Leslie Roberts

Independently completed comprehensive psychosocial assessments to determine emotional, physical, and mental health needs of patients and families Actively collaborated with the interdisciplinary team in the treatment planning process Acted as liaison between the Cleveland Clinic and community resources

Clinical Social Worker at Cleveland Clinic Foundation (2026-03 – 2026-05)

• Independently completed comprehensive psychosocial assessments to determine emotional, physical, and mental health needs of patients and families
• Actively collaborated with the interdisciplinary team in the treatment planning process
• Acted as liaison between the Cleveland Clinic and community resources
• Provided case management to ensure continuity of care in a timely and appropriate manner
• Provided crisis intervention and counseling for patients and families relating to terminal and/or critical illness and treatment

NON-INSTITUTIONAL CARE COORDINATOR at Hershel Woody Williams VA Medical Center (2023-07 – 2025-11)

• Provided administrative, technical, and educational consultation necessary for accomplishing the work of the program, including education to VA staff, and outreach efforts to community partners
• Responsible for the development, evaluation, and communication of standards, policies, and procedures to the interdisciplinary health care teams who serve as primary referral sources for the programs
• Attended and/or participated in a variety of monthly and quarterly conference calls disseminating needed information to the VA staff and community agency staff as warranted
• Prepared any necessary reports such as JPSR (patient safety reports), Issue Briefs, and assist with Congressional response regarding their assigned programs
• Developed and implements systems to track a current list of active patients, service activities, dates of authorizations, utilization of services, and patient satisfaction
• Developed plans of correction for the programs to address program deficiencies
• Responsible for GEC program reports on assigned programs to local management, VISN and VACO - evaluates programs progress, outcomes, and utilizes data to continuously modify and improve the program and processes
• Served on related committees, or workgroups as assigned to represent assigned programs and facilitate collaboration with other stake holders
• Performed clinical functions as required by program policy to include assessment, providing direct clinical services to program enrollees, and communication with family, caregivers, and contracted agencies staff to address and resolve patient concerns
• Ensured that enrollees in these programs meet administrative and clinical eligibility requirements and are receiving the appropriate level of services to meet their needs in accordance with program mandates
• Engaged in continuous quality improvement of assigned programs
• Provided support and assistance to other NIC Social Work staff to address and assist in program workload as needed
• Created Performance Improvement Plans to address inefficiencies with program delivery with strategic target dates and interventions
• Performed as task supervisor facilitator for the student intern program with guidance using CSWE guidelines

LEAD INPATIENT SOCIAL WORKER at Hershel Woody Williams VA Medical Center (2020-07 – 2023-07)

• Independently complete comprehensive psychosocial assessments to determine discharge needs of Veterans and family members in the general medicine population
• Actively collaborate with the interdisciplinary team in the treatment planning process
• Acted as liaison between VA and community resources
• Provided case management to ensure continuity of care from admission to discharge in a timely and appropriate manner
• Provided crisis intervention and counseling for patients and families relating to acute critical illness and hospitalization
• Provided advance directives and organ donation education, as well as completion of appropriate forms/documents
• Assisted patients and/or families/significant others with coping and dealing with the loss and grief experiences in disability, terminal illness, and death
• Assisted patients and/or families/significant others with end-of-life decision making, including goals of care, palliative care, and hospice services
• Acted as consultant to other staff members regarding psychosocial needs of Veterans and the impact of psychosocial issues, mental health disorders, and cultural norms upon compliance with treatment plans
• Facilitated referrals to appropriate programs/agencies based upon needs and eligibility, including palliative care and hospice in accordance with VA guidelines
• Maintained appropriate documentation in CPRS according to VA guidelines and Joint Commission standards

INTERNAL BEHAVIORAL HEALTH CONSULTANT at Blanchfield Army Community Hospital (2016-12 – 2020-07)

• Screened and interviewed patients, and performed bio-psychosocial evaluations
• Performed routine case management functions, including telephonic monitor of symptom severity, adherence to primary care treatment plans, etc.
• Formulate behavioral health interventions appropriate to a primary care setting, and assisting with implementation monitoring of treatment plans
• Provided focused follow ups, including relapse prevention education
• Used objective and measurable outcomes to evaluate treatment effectiveness
• Acted as a primary care team member to develop specific clinical pathways or best practice programs for targeted patient groups, i.e., those with acute stress symptoms and PTSD
• Developed, taught, and provided oversight for classes that promote education and skill-building to enhance psychological and physical health, including but not limited to sleep hygiene, tobacco cessation
• Provided timely and succinct feedback to PCMs regarding consultation findings and recommendations
• Evaluated training opportunities and professional development activities
• Provided concise documentation of care and recommendations in patient's medical record

CLINICAL SOCIAL WORKER at Durham VA Medical Center (2013-04 – 2016-12)

• Independently completed comprehensive psychosocial assessments to determine discharge needs of Veterans and family members in the Medical Intensive Care and Cardiac Intensive Care Units, as well as the general medicine population
• Actively collaborated with the interdisciplinary team in the treatment planning process
• Educated the MICU residents and attending physicians about the palliative care initiative, as well as appropriate referrals and inclusion of the palliative care team in patient goals of care discussions/decisions
• Acted as liaison between VA and community resources
• Provided case management to ensure continuity of care from admission to discharge in a timely and appropriate manner
• Provided crisis intervention and counseling for patients and families relating to acute critical illness and hospitalization
• Provided advance directives and organ donation education, as well as completion of appropriate forms/documents
• Assisted patients and/or families/significant others with coping and dealing with the loss and grief experiences in disability, terminal illness and death
• Assisted patients and/or families/significant others with end-of-life decision making, including goals of care, palliative care, and hospice services
• Initiated family meetings to further discuss goals of care in hopes of improving BFS scores within the Durham VA Medical Center
• Acted as consultant to other staff members regarding psychosocial needs of Veterans and the impact of psychosocial issues, mental health disorders, and cultural norms upon compliance with treatment plans
• Assisted in coordination of family conferences to include appropriate members of the interdisciplinary team
• Facilitated referrals to appropriate programs/agencies based upon needs and eligibility, including palliative care and hospice in accordance with VA guidelines
• Maintained appropriate documentation in CPRS according to VA guidelines and Joint Commission standards
• Participated as a member of the Professional Development Committee for the social work services section
• Served as mentor to new employees and act as consultant to develop appropriate discharge plans for highly complex patients or situations that require special needs, as well as case management strategies for specific cases
• Periodically performed supervisory tasks/duties with a team of 10+ employees in absence of supervisor

CLINICAL SOCIAL WORKER at US Army Winn Army Community Hospital (2010-09 – 2013-03)

• Interviewed Soldiers and/or families and conducted comprehensive individual and/or family bio-psychosocial assessments and treatments such as crisis intervention, medical psychotherapeutic intervention, marriage and family therapy, or group therapy
• Assessed and screened Soldiers on an ongoing basis for suicidal and homicidal risks, then determined risk level for monitoring
• Formulated behavioral health interventions to assist with treatment plan development
• Utilized base knowledge of human physical, psychological, and emotional development and understanding of medical and mental health diagnoses on a regular basis for development of appropriate treatment plans
• Managed identified risks and initiated specialty evaluations, i.e., ASAP, FAP, SWS, BH, inpatient or residential treatment facilities
• Used on a regular basis the DSM-IV and ICD-9M criteria for diagnosing patients and developing treatment plans
• Utilized evidence-based treatment modalities (CBT, PE, CPT) to conduct individual and group therapies, as indicated, for anxiety, depression, PTSD