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Intake and Navigation Care Coordinator - RN - Homeless Health Program
Intake and Navigation Care Coordinator - RN - Homeless Health ProgramAlliance for Healthier Communities • Mississauga, Peel Region, CA
Intake and Navigation Care Coordinator - RN - Homeless Health Program

Intake and Navigation Care Coordinator - RN - Homeless Health Program

Alliance for Healthier Communities • Mississauga, Peel Region, CA
4 days ago
Job type
  • Full-time
  • Permanent
Job description

Role : Intake and Navigation Care Coordinator - RN Homeless Health Program

Salary : $34.06 - $40.53 CAD per hour

Job Type : Existing Vacancy, Full-time, Permanent

The Homeless Health Program is a Nurse Practitioner-led initiative that provides essential healthcare services to individuals who are homeless, precariously housed, or transitioning out of homelessness in the Peel Region. We understand the unique challenges faced by those without stable housing, and our goal is to make healthcare accessible, integrated, and responsive.

Our dedicated team includes Nurse Practitioners, Registered Nurses, Registered Practical Nurses, and Personal Support Workers, all working together to ensure our patients receive the care they need, where and when they need it. We remove barriers to care for those facing housing instability and poor health.

The program manages 45 medical beds at the Dundas Street Shelter, providing 24 / 7 care, as well as daytime mobile primary care services at other shelters and drop-ins across the region.

By providing these services, we help hospitals make the best use of their emergency and acute care resources. Patients who no longer need to stay in the hospital but still require medical support can continue their recovery in a shelter bed with healthcare services. We also offeradditional support for people in shelters who may need extra medical attention, helping to prevent unnecessary hospital visits.

Our medical services include :

  • Care for chronic conditions like diabetes
  • Medication management
  • Support for substance withdrawal and pain management
  • Wound care
  • Mental health services and stabilization
  • Monitoring and support after hospital stays

This program ensures that structurally vulnerable populations in our community have access to the care they deserve, improving overall health and wellbeing.

This role leadstimelyaccess to care acrossWellFortprograms and sites by coordinating centralintake, 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, theIntake& Navigation Care Coordinatortriages 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 withinterprofessional teams and community partners to deliver coordinated, wraparound care.

Core activitiesinclude welcoming clients, completing holistic assessments,developingand updatingindividualized care plans,facilitatingwarm handoffs, androuting clients to theappropriate provideror setting at theappropriate timeusing standardized screening tools and sound judgment.

The successful candidate will bring a deep understanding of the challenges faced by people experiencing marginalizationincluding newcomers,individuals facing homelessness or housing precarity, and other equity-deserving populationsand willdemonstrateempathy, dignity, and respectintheir work.

TheOpportunity

Reporting to a Program Manager, theIntake& Navigation Care Coordinator is a core member of ourinterprofessional team, advancingtimelyaccess, coordinated transitions, and continuity of care across programs and sites,inclose collaboration with partners to deliver holistic,integrated care.

Responsibilitiesinclude :

  • 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; elevate according to protocol.
  • Perform centralintakeacross programs; complete holistic assessments (history, vitals / measurements, screening);triages and prioritizes clients based on their physical and social needs considering the holistic needs of clientsincluding housing,income, food access, language, and transportation; developindividualized prevention / care and self-management plans.
  • Coordinate andmonitorcare-plan delivery; provide ongoing support, follow-up, and case coordination across health, social, and community services,incollaboration with partner organizations.
  • Provide health education to clients, families, and groups.
  • Maintainaccurate,timelyEMR documentation (assessments, care plans, transitions, referrals, outcomes);participateinchart / casereviews;
  • Contribute to data quality, reporting, and continuous quality improvement (CQI);support protocol, pathway, and tool development.
  • Participateinprogram / serviceandpolicydevelopment, implementation, monitoring, and evaluation; coordinate outreach / mobile clinics withinternal programs, community organizations, providers, and local stakeholdersas needed.
  • Participateincase conferences, multidisciplinary meetings, community outreach, and agency awarenessinitiatives.
  • 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-chaincompliance); make purchases withinallocatedbudget lines and follow procurement controls;assistwith operational policies and procedures.
  • Maintaincurrent 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.
  • Participateinapplied research and evaluation projects, asappropriate.
  • Perform other duties asrequiredto meet program and organizational needs.
  • Bachelor’s degreeinnursingor relatedhealth-carefield;ingood standing with the applicable regulatory college.

  • Experience coordinating care withindividuals facingbarriersto accessincluding equity-deserving populations.
  • Demonstrates a strengths-based perspective, recognizingand buildingon theinherent assets, skills, and resilience ofindividuals and communities. Focuses on empowerment rather than deficits, fostering dignity, self-determination, and collaborative problem-solvinginallinteractions.
  • Deep appreciation for the challenges faced by people experiencing homelessness and housing precarity, and thoseimpactedbyintersecting forms of marginalization.
  • Strong understanding of trauma-informed care, harm reduction, and culturally safe practice.
  • Experience with care coordination, case management, and system navigationincommunity-based settings.
  • Excellent written and oral communication skills tailored toappropriate literacylevels.
  • Knowledge of local health, social, and community service systems and referral pathways.
  • Experience working with diverse communities and knowledge of anti-oppressiveframework.
  • Demonstrated ability to organize workload, respond effectively to unexpected situations, and multitaskina fast-paced environment.
  • Valid driver’s license and access to a reliable vehicle.
  • Current First Aid / CPR and a clear Vulnerable Sector Check.
  • Additionallanguages relevant to the community are an asset.
  • Working Environment & Physical Demands

  • Work may be mobile and / or site-based across multiple locations and programsincluding shelters.
  • Ability to work flexible hours,includingsome eveningsand Saturdays.
  • Exposure toindividuals experiencing crisis, complex health conditions, or escalatedbehaviours.
  • Combination of client-facinginteractions, outreach activities, and administrative responsibilities.
  • Requires flexibility, adaptability, and comfort building longitudinal relationships with clients and collaborating across programs.
  • WellFortis an inclusive andequitableemployer. We encourage applications from members of equity-deserving communities, including but not limited to Indigenous peoples, racialized individuals, 2SLGBTQIA+ persons, persons with disabilities, and people with lived experience of poverty, homelessness, or systemic marginalization.

    Requests for accommodation due to disability can be made at any stage in the recruitment process.

    VACCINATION REQUIREMENT

    As a condition of employment, newWellFortstaff must be fully vaccinated unless they have received an exemption from vaccination under the Human Rights Code. Proof of COVID-19 vaccination status will berequiredbefore the first day of work or, proof of religious or medical exemption, if or where applicable.

    Fully vaccinated is defined as having received the completed series of an accepted COVID-19 vaccine, as recommended by the Office of the Chief Medical Officer of Health and having received the final dose at least14 daysbefore your employment start date.

    The candidate will be asked to provideWellFortwith proof of full vaccination, prior to their employment start date. Acceptable proof is a Ministry of Health Dose Administration Receipt (or such other proof of vaccination that the Province of Ontario sanctions). This can be obtained through the Provincial portalhttps : / / covid-19.ontario.ca / get-proof / (link is external) .

    The requirement to be fully vaccinated is subject to the Ontario Human Rights Code. If the candidate is unable to vaccinate for a reason protected by the Code, a request for accommodation can be requested and written proof satisfactory to the organization will berequired.

    #J-18808-Ljbffr

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    Intake and Navigation Care Coordinator RN Homeless Health Program • Mississauga, Peel Region, CA

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