skill in utilizing supportive, problem solving, or crisis intervention techniques. (d) Ability to establish and maintain effective working relationships and communicate with clients, staff, and representatives of community agencies. (e) Fundamental knowledge of medical and mental health diagnoses, disabilities, and treatment procedures. This includes acute, chronic, and traumatic illnesses/injuries; common medications and their effects/side effects; and medical terminology. GS-11: Experience and Licensure. Appointment to the GS-11 grade level requires completion of a minimum of one year of post-MSW experience equivalent to the GS-9 grade level in the field of health care or other social work-related settings, (VA or non-VA experience) and licensure or certification in a state at the independent practice level. OR Education. In addition to meeting basic requirements, a doctoral degree in social work from a school of social work may be substituted for the required one year of professional social work experience in a clinical setting. ANDDemonstrated Knowledge, Skills, and Abilities. In addition to the experience above, candidates must demonstrate all of the following KSAs: (a) Knowledge of community resources, how to make appropriate referrals to community and other governmental agencies for services, and ability to coordinate services. (b) Skill in independently conducting psychosocial assessments and treatment interventions to a wide variety of individuals from various socio-economic, cultural, ethnic, educational and other diversified backgrounds. (c) Knowledge of medical and mental health diagnoses, disabilities and treatment procedures (i.e. acute, chronic and traumatic illnesses/injuries, common medications and their effects/side effects, and medical terminology) to formulate a treatment plan. (d) Skill in independently implementing different treatment modalities in working with individuals, families, and groups who are experiencing a variety of psychiatric, medical, and social problems to achieve treatment goals. (e) Ability to provide consultation services to new social workers, social work graduate students, and other staff about the psychosocial needs of patients and the impact of psychosocial problems on health care and compliance with treatment. Preferred Experience: At least 1-2 years of medical SW case management experience References: VA Handbook 5005, Part II, Appendix G39 dated September 10, 2019. The full performance level of this vacancy is GS-11. The actual grade at which an applicant may be selected for this vacancy is in the range of GS-09 to GS-11. Physical Requirements: This position requires moderate carrying and lifting, 15-44 lbs. Reaching above shoulders; Use of fingers; Walking 1-4 hours; Standing 4 hours and repeated bending 8 hours; Hearing (aid permitted). Operation of a motor vehicle is required to transport Veterans to medical appointments, job sites, social activities and other community resources. ["VA Careers - Social Work: https://youtube.com/embed/enRhz_ua_UU The PACT Social Worker will function as an integral member of their assigned team(s) by actively participating in patient assessment, treatment planning, case management, and the provision of a full range of services within the scope of social work practice, as required to meet the needs of Veterans. Utilization of social work skill and expertise at the independent practice level to establish and maintain therapeutic relationships with Veterans and their families/caregivers. Able to work independently with Veterans experiencing a wide range of complex medical, psychiatric, emotional, behavioral, financial, legal and other psychosocial problems through recurring. supportive case management visits. Coordination of community placements through collaboration with Veterans, their families/caregivers, and PACT members to ensure that the process is completed in a timely manner for the appropriate level of care. Community placements can include, but are not limited to, referrals to state-licensed group and family care homes, assisted living facilities, adult day health care programs, VA contracted and private nursing home placements, Community Living Center, as well as inpatient and outpatient hospice services. Consultation to and education of Veterans and their families/caregivers regarding community resources, VA benefits and specialty programs, and Advance Directives will be a responsibility of the Clinical Social Worker. This includes knowledge of the processes for referral and coordination of community-based services, which includes programs available from the VA, other government agencies, and the community at-large. Consultation to the interdisciplinary team regarding Veteran's and family's/caregiver's psychosocial needs and the impact of identified psychosocial problems on Veteran's healthcare planning and treatment adherence will be provided by the PACT Social Worker, who will also advocate on Veteran's behalf. PACT Social Worker must be knowledgeable of the diagnostic categories that comprise the majority of combat Veterans with medical and psychiatric illnesses. Must have the ability to recognize internal and external conditions and influences, including Veterans Health Administration (VHA) mandates and programs that require the establishment of new management policies, standards, and procedures including the skill to design and develop the tools necessary to cope with varied situations. The PACT Social Worker is responsible for the provision of a level of care that meets both VA and Joint Commission standards for all Veterans assigned to the Licensed Clinical Social Worker and timely completion and maintenance of comprehensive assessments, treatment goals, and progress notes. The ability to provide supportive group and individual counseling within the scope of the role of PACT Social Worker. Active participation in the interdisciplinary treatment team process. Addresses issues or disputes raised by Veterans and/or families and refers them to the Patient Advocate when no solution can be reached through discussion and collaboration with other services. Must have a wide range of knowledge of both VBA and VHA services and benefits, along with VHA Directives and policies. The PACT Social Worker is expected to seek guidance when these directives are vague or require interpretation. The PACT Social Worker must be skillful in approaching individuals or personnel groups to achieve program objectives such as gaining compliance with established policies and regulations. As the procedures may be new and different, the PACT Social Worker may experience others' resistance to change and may have to work to gain cooperation through persuasion, collaboration, or gaining information by establishing rapport. Work Schedule: Monday - Friday, 8:00am to 4:30pm, hours are subject to change based on agency needs Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required"]

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