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Ontario Health atHome

Coordinated home and community healthcare

Care Coordinator

Full-TimeDeadline 10/4/27
CA$44.48 - CA$47.52
Mid
Bachelor's, Associate's
Cornwall, ON, Canada
In Person
Medical, Clinical & Veterinary

About the job

Requirements
  • Registered Nurse with a Bachelor of Science in Nursing or diploma, and registration with the College of Nurses of Ontario; or a degree or diploma in Physiotherapy and registration with the College of Physiotherapy of Ontario; or a degree or diploma in Occupational Therapy and registration with the College of Occupational Therapy of Ontario; or a degree in Social Work and registration with the Ontario College of Social Workers and Social Service Workers; or a degree in Speech Therapy and registration with the College of Audiologists and Speech-Language Pathologists of Ontario; or a degree in Foods and Nutrition or equivalent and registration with the College of Dietitians of Ontario.
  • Related professional experience, normally attained over a period of two years; community-based experience is preferred.
  • Proof of COVID-19 vaccination status must be submitted before the start date as a condition of employment.
  • Work effectively with diverse patient groups with varying levels of comprehension and language capability.
  • Manage difficult conversations and situations, such as advance care planning and goals of care, in a healthy and effective manner.
  • Work effectively in a team environment and independently as required.
  • Use verbal and written communication skills to establish working relationships and maintain partnerships within the healthcare community.
  • Use listening and facilitation skills to work with patients and caregivers.
  • Use diplomacy when dealing with sensitive or confidential issues.
  • Build relationships to develop and maintain health and community stakeholder partnerships.
  • Have working knowledge of email, internet, and Microsoft Office applications, including Word and Outlook.
  • Have a valid driver’s license and access to a vehicle.
  • Fluency in English and French is an asset.
  • Complete a Vulnerable Sector Check within the last six months.
Responsibilities
  • Complete comprehensive patient assessments using a validated assessment tool, including the patient’s clinical, physical, and psychosocial needs and caregiver needs.
  • Assess the patient’s and caregiver’s understanding of, and learning needs related to, diagnosis, treatment, available resources, illness adjustment, and coping mechanisms.
  • Assist the patient and caregiver in setting appropriate individual, joint, short-term, or long-term goals.
  • Collaborate with the patient, caregiver, and care team to develop an individualized care and service plan that reflects the patient’s priorities and desired outcomes, and identify strategies and resources to achieve clinical outcomes.
  • Coordinate the delivery of home and community care services to patients and caregivers.
  • Coordinate vendor and resource utilization involving medical equipment, supplies, and services.
  • Facilitate understanding and cooperation among members of the patient’s multidisciplinary healthcare team, and communicate with team members to maximize patient outcomes.
  • Initiate and authorize implementation of the care plan through contracted providers.
  • Provide regular reports to physicians, service providers, patients, caregivers, and other authorized parties as required.
  • Document cases in accordance with Ontario Health atHome Champlain policies.
Desired Qualifications
  • Community-based experience.
  • Work with diverse patient groups with varying levels of comprehension and language capability.
  • Manage difficult conversations and situations such as advance care planning and goals of care effectively.
  • Work effectively both in a team environment and independently.
  • Use verbal and written communication skills to establish working relationships and maintain partners within the healthcare community.
  • Use listening and facilitation skills to work with patients and caregivers.
  • Use diplomacy when dealing with sensitive or confidential issues.
  • Build relationships to develop and maintain health and community stakeholder partnerships.
  • Have working knowledge of email, internet, and Microsoft Office applications, including Word and Outlook.
  • Fluency in English and French.

About the company

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Ontario Health atHome

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Ontario Health atHome coordinates publicly funded home and community care for patients across Ontario. Its care coordinators assess needs, arrange services and connect people with nursing, therapy, personal support and other resources delivered outside hospitals. The organization also helps patients and families navigate transitions between hospital, home and community settings. Operating within Ontario’s public health system, it manages access and coordination rather than functioning as a private home-care franchise or a single clinical provider. Service delivery depends on clinical, operational and administrative teams working across its care settings.

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