Incumbent is a professional social worker assigned to Outpatient clinic and field outreach; Homeless or potential for, care provided to those with multiple acute/complex mental health conditions; use community mental health approach; conduct community outreach to homeless Veterans who have used the VA or other community agencies with goal to link to services;; adapt clinical social work skills to effectively meet functions assigned in a high-paced setting with multiple admission and discharges Duties: Provides high-risk triage psychosocial assessment, psychosocial assessment, psychosocial counseling, psychosocial education, resource information, and referrals; participate as a member of a multi-disciplinary team in discharge planning for Veterans hospitalized; care coordination for post-hospitalization follow-up and/or upon referral to outpatient team for assessment of care or case management. Based on the social worker state licensure, may also lead or co-lead short-term inpatient or outpatient psychosocial educational support groups or evidenced based practice techniques specific to an already identified clinical mental health or psychosocial diagnosis. High-risk triage assessment is utilized for unscheduled visits and consults. Initial, annual, or referral psychosocial assessment is completed as needed or required within the unit or program. Works with Veterans and their families experiencing a wide range of complicated medical, psychiatric, emotional, behavioral, and psychosocial problems. - As a member of a multidisciplinary team, assists in assessing the needs of Veterans assigned and document the social support services provided utilizing patient centered care approach to assure Veteran is involved in decisions regarding their healthcare. - Participates in collaborative treatment planning with the Veteran, family and the multi/interdisciplinary treatment team; prior to team meetings, reassess the Veterans current psychosocial situation, to include financial, residential status, coordinate any equipment needs and other needs that may affect discharge. - Provide high-risk psychosocial assessment in crisis intervention, seeking to address the cause as well as the presenting complaint; communicating with the consulting team, Veteran/family psychosocial resources available. Utilizes social work professional knowledge and experience as it relates to specialized Veteran medical and mental health diagnoses; disabilities and general treatment procedures. - Assess for and provide care or case management appropriate to the assessed level of care. - General knowledge of Veterans' benefits and services relating to special programs, service connected compensation, non-service connected pension. As consulted or requested, facilitates referrals based upon Veterans needs and eligibility. - Utilize the VA electronic medical record for documentation. - Utilize Event Capture code approved for social workers for inpatient care and uses Appointment Management/Encounters for outpatient clinics following the VA policies and processes for appointment scheduling. - Documentation: the social worker provides a clinical assessment that supports the Veterans current situation or need based on services rendered in the encounter. Documentation codes utilized include diagnosis relate to either previous mental health or psychosocial related; use discipline approved CPT codes. - Complete service and/or program specific documentation pertaining to caseload statistics and outcomes in program identified data bases. - Respond and complete consults assigned. - Completes VA specific clinical reminders within licensure level and social work scope of practice. - Comply with VA and VALB policies and procedures. - Knowledge and skill in the use of word-processing, data management and other computer systems (Outlook, CPRS), especially those programs in use by VA. Work Schedule: Multiple work schedules available. Full Time, 40 Hours a week. Exact work schedule to be discussed during the interview. Partial Telework schedule may be considered at the discretion of the manager. **This is not a Remote or Virtual position** Financial Disclosure 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.