Bilingual Care Coordinator

CARE AND BE CARED FOR – THIS IS YOUR HOME

Are you an experienced registered nurse, physiotherapist, occupational therapist, social worker (RSW), dietitian, or speech language pathologist seeking a rewarding career that cares for others, in a professional practice that cares for you? You’re looking in the right place.

As a Bilingual Care Coordinator, you will assess and determinepatient care needs and eligibility, provide access and referrals to community services, and engage with patients, caregivers and other health care practitioners.

Whether you work in our office, in the community, or a health care facility – you will play a lead role in providing connected, accessible, patient-centered care. As a valued team member, your mission will be to helpour patients be healthier at home, whileyou benefit from our support for professional growth, personal wellness and work-life balance.

What will you do?

Under the general direction of the Manager, Patient Services, the Care Coordinator is responsible for managing a caseload of diverse patients who are living and/or dealing with a variety of health concerns. The Care Coordinator, through in person visits and/or phone conversations, assesses the patient’s care needs and develops, implements, and updates (as required) a care plan that is informed by the patient’s health and psychosocial needs; and, where possible, accommodates patient and caregiver wishes. Care Coordinator also determines eligibility for and arrangesfor Ontario Health atHome Champlain-approved health care servicesand refers patients and caregivers to other community resources and programs.

As a member of the Intake Care Team, the Care Coordinator will be responsible for assessing and developing individual patient care plans over the phone for serviceprovision. Based on patient needs the Care Coordinator will utilize a multi-disciplinary team approach to achieve optimal health outcomes. This is an in office, non-visiting role where referrals are prioritized based on the complexity, urgencyand needs of each patientwhile adhering to Ontario Health atHome Champlain guidelines for care and services.

Primary Responsibilities:

• Completes comprehensive patient assessments using a validated assessment tool, including patient’s clinical, physical and psychosocial needs, and caregiver needs
• Assesses the patient’s and caregiver’s understanding of, and learning needs related to diagnosis, treatment, available resources, illness adjustment, and coping mechanisms
• Assists patient and caregiver in setting appropriate goals (individual, joint,short or long term)
• Collaborates with patient, caregiver and the care team to develop an individualized care and serviceplan reflective of the patient’s identified priorities and desired outcomes; identifies strategies and resources to be used in attaining clinical outcomes
• Coordinates the delivery of Home and community care services to patients and their caregivers
• Coordinates vendorand resource utilization involving medical equipment, supplies and services
• Facilitates understanding and cooperation amongmembers of the patient’s multidisciplinary healthcare team; communicates with members of the patient’s health care team to maximize patient outcomes
• Initiates and authorizes the implementation of the care plan throughcontracted providers
• Provides regular reports to Physicians, service providers, patients, caregivers and other authorized parties as required
• Case documentation in accordance with Ontario HealthatHome Champlain policies

What must you have?

• Registered Nurse (BScN or diploma) and registered with the Collegeof Nurses of Ontario; or
• Degree or diploma in Physiotherapy and registered with the Collegeof Physiotherapy of Ontario; or
• Degree or diploma in Occupational Therapyand registered with the Collegeof Occupational Therapyof Ontario; or
• Degree in Social Work and registered with the OntarioCollege of SocialWorkers and Social Service Workers; or
• Degree in Speech Therapyand registered with the Collegeof Audiologists and Speech-Language Pathologists of Ontario; or
• Degree in Foods and Nutrition or equivalent and registered with College of Dietitians of Ontario.
• Related professional experience (community based experience preferred) which is normallyattained over a period of two years
• We have a mandatory COVID-19 vaccination policy.As a condition of employment, all employees are required to submit proof of COVID-19 vaccination status prior to start date.

What would give you the edge?

• Works with diversepatient groups with varying levelsof comprehension and language capability
• Manages difficult conversations/situations such as advancecare planning and goals of care in a healthy and effective manner
• Works effectively in both a team environment and independently as required
• Verbal and written communication skills to establish working relationships and maintain a wide range of partners (doctors, nurses, social workers, etc.) within the healthcare community
• Listening and facilitation skillsto work with patients and their caregivers
• Diplomacy in dealingwith sensitive and/orconfidential issues
• Relationship building skills to developand maintain healthand community stakeholder partnerships.
• Working knowledge of computersoftware (email, internet) and Microsoft Officeapplications (Word, Outlook, etc.)
• A valid driver’slicense and accessto a vehicle is required
• Fluency in Englishand French is required
• Vulnerable Sector Check completed within the last six months

Equity, Inclusion, Diversity and Anti-Racism Commitment

Ontario Health atHome is committed to a culture of equity, inclusion, diversity and anti-racism. We are committed to attracting, engagingand developing a workforce that reflects the diverse communities we serve. We welcome and encourage applications from all qualified applicants. Accommodations for persons with disabilities required during the recruitment process are available upon request.

This posting is for an existing vacancy.