Social Worker Job at U.S. Department of Veterans Affairs in Garner

Overview

Patient Aligned Care Team (PACT) Social Worker provides clinical psychosocial services to eligible Veterans assigned to Primary Care Patient Aligned Care Teams. As a member of an interdisciplinary treatment team, the incumbent maintains knowledge of the PACT team approach and the role of each health and allied health care team member, as well as an understanding of the role of the social worker per local and/or national policy and directives.

Responsibilities

• The Social Worker collaborates with Veterans, their family/caregivers, and interdisciplinary teams to create patient-centered treatment goals or plans.
• Links the Veteran with services, resources, and opportunities to maximize independence, health, and wellbeing, including interventions to increase access to care (e.g., transportation assistance and advance directives).
• Provides economic assistance, including help with medical bills and financial aid services; implements strategies to increase income and/or reduce expenses (employment, vocational rehabilitation, VA benefits, disability benefits, Medicaid linkage).
• Aids in finding appropriate housing for the patient’s level of need (e.g., affordable independent housing, homeless shelters, group and family care homes, Veterans Homes, assisted living, nursing homes, respite care, hospice).
• Provides support for caregiver burnout by linking to resources.
• Serves as a liaison between Veterans and/or their families and VA and community resources to ensure thorough delivery of services.
• Manages referrals typically originating from any member of the interdisciplinary team, from Veterans and/or their families who call or walk in for assistance, and from community professionals.
• Assesses health care and psychosocial problems and needs, including medical, behavioral health, financial, legal, and psychosocial factors.

Functions or scope of assigned duties

Included but not limited to the items above.

Requirements