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Social Worker, Primary Care & Whole Health Coordinator - External

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Veterans Affairs, Veterans Health AdministrationBrockton, MA
  • Veterans Affairs, Veterans Health Administration.
  • Work Schedule is Full Time - Permanent.
  • Opened Friday 12/23/2016 (1 day(s) ago)
  • Closes Tuesday 1/17/2017 (24 day(s) away)
  • As a VA professional, your opportunities are endless.
  • With many openings in the multiple functions of VA, you will have a wide range of opportunities and leadership positions at your fingertips.
  • Not only is it the largest, most technologically advanced integrated health care system in the Nation, but we also provide many other services to Veterans through the Benefits Administration and National Cemeteries.
  • VA professionals feel good about their careers and their ability to balance work and home life.
  • VA offers generous paid time off and a variety of predictable and flexible scheduling opportunities.
  • Incumbent will serve as the PACT (Patient Aligned Care Team) Primary Care Social Worker.
  • The role of the social worker case manager in the PACT is to assess and treat psychosocial and environmental factors that impact the patient's ability to achieve maximum health and wellness.
  • Social work case managers assess the patient's psychological and emotional adjustment to illness within the context of medical diagnosis, prognosis, and treatment options.
  • An assessment of environmental factors includes a review of the dynamics of the patient's support system, functional status, vocational, economic, housing, spiritual, cultural and legal factors that influence their ability to adhere to medical recommendations and management of self.
  • The social worker assesses the underlying factors that contribute to the presenting concerns and develops interventions designed to promote lasting positive change to decrease stress, promote health and wellness and remove barriers to care.
  • Psychosocial treatment options are reviewed with the patient, family and PACT team.
  • A treatment plan based on the patient's identified concerns and goals is established.
  • Patients are given supportive assistance and referrals to appropriate resources to lessen the acuity of psychosocial stressors.
  • These stressors can include adjustment to the current medical condition, untreated or under-treated mental health or substance abuse condition, economic instability, legal problems, and inadequate housing and transportation.
  • The social worker 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.
  • The social worker will severe as a liaison with community professionals regarding coordination of services for veterans and/or their families.
  • Services include, but are not limited to, interventions to increase access to care, transportation assistance, advance directives, economic assistance, including assistance with medical bills, financial aid services, and strategies to increase income.
  • This is done through employment resources, vocational rehabilitation, referral to VA Benefits and disability.
  • The incumbent will also work with the veteran and family to reduce expenses and find the level of housing which is most appropriate to the veteran's medical and financial needs.
  • This includes referrals to, independent housing, homeless shelters, group and family care homes, Veterans Homes, CRC homes, assisted living, nursing homes, respite care, hospice care, and other necessary services to assist with functional decline.
  • The incumbent will serve as a Whole Health Coordinator for VA Boston.
  • The Whole Health Coordinator will work with veterans to create unique and personalized health plans built upon the veteran's goals, beliefs, medical conditions and life circumstances.
  • The social worker will collaborate with Veterans to find proactive opportunities that support the innate healing response through nutrition, stress management, movement and mindful awareness.
  • The clinician will support the veteran by providing them with the appropriate skillset to manage their chronic medical conditions and to maintain optimal health.
  • The coordinator will work with veterans and families through

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