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    The Social Worker, Patient Aligned Care Team (PACT), positions are within Social Work Services for VA Roseburg Health Care System located in North Bend, Oregon.

    The Social Worker, Patient Aligned Care Team (PACT), provides psychosocial assessments, treatment/service planning, service delivery/interventions, and case management to Veterans needing Mental Health treatment.

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    The Social Worker is assigned to Veterans in the PACT setting. The incumbent must use a high level of skill in assessing, completion of treatment or service planning, service delivery/interventions and case managing complicated psychosocial problems experienced by Veterans. Social work responsibilities include the assessment of psychosocial problems often at a time when the Veteran is experiencing crisis and include the provision of short-term, solution focused goal planning and case management with Veterans and/or their families. Referrals typically originate from members of the interdisciplinary team, from Veterans and/or their families presenting as walk-ins to seek assistance, and from community professionals. The incumbent must complete thorough assessments to determine the presenting problem, to determine in-home factors impacting the problem, and to determine obstacles to treatment and/or follow through with recommended treatments. Case management with members of the outpatient interdisciplinary team is provided in order to coordinate a collaborative effort to meet the agreed upon goals for a Veteran's treatment needs. Services include, but are not limited to, homelessness, hospice services, nursing home care, home health services, financial resources, VA benefits, and transportation services.

    Duties include, but are not limited to the following:

    1. Establishes and maintains effective therapeutic relationships with Veterans and/or their families in the PACT setting.
    2. Independently completes thorough psychosocial assessments to determine the psychosocial functioning and needs of Veterans and/or their families.
    3. Participates as a member of the interdisciplinary treatment team and collaborate with Veterans and Veteran family members to development and implement treatment/service plans and interventions.
    4. Working knowledge and experience in use of medical and mental health diagnoses, disabilities, and treatment procedures.
    5. Facilitates action for community referrals/placements through collaboration with Veterans, Veteran families, and interdisciplinary treatment team members to ensure that appropriate community placements are completed in a timely manner.
    6. Serves as an advocate and liaison between Veterans and/or their families and VA and community resources in order to ensure thorough delivery of services.
    7. Knowledge and ability to independently implement treatment goal planning, provide educational classes, and/or supportive groups for Veterans and families.
    8. Provides consultation and education to Veterans and their families regarding community resources, VA benefits and specialty programs, and advance directives. This includes the incumbent's knowledge of the process for accessing and/or coordinating community-based services, including information and referral for additional services from other VA programs, other government programs, and community programs.
    9. Provides consultation to other treatment team and staff members regarding psychosocial needs of Veterans and/or their families and the impact of the identified psychosocial problems on the Veteran's health care planning and compliance with treatment.
    10. Knowledge of Veteran's benefits and services, community resources, and process for making appropriate referrals to community and other governmental programs or agencies.
    11. Skills and knowledge to provide case management services to Veterans and their families throughout the continuum of care. The incumbent will be able to appropriately utilize principles of human growth and development over the life span and will be able to assist Veterans in coping with the loss and grief experiences from disability and terminal illness.
    12. Demonstrates ability to communicate effectively, both orally and in writing, with people from varied backgrounds.
    13. Responsible for supporting the mission, policies, and procedures of the Department of Veterans Affairs, the Veterans Health Administration (VHA), the appropriate Veterans Integrated Service Network (VISN), and the facility.
    14. Serves on committees, work groups, and task forces at the facility as deemed appropriate by the supervisor and Chief of Social Work Services.
    15. Keeps their supervisor apprised of problems and recommended solutions to problems encountered in the incumbent's area of responsibility.
    16. Provides assistance with the orientation and learning of less experienced social workers.
    17. Demonstrates knowledge and skill in the use of software applications for drafting documents and data management as well as other computer systems in use by the Veterans Health Administration.
    18. Maintains a level of productivity and quality consistent with the complexity of the assignment and consistent with social work standards, Joint Commission standards, and facility standards.

    Work Schedule: Monday - Friday, 8am to 4:30pm; (Possible on-call and weekend rotation)
    Financial Disclosure Report: Not required

    Travel Required

    25% or less - You may be expected to travel for this position.

    Supervisory status


    Promotion Potential


This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/GetJob/ViewDetails/580045200. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.