Transitions Care Lead

2 weeks ago

Richmond Hill, Canada SE Health Full time

**About the Role**

An exciting leadership role within hospital transitional programs working with closely with hospitals to transition and reintegrate clients back into the community.

As a member of the Acute Transitions leadership team, you are passionate about informing and shaping the transition from hospital to home and being at the forefront of healthcare innovation in Canada.

Hybrid role (virtual /in-person) covering North Toronto and York Region, primarily in Vaughan and Richmond Hill.

Weekday Evenings and Every Other Weekend (Days)

As the Transitions Care Lead You will provide exemplary leadership and care flow management between the hospital partners and community care teams while ensuring excellence in the provision of client care and the achievement of corporate/program objectives. This exciting position will manage relations and collaborate with hospitals to ensure a smooth and seamless transition to a client’s home environment. Additionally this position will help to ensure performance targets are met and be involved in quality improvement initiatives as it relates to optimizing patient flow and management processes within the Acute Transition programs.

**Main responsibilities**:

- Act as the primary point of contact for the hospital navigator/coordinator
- Receive, monitor and update the client tracking/notification/flow tools
- Receive, review, and accept referrals for in-home transition services
- Participate in hospital discharge care conference for complex clients as required
- Prepare an initial care plan (e.g. for 48-72 hours post transition) and place an initial equipment and supplies order as required
- Attend program huddles with hospital (as per contract requirements)
- Monitor and communicate significant deviations from the care plan to the hospital as required.
- Communicate to the hospital any risk-related events
- Monitor timely completion and reporting outcomes of patient/family care conferences to partner hospital(required in contract)Monitor Program Metrics (e.g. client experience, time to first visit, service volumes, risk events, etc.)
- Facilitate risk management as per established policies and procedures
- Communicate patient and family complaints or issues back to partner hospital and share associated action plans in partner meetings
- Participate in program evaluation and process improvement
- On-call as required for programs support
- Other duties to ensure program is running smoothly

**Requirements**:

- Membership, in good standing, with the applicable regulatory body:

- College of Nurses of Ontario.
- College of Physiotherapists of Ontario.
- College of Occupational Therapists of Ontario.
- Ontario College of Social Workers and Social Service Workers.
- 3+ years of recent experience in community health or a related field.
- Knowledge of the health care delivery system including hospital discharge planning, community care and support services
- Excellent skills in case management and coordinating care within interdisciplinary teams
- Excellent assessment and decision-making skills
- Passion for excellent customer service and customer experience
- Demonstrates strong critical thinking, problem-solving and self-directed skills.
- Excellent interpersonal communication, and presentation skills with a diverse group or stakeholders (hospital partners, front line staff, management team)
- Effective time management skills, with the ability to work independently and co-operatively in a busy multidisciplinary environment in various settings (e.g. at the hospital, in the office, in the community).
- Advanced skills in Microsoft Office (Word, Excel, PPT, Visio) and comfort with learning/working with new and emerging technologies (e.g. remote patient monitoring/virtual care technologies, EHR systems, reporting systems)
- A valid driver’s license and access to a reliable vehicle.

**About SE Health**

At SE, we love what we do. Every day, we bring hope and happiness to clients, homes, and communities across Canada. We treat each person with dignity and love, like our own family; we build empathy; and we do the right thing. We are always inspired to make a difference. As a not-for-profit social enterprise, we share knowledge, provide the best care, and help each client to realize their most meaningful goals for health and wellbeing. We are an inclusive workplace offering competitive pay, benefits, pension, and work life balance. We’re a great place to work, and we hope you’ll join our team.

Please note that due to the unprecedented circumstance of the Global Pandemic and the resultant public health crisis; and in the interest of the health and safety of our patients/clients, employees, and greater good of public health, **SE Health requires those that wish to work for this organization to be fully vaccinated against COVID-19.** Fully vaccinated means a person has received both doses of the COVID-19 vaccine and it has been 14 days since the last dose

  • Transitions Care Lead

    4 weeks ago

    Richmond Hill, Ontario, Canada Saint Elizabeth Health Care Full time

    About the Role An exciting leadership role within hospital transitional programs working with closely with hospitals to transition and reintegrate clients back into the community. As a member of the Acute Transitions leadership team, you are passionate about informing and shaping the transition from hospital to home and being at the forefront of healthcare...

  • Transitions Care Lead

    4 days ago

    Richmond Hill, Canada SE Health Full time

    **About the Role** An exciting leadership role within hospital transitional programs working with closely with hospitals to transition and reintegrate clients back into the community. As a member of the Acute Transitions leadership team, you are passionate about informing and shaping the transition from hospital to home and being at the forefront of...

  • Transitions Care Lead

    4 weeks ago

    Richmond Hill, Canada SE Health Full time

    **About the Role** An exciting leadership role within hospital transitional programs working with closely with hospitals to transition and reintegrate clients back into the community. As a member of the Acute Transitions leadership team, you are passionate about informing and shaping the transition from hospital to home and being at the forefront of...

  • Market Sector Lead, Transit

    3 weeks ago

    Richmond Hill, Canada hdr Full time

    Market Sector Lead, Transit-(177649) Description About Us At HDR, we specialize in engineering, architecture, environmental and construction services. While we are most well-known for adding beauty and structure to communities through high-performance buildings and smart infrastructure, we provide much more than that. We create an unshakable...

  • Market Sector Lead, Transit

    3 weeks ago

    Richmond Hill, ON, Canada Fashion Institute of Design & Merchandising Full time

    At HDR, we specialize in engineering, architecture, environmental and construction services. While we are most well-known for adding beauty and structure to communities through high-performance buildings and smart infrastructure, we provide much more than that. We create an unshakable foundation for progress because our multidisciplinary teams also include...

  • Registered Practical Nurse

    3 weeks ago

    Richmond Hill, Ontario, Canada Saint Elizabeth Health Care Full time

    We are looking to hire Registered Practical Nurses (RPNs) to join our Transitions team - this is an exciting opportunity to be at the front-line of health care innovation in Canada.POSITION SUMMARY:We are seeking several dynamic, passionate Registered Practical Nurses (RPNs), who want to be part of the transformational change in home and community care by...

  • Industrial Design Manager

    3 weeks ago

    Richmond Hill, Canada hdr Full time

    Industrial Design Manager - Transit Facilities-(174777) Description About Us At HDR, we specialize in engineering, architecture, environmental and construction services. While we are most well-known for adding beauty and structure to communities through high-performance buildings and smart infrastructure, we provide much more than that. We create...

  • Charge Nurse

    3 weeks ago

    Richmond Hill, Canada Bayshore HealthCare Full time

    Job Description Bayshore HealthCare is one of the Canada’s leading providers of home and community health care services and is a privately owned company. Bayshore HealthCare is proud to showcase its achievement as a Platinum member of Canada’s Best Managed Companies Program every year since 2006. In 2015, Bayshore achieved the designation for Best...

  • Client Care Supervisor, Rpn

    1 day ago

    Richmond Hill, Canada RNS Health Care Services Inc. Full time

    **Home and Community Care Client Care Supervisor (RPN)** **About the Role**: We are seeking a dedicated and experienced Client Care Supervisor (RPN) to join our growing Client Services team at RNS Health Care. As a Supervisor, you will be responsible for overseeing the delivery of high-quality care to our clients, ensuring compliance with all regulatory...

  • Registered Nurse

    3 weeks ago

    Richmond Hill, Ontario, Canada Saint Elizabeth Health Care Full time

    We are currently hiring Full-Time and Part-Time Registered Nurses (RN), Community/Home Care in North York/Markham/Stouffville/Richmond Hill area. Offering sign on bonus $2000We are seeking a dynamic, passionate Registered Nurse (RN), who wants to be part of the transformational change in home and community care by providing care in a truly client-centered...

  • Quality Management Systems Lead Auditor

    3 weeks ago

    Richmond Hill, Canada TES The Employment Solution Full time

    - , - • Formal training as a Quality Management Systems Lead Auditor. • Familiarity with ISO9001 and Six Sigma • Experience in leading internal and external quality audits for process and contract compliance, and business improvement; • Experience and knowledge in quality management and continuous improvement; • Extensive Experience in...

  • Quality Management Systems Lead Auditor

    3 weeks ago

    Richmond Hill, Canada TES The Employment Solution Full time

    - , - • Formal training as a Quality Management Systems Lead Auditor. • Familiarity with ISO9001 and Six Sigma • Experience in leading internal and external quality audits for process and contract compliance, and business improvement; • Experience and knowledge in quality management and continuous improvement; • Extensive Experience in...

  • Quality Management Systems Lead Auditor

    3 weeks ago

    Richmond Hill, Canada TES The Employment Solution Full time

    - , - • Formal training as a Quality Management Systems Lead Auditor. • Familiarity with ISO9001 and Six Sigma • Experience in leading internal and external quality audits for process and contract compliance, and business improvement; • Experience and knowledge in quality management and continuous improvement; • Extensive Experience in...

  • Quality Management Systems Lead Auditor

    3 weeks ago

    Richmond Hill, Canada TES The Employment Solution Full time

    -, -• Formal training as a Quality Management Systems Lead Auditor. • Familiarity with ISO9001 and Six Sigma • Experience in leading internal and external quality audits for process and contract compliance, and business improvement; • Experience and knowledge in quality management and continuous improvement; • Extensive Experience in implementation...

  • Child Care Provider

    1 week ago

    Richmond Hill, Ontario, Canada CanadianNanny Full time

    HelloWe are looking for occasional part time help on weekday evenings and weekends. We have three well behaved little ones , Aged 5, 4, and 1.One of our major needs is light housework and home organization.Hours are flexible.The kids love playing with each other and love the outdoors. They have many arts and crafts and other activities available for them in...

  • Therapy Assistant

    7 days ago

    Richmond Hill, Canada SE Health Full time

    We are looking to hire **_Therapy Assistants (OTA/PTA)_** to join our Transitions team - this is an exciting opportunity to be at the front-line of health care innovation in Canada. ***: - We are seeking several dynamic, passionate Therapy Assistants (OTA/PTA) _who want to be part of the transformational change in home and community care by providing care...

  • Production Coordinator

    3 days ago

    Richmond Hill, Canada Amico Patient Care Full time

    **Production Coordinator (Warehouse Environment) - Amico Patient Care** Amico Patient Care is a growing company looking for enthusiastic individuals to join our fast-paced production environment. If you’re looking for a job within a “large family” then Amico Patient Care is the right place for you. With a culture that sees people enjoy coming to work,...

  • Production Coordinator

    4 weeks ago

    Richmond Hill, Canada Amico Patient Care Full time

    Amico Patient Care is a growing company looking for enthusiastic individuals to join our fast paced production environment. If you’re looking for a job within a “large family” then Amico Patient Care is the right place for you. With a culture that sees people enjoy coming to work we value our people and help to make each day enjoyable while still being...

  • Team Lead

    1 day ago

    Richmond Hill, Ontario, Canada AtkinsRéalis Full time

    Job DescriptionTeam Lead - Geospatial & GISThis role offers a hybrid work environment and can be based at any of our offices in BC, Alberta, Saskatchewan or Ontario.Come join us in reshaping the future with AtkinsRéalis. AtkinsRéalis is dedicated in engineering a better future for our planet and its people.Our vision is to be the premier engineering...

  • Nursing Graduate Guarantee

    2 weeks ago

    Richmond Hill, Canada Mackenzie Health Full time

    Job Description Nursing Graduate Guarantee Program – Nursing Opportunities Temporary full time The Nursing Graduate Guarantee (NGG) program is funded by the ministry to provide new graduate Registered Nurses and Registered Practical Nurses with temporary full-time employment, above staffing complement, to support their successful transition to...