The Post 9/11 Military2VA (M2VA) Social Work Case Manager provides comprehensive social work service primarily to Post 9/11 transitioning and established Service members and Veterans (SM/Vs) and their families across the continuum of care and during the various phases of readjustment to civilian life. The incumbent provides an array of social work interventions including: high-risk screening, psychosocial assessments, treatment planning, resource education and referral, and case management. Major Duties include, but are not limited to: Clinical Functions: Develops a high level of skill and expertise in the work with patients and families who are experiencing a wide range of complicated mental, emotional, behavioral, physical, psychosocial, and environmental problems. Develops knowledge of medical and mental health diagnoses (included but not limited to amputation, burns, vision loss, TBI, PTSD, and the Adjustment/Anxiety/Mood disorders, and other mental health diagnosis) as well as insight into the needs of and services required for individuals with these conditions and the skills to implement treatment modalities. Utilize appropriate assessment tools, clinical interviewing skills, and the DMS-V for diagnostic evaluations and treatment. Uses the social work process (psychosocial assessment, diagnosis, and treatment), with supervision, in collaboration with interdisciplinary team members to develop holistic case management care plan and appropriate psychosocial treatment interventions. Evaluates the need for mental health services and makes appropriate referrals for individual, group, couple, and family treatment services in concert with direct clinical supervision. Evaluates the need for mental health services and makes appropriate referrals for individual, group, marital and family treatment services. Must be sensitive to the ethnic and cultural diversity and age-specific challenges of the population and adjusts intervention and treatment plans as appropriate. As a member of the health care team, participates in developing, planning, implementing and evaluating and following up on the needs of SM/V. In addition, s/he maintains data entry within the Care Management Tracking Referral Application (CMTRA) system. Coordinates care with interdisciplinary team to promote continuity for Post 9/11 SM/Vs and their families. Researches, develops, maintains and uses appropriate community resources. Serves as an advocate for SM/Vs and their families, helping them access needed services at the facility, at other VA facilities, and in the community. Assists SM/Vs and their families with advance directives, guardianships, and applications for home care and extended care services. Travels may be required as part of providing social work care management services to SM/V's and their families. Conducts and/or participates in process improvement, outcomes management, research and/or program evaluation as appropriate. Seeks consultation and guidance routinely from the REC social work supervisor, LICSW prepared social work colleagues, and the POST 9/11 M2VA program manager. Performs other duties as assigned. Administrative Functions: Supports the mission, policies, and procedures of VA, the Veterans Health Administration (VHA), the appropriate Veterans Integrated Service Network (VISN), and the facility. May serve on committees, work groups, and task forces at the facility. Keeps supervisor apprised of problems and recommended solutions to problems encountered in the incumbent's area of responsibility. Attends and actively engages in clinical supervision, both group and individual. Adheres to professional education, appropriate to area of assignment, and provides coverage during social worker absences. Must maintain a level of productivity and quality consistent with facility and Social Work standards and the complexity of the assignment. Participates in interdisciplinary team meetings, appropriate facility meetings, and Social Work and program specific staff meetings. Shares knowledge and experiences gained from own clinical practice and education relevant to the field of Social work. Must comply with Equal Employment Opportunity (EEO) Program and safety policies and procedures. Work Schedule: Administrative Days Telework: Telework, if approved, will be on an Ad-Hoc basis only 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.