The incumbent is assigned to the Albuquerque Geriatric PACT Clinic. This positions requires advance practice specialized experience in managing a high complexity and acuity of needs of this population and their caregivers. The Patient Aligned Care Team (PACT) 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. Basic Requirements: Citizenship: Citizen of the United States. Licensure: Candidate must be licensed or certified by a state at the advanced practice level which included an advanced generalist or clinical examination, unless they are grandfathered by the state in which they are licensed to practice at the advanced practice level (except for licenses issued in California, which administers its own clinical examination for advanced practice) and they must be able to provide supervision for licensure. Education: Master's degree in social work (MSW) 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 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 master's degree in social work. Grade Determinations:GS-12 Senior Social Worker Experience: In addition to the basic requirements, applicants must have at least two years of experience post advanced practice clinical licensure and should be in a specialized area of social work practice of which, one year must be equivalent to the GS-11 grade level. In addition to the experience above, candidates must demonstrate all of the following KSAs: Skill in a range of specialized interventions and treatment modalities used in specialty treatment programs or with special patient populations. This includes individual, group, and/or family counseling or psychotherapy and advanced level psychosocial and/or case management. Ability to incorporate complex multiple causation in differential diagnosis and treatment within approved clinical privileges or scope of practice. Knowledge in developing and implementing methods for measuring effectiveness of social work practice and services in the specialty area, utilizing outcome evaluations to improve treatment services and to design system changes. Ability to provide specialized consultation to colleagues and students on the psychosocial treatment of patients in the service delivery area, as well as role modeling effective social work practice skills. Ability to expand clinical knowledge in the social work profession, and to write policies, procedures, and/or practice guidelines pertaining to the service delivery area. Assignments. Senior social workers are licensed or certified to independently practice social work at an advanced level. Senior social workers typically practice in a major program area such as but not limited to: Polytrauma Rehabilitation Center or Polytrauma Network Site; a Spinal Cord Injury Rehabilitation Center, or a national VHA referral center, such as a national Center for Post-Traumatic Stress Disorder or a national Transplant Center, or other program areas of equivalent scope and complexity. The senior social worker may be assigned administrative responsibility for clinical program development and is accountable for clinical program effectiveness and modification of service patterns. Assignments include clinical settings where they have limited access to onsite supervision such as CBOCs or satellite outpatient clinics. The senior social worker collaborates with the other members of the treatment team in the provision of comprehensive health care services to Veterans, ensures equity of access, service, and benefits to this population, ensures the care provided is of the highest quality. The senior social worker provides leadership, direction, orientation, coaching, in-service training, staff development, and continuing education programs for assigned social work staff. They serve on committees, work groups, and task forces at the facility, VISN and national level, or in the community as deemed appropriate by the supervisor, Social Work Executive or Chief of Social Work Services. This assignment is to be relatively few in number based on the size of the facility/service and applying sound position management. References: VA Handbook 5005, Part II, Appendix G39 - Social Worker Qualification Standard. Physical Requirements: Light lifting and carrying (up to 15 pounds); reaching above shoulder; use of fingers; both hands required, walking/standing (up to 6 hours); kneeling (up to half an hour); repeated bending (up to .25 hours); climbing, legs only (up to 1 hour); both legs required, ability for rapid mental and muscular coordination simultaneously; near vision correctable in one eye at 13' to 16' to Jaeger 1 to 4; far vision correctable in one eye to 20/20 and to 20/40 in the other; both eyes required, depth perception, ability to distinguish basic and shades of colors; hearing (aid permitted); mental and emotional stability; cognitive stability. ["Duties include but not limited to the following: Provides services on an inpatient and outpatient basis. Establishes and maintain effective therapeutic relationships with Veterans in the Primary Care Clinic and/or their families. Works with Veterans and their families who are experiencing a wide range of complicated medical, psychiatric, emotional, behavioral, financial, legal and psychosocial problems. Effective social work in the Patient Aligned Care Team context often occurs over a series of several visits. Independently complete thorough psychosocial assessments to determine the psychosocial functioning and needs of Veterans and/or their families. Utilizes assessment in facilitating the Veteran's maximum use of treatment for attainment of the highest level of independence that is possible and practicable. Participates as a member of the interdisciplinary treatment team and actively participate through collaboration with Veterans and family as well as interdisciplinary treatment team members in the development and implementation of treatment goals and interventions. Experience in use of medical and mental health diagnoses, disabilities, and treatment procedures, including acute, chronic and traumatic illnesses, substance abuse disorders, common medications and their effects/side effects, and medical terminology. Facilitates action for community placements through collaboration with Veterans and their families as well as interdisciplinary treatment team members to ensure that appropriate community placements are completed in a timely manner. Community placements can involve but are not limited to referrals to group and family care homes, assisted living facilities, adult day health care programs, contract nursing homes, Community Living Centers, residential care homes, inpatient and outpatient hospice services. Serves as a liaison between Veterans and/or their families and VA and community resources in order to ensure thorough delivery of services. Works independently to implement treatment modalities, provide educational classes, and/or supportive groups for Veterans and families, including shared medical appointments. Teaches Veterans in the effective use of the My HealtheVet (MHV) system. Utilizes computer systems, especially the internet for Veterans who choose this modality to communicate with the team. Provides consultation and education to Veterans and their families regarding community resources, VA benefits and specialty programs, and advance directives. This includes the incumbent's knowledge of the process for accessing and/or coordinating community-based services, including information and referral for additional services from other VA programs, other government programs, and community programs. Offers consultation to colleagues and students on the psychosocial treatment of patients treated in specialty areas, rendering professional opinions based on experience and expertise and role modeling effective social work practice skills. Demonstrates the ability to teach and mentor staff and students in the special area of practice and to provide supervision for licensure or specialty certifications. Develops and implements methods for measuring effectiveness of social work practice and services in specialty areas, utilizing outcome evaluations to improve treatment services. Knowledgable of Veteran's benefits and services, community resources, and process for making appropriate referrals to community and other governmental programs or agencies. Provides case management services to Veterans and their families throughout the continuum of care. Utilize principles of human growth and development over the life span and will be able to assist Veterans in coping with the loss and grief experiences from disability and terminal illness. Acts as \"lead\" social worker for any other PACT Social Workers in their section. Demonstrates ability to communicate effectively, both orally and in writing with people from varied backgrounds. Supports the mission, policies, and procedures of the Department of Veterans Affairs, the Veterans Health Administration (VHA), Veterans Integrated Service Network (VISN) 22, and New Mexico VA Health Care System. Serves on committees, work groups, and task forces at the facility as deemed appropriate by the supervisor and Chief of Social Work Services. Continues professional growth through education. Provides 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 and/or provide clinical supervision for licensure. Work Schedule: Full-time, Monday-Friday 8:00 am - 4:30 pm\nCompressed/Flexible: Not Available\nTelework: Not Available\nVirtual: This is not a virtual position.\nFunctional Statement #: Social Worker / 000000\nRelocation/Recruitment Incentives: Not Authorized\nFinancial Disclosure Report: Not required"]