Care Navigator

2 months ago


Mississauga, Canada Trillium Health Partners Full time

**Job Description**:
**Position**: Care Navigator

**Job ID**: 2024-39193

**Status**: Permanent Full-Time (2)

**Role Level**: Allied Health (AH10.6) - $44.67 to $57.90 per hour

**Site(s)**: Mississauga Hospital & Credit Valley Hospital

**Hours of Work/Shifts**: 8 & 12 Hour Shifts - Days

**Posted**:October 11, 2024

**Internal Deadline**:October 18, 2024

Trillium Health Partners (THP) is one of the largest community-based acute care facilities in Canada. Comprised of the Credit Valley Hospital, the Mississauga Hospital and the Queensway Health Centre, Trillium Health Partners serves the growing and diverse populations of Mississauga, West Toronto and surrounding communities and is a teaching hospital affiliated with the University of Toronto.

Our Mission**:A New Kind of Health Care for a Healthier Community**

Our Values**:Compassion, Excellence, Courage**

Our Goals**:Quality, Access, Sustainability**

Our Enablers**:People, Education, Innovation, Research**

**Position Description**:
Working collaboratively with an inter-professional team, both internal and external to THP and which include family members and support networks, the Care Navigator will identify and facilitate access this program for rapid access to care that enables admission to hospital and/or reduction in hospital length of stay.

Reporting to the Manager, Primary and Integrated Care, the Care Navigator will assess patients in ED or inpatient units, arrange for expedited transportation and supports at home, collaborate with community and primary care providers, phone patients at home for follow-up, and assist with health care navigation and accessing community resources. The Care Navigator will act as a liaison between patients and other care providers. This program leverages technology to support patient care and seamless transitions from hospital to community and ongoing community management.

**Responsibilities**:

- Enhance work-flow and communication between hospital, primary care, home care and community care by identifying barriers to access, and work towards creating pathways to promote and optimize care for the patient
- Identify gaps in the program needed to meet its purpose and targets, and system level changes required to meet changing needs of the patient population
- Develop and foster links with external partners to facilitate continuity of patient care; including community outreach
- Attend Case Conference calls with homecare and community support providers to arrange for expedited transportation and supports at home, with the intention to discharge patients quickly and effectively - avoiding an admission from ED, or shortening a stay in hospital
- Collaborate with primary care providers to ensure the patient has necessary medical oversight and a complete care plan while supported at home
- Call patients after they have returned home for follow-up and prevention of further ED visits. Use expert decision-making and evidence informed tools to provide triage and symptom management advice over the telephone
- Ensure seamless navigation of services and supports required by the patient; triage and forward referrals to appropriate community services. Provide information and assist patients and families to overcome barriers
- Communicate and collaborate with patients, families, members of the health care team, and community resources to facilitate decision making regarding appropriate services. Act as a patient advocate
- Collect data for reporting, monitoring and evaluation

**Qualifications**:

- Degree in a Regulated Health Profession discipline
- Current membership in good standing with a regulatory health professional body in Ontario
- Three (3) years of recent related experience in ED, acute care, discharge planning, and/or community health care setting

**Competencies**:

- Comprehensive knowledge of community resources and health care delivery systems in acute and community settings
- Demonstrated ability to respond to patients with flexibility and adaptability
- Experience in performing case management functions is required
- Demonstrated expertise and competence in symptom management for areas of patient need, such as chronic disease management, complex family systems and the frail elderly
- Evidence of program design and resources development skills, including knowledge of evaluation methodologies
- Comfortable working in an evolving program, with changing responsibilities over time
- Demonstrated ability to develop collaborative practices internally and in the community
- Excellent interpersonal, communication, organizational and decision making skills required
- Consistently demonstrated strong leadership skills, including problem solving, critical thinking, conflict resolution and negotiation skills
- Demonstrated ability to work independently and collaboratively with an interdisciplinary team, family members, support networks, and a variety of formal and informal service providers
- Demonstrated commitment to



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