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Ontario Health atHome

Provincial coordinator of home and community care

Bilingual Care Coordinator

Full-TimeDeadline 10/4/27
CA$44.48 - CA$47.52
Mid
Bachelor's, Associate's
Ottawa, 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 with registration in the College of Physiotherapy of Ontario, or a degree or diploma in Occupational Therapy with registration in the College of Occupational Therapy of Ontario, or a degree in Social Work with registration in the Ontario College of Social Workers and Social Service Workers, or a degree in Speech Therapy with registration in the College of Audiologists and Speech-Language Pathologists of Ontario, or a degree in Foods and Nutrition or equivalent with registration in the College of Dietitians of Ontario.
  • At least two years of related professional experience.
  • Proof of COVID-19 vaccination status is required before the start date.
  • Fluency in English and French is required.
Responsibilities
  • Assess clients for admission and establish a helping relationship with eligible clients and their families while honoring client values and preferences.
  • Perform multidimensional assessments and identify the need for crisis intervention or prevention strategies.
  • Establish care and service plans that balance client needs, choices, and available resources; develop plans collaboratively with clients, health care professionals, care providers, or family, documenting priorities, authorized services, mutual goals, and anticipated service duration.
  • Collaborate and partner with service-provider networks.
  • Initiate and authorize implementation of care plans.
  • Review and maintain care plans in compliance with quality standards, outcome measures, and quality indicators.
  • Conduct the discharge-from-service process or redirect clients and families to alternative resources.
  • Assess clients, determine eligibility, coordinate admission, service planning and authorization, implement and monitor programs, reassess and adjust services, and plan discharges for home care and placement programs, including community resource information and referrals.
  • Work collaboratively with patients, families, caregivers, and hospital partners to develop care plans supporting safe transfers from hospital to home for complex and non-complex patients.
  • Prioritize work according to changing patient and hospital needs while meeting Ontario Health atHome Champlain Guidelines of Care.
  • Participate in family meetings, care conferences, bullet rounds, and joint discharge rounds to support care planning and communication with partners in the circle of care.
Desired Qualifications
  • Knowledge of health care delivery systems and community resources within the Champlain region.
  • Knowledge of medical conditions and cognitive or psychiatric disorders.
  • Knowledge of a client-centered, multidisciplinary approach to client care.
  • Proficiency using computerized processes, including mobile laptop technology.
  • Effective time management and organizational skills.
  • Effective decision-making and problem-solving in crisis situations.
  • Ability to negotiate and implement an effective goal-oriented, client-centered care plan.
  • Ability to organize daily workload amid frequent interruptions.
  • Vulnerable Sector Check completed within the last six months.
  • Valid N95 mask fit test results or documentation of a medical exception from within the past two years.

About the company

Ontario Health atHome coordinates in-home and community-based care for patients across Ontario and manages access to long-term care home placement. Its teams assess care needs, arrange services, and connect patients and caregivers with nursing, personal support, rehabilitation, and other community resources. The organization works with hospitals, primary care providers, Ontario Health Teams, and contracted service providers to plan care and support transitions between settings. It also helps people find health and social services, navigate supportive living options, and receive palliative care in their chosen setting. The agency was formed in June 2024 by amalgamating the fourteen Home and Community Care Support Services organizations.

Company Size

5,001-10,000

Company Stage

N/A

Total Funding

N/A

Headquarters

N/A

Founded

2024

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