Home Care Specialist
VHA Home HealthCare View all jobs
- Toronto, ON
- $61,000-76,000 per year
- Permanent
- Full-time
#LI-MD1Key Areas of Accountability:
- Coordinates services within the clients home, community, delivery and pick up of medical equipment and supplies as needed based on program-specific workflows
- Conduct occasional hospital visits to support hospital discharge planning or participate in case conferences for complex cases
- Conducts home visits with the client following program-specific timelines to complete comprehensive assessments in partnership with the program funder, client and family to inform the development client goals within the program and an individualized client care plan
- Arranges and adjusts home care services according to the care plan and in alignment with services contained within the program bundle
- Monitors appropriate service allocation and bundle management
- Attends program huddles with internal teams, hospital partners and/or program funders
- Arranges appointments and liaise with the client’s primary care provider within set program specific timelines, supports the client to connect with primary care when required
- Completes documentation after encounters with clients and their care team and communicates any risk-related events to the VHA team in a timely manner
- Completes referrals to appropriate community services when needed and facilitates a seamless and supporting transition to these services
- Provides direct care to the client and trains staff on delegated acts as required
- Monitors program metrics and participates in program evaluation and process improvement
- Undergraduate degree in Nursing (RN Required)
- 5+ years of experience in home and community health or a related field
- Member, in good standing with College of Nurses of Ontario
- Knowledge of the health care delivery system including hospital discharge planning, home and community care, and support services
- Excellent skills in case management, coordinating care within interdisciplinary teams, interRAI assessments and navigation of community services
- Excellent assessment and decision-making skills
- Passion for excellent customer service and customer experience
- 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).
- Proficient skills in Microsoft Office (Word, Excel, PPT) and comfort with learning/working with new and emerging technologies (e.g. EHR systems, reporting systems)
- Intersectoral experience and excellent relationship building skills and dispute resolution
- Must be available for on-call support
- A valid driver’s license and access to a reliable vehicle