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Summary The Patient Aligned Care Team (PACT) Social Worker 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 in this Veteran-centric approach often functions as a care coordinator with a panel of veterans to ensure that health care meets the needs, as defined by the Veteran. Responsibilities Clinical Functions: The incumbent: Must use a high level of skill in assessing and treating the complicated psychosocial problems of Veterans and their families/significant others. Social Work responsibilities include the assessment of psychosocial problems that cause distress, often impacting the health condition and creating barriers to care. Must complete thorough assessments to determine 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. Will help the patient and family to understand the contributing factors to the problem(s), will discuss with them the pros and cons of possible short-term and long-term solutions, encouraging them to make positive and lasting changes to reduce stressors. Will coordinate with VA staff and community agencies to assist in problem solving as needed. 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 and include liaison with community professionals regarding needed services for Veterans and/or their families. Services include but are not limited to interventions to increase access to care, including transportation assistance and advanced directives, economic assistance, including assistance with medical bills, financial aid services and strategies to increase income (employment, vocational rehabilitation, VA benefits, disability), and/or reduce expenses, find the appropriate housing for the patient's level of need (affordable independent housing, homeless shelters, group and family care homes, Veterans Homes, assisted living, nursing homes, respite care, hospice care) and order necessary services to assist with functional decline. Administrative Functions: The incumbent: Is 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 Is willing to serve on committees, work groups, and task forces at the facility as deemed appropriate by the supervisor and Chief of Social Work Services. Is mindful of keeping their supervisor apprised of problems and recommended solutions to problems encountered in the incumbent's area of responsibility Is responsible for furthering one's own professional growth through continuing education and for ensuring continuing education appropriate to the area of assignment. Is able to provide assistance with the orientation and learning of less experienced social workers and; if interested, to serve as a field instructor for graduate level social work students. Is able to demonstrate 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 VHA. Is able to maintain 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. Is willing to modify tour of duty as necessary to accommodate the needs of Veteran patients. The incumbent performs other related duties as assigned. Which may require covering other Social Work positions within the medical center. Work Schedule: 7:30am-4pm, M-F Telework: Not Available . Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job. Selective Service Registration is required for males born after 12/31/1959. Must be proficient in written and spoken English. You may be required to serve a probationary period. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Must pass pre-employment physical examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). Qualifications 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: You must 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 or Certification: You 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/. Exception. VHA may waive the licensure or certification requirement for persons who are otherwise qualified, pending completion of state prerequisites for licensure/certification examinations. This exception only applies at the GS-9 grade level. English Language Proficiency: Candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. § 7403(f). Grade Determinations: Social Worker, GS-9: Experience, Education, and Licensure. None beyond the basic requirements. Demonstrated Knowledge, Skills, and Abilities: In addition to meeting the basic requirements, to qualify for the GS-09, you must demonstrate all of the following KSAs: Ability to work with Veterans and family members from various socioeconomic, cultural, ethnic, educational, and other diversified backgrounds utilizing counseling skills. 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. 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. Ability to establish and maintain effective working relationships and communicate with clients, staff, and representatives of community agencies. 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. Social Worker, GS-11: Licensure Requirement: You must be licensed or certified by a state to independently practice social work at the master's degree level. AND Experience or Education Requirement: In addition to meeting basic requirements, to qualify for the GS-11, you must possess a minimum of one year of post-MSW experience equivalent to the GS-09 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. Examples of specialized experience include but are not limited to: Working under close supervision in program areas that do not require specialized knowledge or experience. Identifying behaviors or symptoms of abuse, neglect or exploitation; providing education on advance directives and advanced care planning; providing social work case management; acting as an patient/family member/caregiver advocate with community service providers/agencies; assessing the psychosocial functioning and needs of patients and their family members. In collaboration with the patient, family, and interdisciplinary treatment teams, identifying strengths, weaknesses, coping skills and psychosocial acuity. Maintaining a current network of internal and external resources to educate the patient and/or family members/caregivers and assist with appropriate referrals -OR- 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. AND Demonstrated Knowledge, Skills, and Abilities: In addition to the experience above, candidates must demonstrate all of the following KSAs: Knowledge of community resources, how to make appropriate referrals to community and other governmental agencies for services, and ability to coordinate services. 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. 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. 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. 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. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. 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: See VA Directive and Handbook 5019, Employee Occupational Health Services. Education Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/. Additional Information Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions. This job opportunity announcement may be used to fill additional vacancies. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.