Social Worker

The Acute Care Transitions Program ensures seamless, compassionate care as patients move from hospital to home. Designed to support both patients and their families, the program connects individuals with community-based healthcare providers, social support services, primary care, and acute care teams. Together, they create personalized plans that improve outcomes and ease the transition to home.

**JOB SUMMARY**:
We are hiring a dynamic and passionate Social Worker who wants to be part of the transformational change in home and community care by providing care in a truly client-centered approach. You are excited about working in an environment that puts the care team in the driving seat, being part of a self-directed team that offers a high level of professional autonomy and responsibility. You will be part of a diverse care team that will provide services to a roster of clients in the community. You will be part of a collaborative team that will conduct joint care planning with a focus on client-centered goals, addressing the client’s physical, cognitive, social, emotional, and spiritual domains, and creating a holistic care plan. Each client is assigned a primary care clinician, a member of the interdisciplinary team who will lead care planning for that client and facilitate the interdisciplinary team to reach the client’s care goals. As part of the SE Transitions team, you will be a part of the team that will be accountable for the care and services you provide and the outcomes your clients achieve.

**Independent Contract or Employment options are available.**

**WHY JOIN OUR TEAM?**
- ** Competitive compensation**. Our Total Rewards package includes a competitive salary, group benefits, RRSP pension, on demand pay and exclusive perks/discounts available only to SE Health staff
- ** Develop yourself with SE**. We have Tuition Assistance Programs, continuing education, training, and professional development to support your lifelong learning. And our leadership team will support you to practice to full scope, to integrate the most current evidence into your practice, and to be part of a strong and supportive team that gives you the right mix of team and independence. SE’s orientation and development programs are designed to support both new and seasoned practitioners to excel, and to enable you to provide the very best care in a warm and nurturing way.
- ** Grow your career.** SE Health is a large national organization with diverse healthcare business lines. You’ll have an opportunity - and will be supported - to do different types of patient-facing therapy roles in different locations if that is what you’re interested in. Or you can pivot to supporting or leadership positions where you use your therapy skills as a foundation to contribute and make an impact in different ways.
- ** Manage your life**. At SE, you’ll have the flexibility to control your schedule to balance your life around child care or elder care, or whatever it is you need to do to have a healthy balance of life and work. You have the freedom to set and adjust your schedule, with your roster of clients.
- ** Support to be your best.** SE Therapists are afforded the time they need to help their patients, to build rapport, to accomplish patient care and recovery goals, and to understand the home and life environments that impact recovery in a way you can’t in most other settings. At SE, you meet your patients where they are, and together you take them to new heights

**RESPONSIBILITIES**:

- Provision of comprehensive care in an interdisciplinary team
- Primary contact for a client when designated as the primary care provider/clinician for the client’s interdisciplinary team
- Provide continuous and comprehensive support to your team in the delivery of care for your client’s
- Complete a client assessment and develop an interdisciplinary care plan based on best evidence/practices and on client’s unique needs.
- Lead the care planning process and work with other disciplines to complete and implement interdisciplinary client care plans
- Facilitate regular interdisciplinary team communication (e.g. huddle, rounds, status updates) when designated as the primary care provider/clinician
- Lead discharge and transition care planning discussions during regular integrated team meetings with their front-line staff when designated as the primary care provider/clinician
- Facilitate and organize family and caregiver meetings
- Support the client through care transitions by collaborating and connecting the client with community support services in their local community.
- Support clients, families and caregivers to develop strong self-care strategies, anticipate and address health issues, as well as optimize their health through effective health promotion strategies

**REQUIREMENTS**:

- Registered in good standing with the Ontario College of Social Workers and Social Services Workers
- Master’s Degree in Social Work from an accredited post-secondary