RN Intake and Navigation Care Coordinator

RN Intake and Navigation Care Coordinator

Interprofessional Care Team Full Time Brampton, ON $34.88 - $41.16 CAD per hour

We are seeking a full-time RN Intake and Navigation Care Coordinator

Contract Role: Ending March 31, 2027
Availability: Must be available to work evenings and weekends.

Role Overview

This role leads timely access to care across WellFort programs and sites by coordinating central intake, system navigation, and warm referrals across primary care, mental health and addictions, chronic disease and wellness, and community/social services.

Working from a trauma-informed, harm-reduction, and culturally safe approach, the Intake & Navigation Care Coordinator triages and prioritizes clients based on physical and social needs, guided by the social determinants of health (e.g., housing, income, food access, language/immigration, transportation) and aligns response levels and follow-up timeframes with program standards and partner pathways. The role collaborates with interprofessional teams and community partners to deliver coordinated, wraparound care.

Core activities include welcoming clients, completing holistic assessments, developing and updating individualized care plans, facilitating warm handoffs, and routing clients to the appropriate provider or setting at the appropriate time using standardized screening tools and sound judgment.

The successful candidate will bring a deep understanding of the challenges faced by people experiencing marginalization including newcomers, individuals facing homelessness or housing precarity, and other equity-deserving populations and will demonstrate empathy, dignity, and respect in their work.

The Opportunity

Reporting to a Program Manager, the RN Intake & Navigation Care Coordinator is a core member of our interprofessional team, advancing timely access, coordinated transitions, and continuity of care across programs and sites, in close collaboration with partners to deliver holistic, integrated care.

Responsibilities include:

• Under the direction/delegation of an authorized clinician, perform specific clinical acts (e.g., specimen collection, vaccine administration) and, as delegated, communicate routine test results and follow-up plans; escalated according to protocol.
• Perform central intake across programs; complete holistic assessments (history, vitals/measurements, screening); triages and prioritizes clients based on their physical and social needs considering the holistic needs of clients including housing, income, food access, language, and transportation; develop individualized prevention/care and self-management plans.
• Coordinate and monitor care-plan delivery; provide ongoing support, follow-up, and case coordination across health, social, and community services, in collaboration with partner organizations.
• Provide health education to clients, families, and groups.
• Maintain accurate, timely EMR documentation (assessments, care plans, transitions, referrals, outcomes); participate in chart/case reviews;
• Contribute to data quality, reporting, and continuous quality improvement (CQI); support protocol, pathway, and tool development.
• Participate in program/service and policy development, implementation, monitoring, and evaluation; coordinate outreach/mobile clinics with internal programs, community organizations, providers, and local stakeholders as needed.
• Participate in case conferences, multidisciplinary meetings, community outreach, and agency awareness initiatives.
• Advocate with and for clients to reduce barriers and ensure fair, dignified access to care and supports; contribute to community education and collaborative strategies.
• Manage clinic readiness operations: maintain/order equipment and supplies; share responsibility for safe handling of medications and vaccines (including cold-chain compliance); make purchases within allocated budget lines and follow procurement controls; assist with operational policies and procedures.
• Maintain current knowledge of relevant government guidelines, acts, and legislation affecting client care and organizational practice.
• Supervise and support students/learners from various disciplines; contribute to orientation and teaching activities with a determinants-of-health lens.
• Participate in applied research and evaluation projects, as appropriate.
• Perform other duties as required to meet program and organizational needs.

Knowledge, Skills, and Abilities

• Bachelor’s degree in nursing; in good standing with the applicable regulatory college.
• Experience coordinating care with individuals facing barriers to access including equity-deserving populations.
• Demonstrates a strengths-ba