Community Care Specialist

3 days ago


Port Moody, British Columbia, Canada Fraser Health Full time
About Our Team

At Fraser Health, we value diversity in the workforce and strive to maintain an environment of respect, caring, and trust. We are committed to planetary health and people - those we care for and those who care for them - are at the heart of everything we do.

Key Responsibilities
  1. You will facilitate care conferencing to review client care plans, collaborate with the interprofessional team and primary care provider to determine timing and referral to other services and/or interventions to improve client outcomes.
  2. You will discuss clinical findings with client/family, collaborate with the interprofessional team to develop action plans and set goals directed at clinical needs, self-management, self-care, and improved health-related quality of life.
  3. You will support clients and their families before, during, and after interprofessional conferences and clinic visits by providing information through their decision-making process regarding treatment options.
  4. You will arrange and participate in joint home visits to clients and/or families with other healthcare professionals, as required.
  5. You will provide health counseling to clients, including education, self-management, self-monitoring, and wellness/health promotion/prevention through a combination of clinic, telephone, or home visits.
Qualifications
  • Demonstrated knowledge, skills, and competence in the areas such as gerontology and adults living with complex frailty and chronic illnesses.
  • Demonstrated ability to complete initial and ongoing client assessments and provide nursing care through therapeutic interventions.
  • Demonstrated ability to communicate effectively, both verbally and in writing.


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