The Community Nursing Home (CNH) Social Worker provides oversight, care coordination, and discharge/disposition planning for Community Nursing Home Veterans. Reviews and assists referrals to CNH facilities and performs follow-up and oversight visits after admission to the CNH to ensure adequate and safe care is being provided. Advocates for holistic care through education and provider interaction and implements an educational plan to meet the patient care needs.
Total Rewards of a Allied Health Professional Duties and skills needed to be successful in this position include, but are not limited to: The incumbent independently coordinates high-risk patients and provides care management services to Veterans and families. The incumbent participates in the admission screening process and assists in coordinating the admission. The incumbent establishes and maintains effective therapeutic relationships with patients and their families.
The incumbent independently works with patients and families who are experiencing a variety of psychiatric, medical, and social problems utilizing individual, group and family counseling and therapy skills. The incumbent conducts psychosocial assessments to determine the needs of Veterans and family members. The incumbent possesses the skills to offer psychosocial interventions and measure outcome to interventions.
The incumbent coordinates community-based services, including information and referral for additional services from other VA government, and community agency programs. The incumbent assists with discharge planning from the Community Nursing Home and coordinates with the nursing home, PACT and/or specialty programs to ensure continuity of care.
The incumbent independently provides consultation services to other staff regarding the psychosocial needs of Veterans and the impact of psychosocial problem on health care and adherence to treatment plans. The incumbent evaluates their own practice through professional peer review, case conference and other organization means. The incumbent communicates effectively both orally and in writing with people from varied backgrounds.
The incumbent develops an assessment of the Veteran in collaboration with interdisciplinary treatment teams, the Veteran, family members and significant others, whenever possible. The incumbent meets the needs of customers while supporting VA missions. The incumbent handles conflict and problems in dealing with consumer constructively and appropriately.
The incumbent utilizes word processing, data management, email, CPRS and other computer systems, especially those programs in use by VHA. The incumbent documents all efforts in the electronic medical record in a professional and timely fashion. The incumbent will participate in committee assignments as deemed necessary by the service manager.
The incumbent is responsible for assuring that monthly follow-up visits to Veterans in the CNHs are completed and documented utilizing CPRS and ensure appropriate hand off when transferring of patient care, as required by the program. The incumbent is responsible for providing input to the CNH Coordinator and/or Supervisor to assist in assuring that Quality Assurance monitors related to these programs are completed and reported to the CNH Oversight committee.
The incumbent is involved in the annual inspection of the nursing homes with lead support provided by the CNH Coordinator and/or Supervisor. Incumbent must possess and maintain a current, valid, and unrestricted state drivers license in order to operate a government owned vehicle. The incumbent performs other duties as assigned.
Work Schedule: Monday-Friday, 7:30am-4:00pm Recruitment Incentive (Sign-on Bonus): Not Authorized Permanent Change of Station (Relocation Assistance): Not Authorized Pay: Competitive salary and regular salary increases when setting pay, a higher step rate of the appropriate grade may be determined after consideration of higher or unique qualifications or special needs of the VA (Above Minimum Rate of the Grade).
Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Selected applicants may qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience. Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child.
Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66.
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Telework: Ad-Hoc Virtual: This is not a virtual position. Functional Statement #: 56782-A,56783-A Permanent Change of Station (PCS): Not Authorized
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: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.
V19USAJOBS@VA.GOV · 719-227-4600
This position is with Veterans Health Administration, Department of Veterans Affairs.
The posted pay range is $73317 – $73317/yr.
This position is eligible for telework.
Applications close on 2026-09-25.
This position is open under the 'Fed Competitive' hiring path.
Source: USAJOBS.gov — U.S. Federal Government
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