Care Coordinator - Complex

CARE AND BE CARED FOR – THIS IS YOUR HOME

Are you a registered nurse (RN, BScN) with experience and training specific to palliative care. Are you seeking a rewarding career that cares for others, in a professional practice that cares for you? You’re looking in the right place.

As a Complex Care Coordinator, you will coordinate the care and management of palliative care patients in the community across diverse and often complex settings. You will act as a patient advocate to affirm life, and offer supports that help patients live as actively as possible until death, with optimal quality of life.

Whether you work in our office, in the community, or a health care facility – you will play a lead role in providing connected, accessible, patient-centered care – and be supported by our collaborative team that includes over 9,000 regulated health care and other professionals.

As a valued team member, your mission will be to help our patients be healthier at home, while you benefit from our supports for professional growth, personal wellness and work-life balance.

What will you do?

• In collaboration with patients and their families, assess care needs, determine eligibility for services, and develop individual care and service plans for the complex population
• Link patients with community service providers to maintain the patient’s safety in their own home while prioritizing the prevention of hospital admission or ED visits
• Coordinate and monitor care plan delivery
• Establish a helping relationship with patients and their families
• Act as a subject matter expert for colleagues and external partners with respect to palliative care needs of patients in the community.
• Balance patient needs and choices with available resources, ensuring patients’ values and preferences are respected

What must you have?

• Membership, in good standing, with an applicable regulatory body as a Registered Nurse (RN, BScN)
• 1+ years of recent experience in community health or a related field
• Training/certification specific to palliative care (i.e., Fundamentals, LEAP, CAPCE, etc.).
• Knowledge of:
  • EDITH protocol, Symptom Response Kits and DNR-C paperwork, and PPS Scale.
  • Common prognosis and trajectories of life-limiting conditions.
  • Pain and symptom management needs of palliative care patients
• Possesses a strong clinical background with a patient-centered approach
• Knowledge of the health care delivery system and community resources
• Is a natural motivator, leader and advocate
• Excellent interpersonal, communication, asse