Integrated Care Coordinator

The Integrated Care Coordinator (ICC) will provide patient centered system navigation, intensive case management and coordination of services to a selected group of patients as they access care with Hamilton Health Sciences and with partner organizations. The ICC will identify and facilitate access to the right services from the right provider at the right time based on assessed needs by working collaboratively with an inter-professional team, family members, support network, and a variety of informal and formal service providers. The ICC Coordinator acts as a key resource to community service providers such as Home Care, and hospital staff regarding the ICC program and patients.

1. Undergraduate Degree in Regulated Health Professional
2. 3 to 5 years demonstrated expertise in chronic disease management, mental health and addictions, complex and dysfunctional family systems, older adults who are frail and/or palliative, medication and symptom management for Heart Failure and COPD
3. Able to exchange knowledge related to specific health conditions and the continuum of services across sectors, and resources to enhance patient self-management and quality of care
4. High degree of autonomy and independent decision-making on a daily basis related to work with clients, HHS and Home Care staff, Specialty
5. Physicians, Primary Care Physicians and staff at other hospitals and community service agencies
6. Prioritization of work based on patient needs and program goals and development
7. Excellent communication and leadership skills such as; problem solving, critical thinking, negotiating and conflict resolution
8. Responsible for establishing and maintaining relationships with other health care professionals in designated specialty functions to ensure quality of care
9. Excellent interpersonal, communication, organizational and decision making skills required