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Hospital to Home (H2H) Coordinator
- Brantford, ON, Canada
Full-time
This opening has closed.
The original listing is kept below for reference.
Job details
- Job type
- Full-time
- Closing date
- Posting language
- English
- Posted
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Archived listing. The details below describe a past opening.
At BCHS, we are driven by a bold vision: To Lead Beyond Care. As a two-site community hospital system in Brantford and Paris, Ontario, we serve with purpose, passion, and a deep commitment to the people who rely on us.
- Brantford General Hospital – Our acute care hospital offering a full spectrum of inpatient and outpatient services.
- The Willett in Paris – Home to our urgent care centre and transitional care services, supporting patients through every step of their healthcare journey.
Core Values: Be Bold and Courageous | Commit to Excellence | Champion Equity | Be Trustworthy
Four Pillars: Patient-First | People-Centred | Partnership-Based | Progress-Focused
These values reflect who we are, what we stand for, and how we work together to have influence. Join us in shaping the future of healthcare - right here at BCHS.
Why Choose BCHS?
- Investing in You – Access to a centralized Education Fund, tuition support, and professional development opportunities.
- Flexible Scheduling – Within a standard work week
- Career Growth – Internal job postings, mentorship programs, and leadership development.
- Predictable Work Locations – Stability and consistency in your work environment.
- Collaborative Team Culture – Work alongside skilled professionals in a supportive, interdisciplinary setting.
- Employee Wellness Matters – Peer Support Team, Wellness Committee, Free, confidential Employee Assistance Program (EAP) for employees and their families.
- Commitment to Safety – Comprehensive safety programs for all
- Competitive Compensation and Benefits –– Salaries and benefits designed to align with industry standards, reinforcing our commitment to attracting and retaining top talent. Excellent Pension Plan.
- Diversity & Inclusion – We are actively working to diversify our teams and remove systemic barriers in hiring, retention, and advancement. We track and report on our progress because representation matters. We regularly review our benefits, policies, and programs through an equity lens to meet the needs of our diverse teams. Provide accommodations for religious practices and use trauma-informed policies that support mental wellbeing.
- Recognition & Rewards – Employee appreciation programs and professional recognition opportunities and Corporate Committee
- Community Impact – Make a real difference in patient care and public health every day.
- Choose Civility – Where every interaction matters. Civility and respect shape our workplace, as individuals treat one another - and the communities we serve with dignity, empathy, and cultural awareness. We foster a culture of civility by raising awareness, setting clear expectations, and continually reviewing our policies and practices to ensure respect is at the core of everything we do.
Reporting to the Clinical Manager Access & Flow, the BCHS Hospital to Home (H2H) Coordinator in collaboration with the patient, family/supports, physician, and members of the clinical team will identify eligible patients for the Hospital to Home Program. The coordinator acts as the liaison between the hospital team, the home care service provider, and the primary care physician. The aim of the program is to transition medically stable patients who have restorative potential back home with a clear, comprehensive bundled care plan of professional and personal support services.
The H2H Coordinator practices in accordance with standards of professional practice and the BCHS corporate mission, vision and values providing program oversight and ensuring identified patients have a comprehensive eligibility assessment, and a high-quality patient and family-centered transition care plan prepared to enable the safe and effective delivery of care in the patient’s home environment.
Primary Responsibilities
- Collaborate with community care partners and respective leadership to gain appropriate insights to support the creation of a safe and feasible transition care plan that will achieve the patients’ care goals within the appropriate amount of time
- Liaise with the community providers daily to provide case management support and to ensure the interventions are meeting the patients’ goals
- Complete referrals to Ontario Health@Home, and/or Community Support Services as applicable to support timely transitions from the BCHS@Home program.
- Support the delivery of, while providing a great patient care experience, receiving and responding to feedback, in collaboration with leadership and service provider partners, as applicable.
- Bachelor’s degree in Occupational Therapy, Physiotherapy, Speech Language Pathology, or Social Work
- Registered and in good standing with a regulatory body
- Three to five years clinical experience in an acute care or rehabilitation healthcare setting
- Excellent interpersonal, communication, organizational and time management skills
- Understanding of disease progression
- In depth understanding of community resources and relevant stakeholders
- Demonstrated ability to develop and implement project plans
- Strong analytical and data interpretation skills, with experience in using data to drive decision-making.
- Experience in stakeholder engagement and communication, with the ability to build and maintain relationships.
- Proven ability to manage multiple tasks and meet tight deadlines.
- Excellent written and oral communication skills, with the ability to present complex information clearly.
- Familiarity with industry best practices and trends in program management
- Strong problem-solving skills and the ability to think critically and strategically.
- Experience with tools and methodologies for data collection, analysis, and reporting.
- Proficient with computer systems such as email, MS Word, MS Excel, MS PowerPoint, and other project management tools.
- Demonstrated experience working with financial decision support systems, electronic health records, and administrative information systems.
- Our Commitment to Equity, Diversity, and Inclusion
We are dedicated to removing barriers and providing accommodations at every stage of the hiring process in accordance with the Accessibility for Ontarians with Disabilities Act (AODA). If you require any accommodations, please inform us when contacted, and we will work with you to meet your needs.
Ready to Make a Difference?
If you are passionate about healthcare and looking for a supportive and dynamic work environment, we would love to hear from you! Apply today and join BCHS in delivering exceptional care with compassion and integrity.
AI Use in Hiring
Brant Community Healthcare System does not use artificial intelligence (AI), automated tools, or algorithms to screen, assess, or rank candidates during the hiring process; all applications are reviewed by our recruitment team.
tient, worker & workplace) is a BCHS Corporate Priority. The successful applicant will demonstrate good stewardship in the identification, reporting and mitigation of unsafe acts or conditions.
More about this job
Responsibilities
Identify eligible patients and coordinate safe, patient- and family-centered transitions from hospital to home, including comprehensive care plans and referrals to community services. Liaise with hospital teams, home care providers, physicians, and community partners to monitor services, support case management, and address feedback.
Requirements
A bachelor's degree in Occupational Therapy, Physiotherapy, Speech Language Pathology, or Social Work is required, along with current registration in good standing with a regulatory body. Candidates must have three to five years of clinical experience in acute care or rehabilitation and strong communication, coordination, analytical, organizational, and community-resource knowledge.
Skills
- Patient Assessment
- Care Coordination
- Case Management
- Transition Planning
- Community Resource Knowledge
- Stakeholder Engagement
- Interpersonal Communication
- Project Planning
- Data Analysis
- Decision-Making
- Problem-Solving
- Time Management
- Disease Progression Knowledge
- Electronic Health Records
- Microsoft Office
- Financial Decision Support Systems
Benefits
- Tuition Support
- Professional Development
- Mentorship Programs
- Leadership Development
- Employee Assistance Program
- Employee Wellness Programs
- Pension Plan
- Employee Recognition Programs
Visa sponsorship
Not detected in the job text
Categories
- Healthcare
- Management & Leadership
- Social Services
Keywords
- Hospital To Home Program
- Patient Transition
- Care Coordination
- Case Management
- Patient-Centered Care
- Family-Centered Care
- Eligibility Assessment
- Transition Care Plan
- Home Care
- Community Support Services
- Ontario Health At Home
- Community Care Partners
- Clinical Team Collaboration
- Stakeholder Engagement
- Project Planning
- Data Collection
- Data Analysis
- Data Interpretation
- Reporting
- Disease Progression
- Electronic Health Records
- Financial Decision Support Systems
- Administrative Information Systems
- Microsoft Word
- Microsoft Excel
- Microsoft PowerPoint
- Occupational Therapy
- Physiotherapy
- Speech Language Pathology
- Social Work