Integrated Care Coordinator

The Integrated Care Coordinator (ICC) will coordinate virtual care for patients being discharged from hospital. The ICC will work collaboratively with patients, families, and other health professionals to implement one of three pathways developed for patients living with Chronic Obstructive Pulmonary Disease (COPD) and Heart Failure (HF).

1. Regulated Health Professional in good standing with regulatory college

2. Undergraduate degree or equivalent experience

3. 3 to 5 years demonstrated expertise working with patients impacted by: multimorbidity including COPD and HF, frailty, functional impairment, health literacy challenges, and social determinants of health

4. 3 to 5 years demonstrated expertise related to chronic disease management including self-management

5. Ability to teach the application and use of telemonitoring equipment to patients and families utilizing teach-back an asset

6. Demonstrated experience working independently and inter-dependently with teams

7. Excellent communication and leadership skills such as; problem solving, critical thinking, negotiating and conflict resolution

8. Excellent interpersonal, communication, organizational and decision-making skills required

9. Knowledge of quality improvement methodology required

10. Knowledge of EPIC, Microsoft Word and Excel required