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Summary As an integral member of the Primary Care Patient Aligned Team (PACT), and serving our Veterans -- ongoing therapeutic interventions, will work with Veterans, spouses, significant others, and adult children in the care planning and treatment process to assist in finding practical solutions to complex problems and life management issues associated with acute and chronic illnesses. Responsibilities Duties include, but not limited to the following: Screening and Assessment: The incumbent independently conducts psychosocial assessments, within program prescribed timeframes, to include the Veteran's strengths, limitations, internal/external supports, and service needs in order to optimize the Veteran's functional status and safely maintain the Veteran in their preferred living situation. Develops and implements realistic and achievable psychosocial treatment plans and goals as part of the PACT treatment plans reflecting effective utilization of a broad range of treatment modalities and interventions. Further possesses the skills to measure outcomes of provided psychosocial interventions. The incumbent applies a working knowledge and experience in use of medical and mental health diagnoses, disabilities and treatment procedures for acute, chronic, and traumatic illness/injuries, common medications including their effects and side effects, non-pharmacological pain interventions, stress management, and, medical terminology. Applies knowledge of social determinants of health to the assessment of need and risk. Treatment Planning: The incumbent develops achievable Veteran centric care/treatment plans and discharge plans (when indicated) in collaboration with the interdisciplinary treatment team, the Veteran, and family members/significant others. Addresses the unique needs of the Veteran including, homebound, frail, disabling/chronic conditions, end of life needs, and food insecurity. The incumbent is responsible for educating the Veteran and/or caregiver of the availability of services and assist them in accessing appropriate/preferred resources. Ongoing assessments and updating of treatment plans will occur at prescribed intervals or as clinically indicated. Resource/Referral Development: The incumbent serves as the subject matter expert on VA and community resources, collaborating with other services providers. Applies their general knowledge of Veterans' benefits and services related to special programs, service connection compensation, and non-service connected pension to assist with application processes and referrals. The incumbent develops a resource file of VA and community resources and collaborates with other VA social workers to keep the file comprehensive and current. Crisis Intervention: The incumbent provides crisis intervention services, seeking to address causation as well as presenting complaints. Makes rapid assessments and develop crisis management plans to return Veterans to a state of homeostasis including maintaining Veteran in the home, admission to acute, psychiatric, or short term/long term placements. The incumbent establishes and maintains effective therapeutic relationships with Veterans and their families. Education/Health Promotion and Prevention: The incumbent provides education related to VA and community resources, entitlements, and care/end of life planning. Counsels Veterans regarding advance directives/living wills. The incumbent participates in facility outreach activities in order to disseminate needed information to Veterans, VA staff, and community agencies to strengthen service linkages. Advocacy: The incumbent delivers service from a Veteran-centric perspective. Acts as an advocate on behalf of the Veteran when it serves the best interest of the Veteran/family. When appropriate and feasible, the incumbent educates and encourages the Veteran/family to advocate on their own behalf in order to promote a sense of independence and empowerment. Administrative Duties: The incumbent aspires to follow and promote the VA Core Values of Integrity, Commitment, Advocacy, Respect, and Excellence (I CARE). Responsible for planning and carrying out the assignment, resolving most conflicts that arise, coordinating and communicating with others as necessary and interpreting policies to accomplish their work. The incumbent independently organizes work, sets priorities, meets multiple deadlines and evaluates assigned program areas. Knowledge of PACT programs and the ability to compose standard operating procedures and practice guidelines. The incumbent correctly utilizes the computerized patient electronic record (CPRS) to capture care activities and productivity workload. Work Schedule: 8:00am to 4:30pm, Monday thru Friday Virtual: This is not a virtual position. EDRP: Not Authorized Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized 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. 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. 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. 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. 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-11 Level 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. 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. References: VA Handbook 5005, Part II, Appendix G-39The 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-11. Physical Requirements: The work requires sitting, bending, stooping and walking consistent with the delivery of services in the office, hospital and community. The position may entail lifting of no more than 25 pounds on an occasional basis. Whenever possible, carts and dollies will be utilized as an alternative to lifting. In carrying out responsibilities, operation of a motor vehicle with a valid driver's license is required. The social worker must meet the requirements to use a government vehicle in accordance with VHA directive 2008-020. It will be necessary for the social worker to travel throughout the Wilkes-Barre VAMC catchment area where they conduct interviews with Veterans, family members, representatives of community health, welfare and law enforcement agencies. Education IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on 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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html. 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.