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Mississauga Halton CCAC

Clinical Practice Lead - Complex Care



Company Information

We’re Seeking Exceptional People to Join Our Team

Mississauga Halton Community Care Access Centre (CCAC) is committed to providing outstanding care -every person, every day.

As one of 14 CCACs across Ontario, our staff help patients plan and make informed choices about their health care options. To do this, they work in partnership with patients, families, care providers, hospitals, long-term care homes and others.  At the heart of our work is quality community care that focuses on meeting each patient’s best interests. Whether a job involves direct patient contact or supports those who interact with patients daily, we empower every employee to focus on our patients and their families.  As demand for Mississauga Halton CCAC services continues to rise, we have a strategic plan that positions us to successfully meet this challenge. Integral to this plan is having exceptional people in place.

For more information on Mississauga Halton CCAC, please visit our website at

Job Description

We are currently recruiting a Clinical Practice Lead- Complex Care.

Competition #:   FY1617-107

Start Date:   immediately

Reports to:   Manager, Patient Care - Operations

Category:   Temporary Full-time (up to 24 months)

Team:   Central Community

Primary assigned location:   2655 North Sheridan Way, Mississauga


Reporting to the Manager, Patient Care - Operations, the Clinical Practice Lead-Complex Care works in collaboration with Patient Care leadership, frontline team members across the Patient Care portfolio, Health Link Secretariat team, Service Provider partners, other internal and external partners, as well as patients and families, to ensure that quality patient-centred care is designed, delivered, measured and improved.  The Clinical Practice Lead ensures application of best clinical practices at the point of care, with the goal of greater coordination of services across health, community, social and justice sectors so that every patient with complex health issues receives timely and quality care matched to their need.

As an advocate for quality clinical care, the Clinical Practice Lead facilitates and supports continuous learning, professional development, and consistently excellent evidence-based care delivery through education, coaching, and mentorship of staff. An excellent communicator, critical thinker, lifelong learner and problem solver, the Clinical Practice Lead competencies include: expertise in the clinical area of focus, ability to apply research and evidence to inform processes and program development and improvement, ethical decision-making, collaboration with a variety of different stakeholders, and demonstrated leadership.


Patient Care Delivery

  • Provides  leadership  in  the  development,  evaluation,  and  improvement  of clinical practice as it relates to a specific clinical area of focus
  • Triages issues related to adoption and fidelity of Health Links approach and philosophy; problem solves with Health Links stakeholders and leadership; supports change management efforts related to the CCPW and Health Links evolution/innovation.
  • Provides  relevant clinical  practice consultation  to front line staff and system partners
  • Works closely with Patient Care Program Managers towards the advancement of clinical practice through program integration and standardization
  • Provides coaching, teaching, and mentorship to care coordinators and community partners engaged within the circle of care to augment “complexity capacity” through adherence to professional practice standards for complex patients including application of care coordination core competencies, chronic disease management principles, adherence to guidelines of care articulated for complex patients etc.
  • Works collaboratively with stakeholders to embed Health Links approach and philosophy along all steps of the clinical pathway.
  • Works with Patient Care Leadership and Quality & Outcomes Department to identify clinical practice gaps/trends that, in collaboration with program managers and other relevant stakeholders, supports meaningful program and system  improvements
  • Participates in researching, integrating, and promoting evidence-based clinical care  models to achieve organizational goals and objectives
  • Supports implementation of best practice methodologies
  • Participates as a leader in change management initiatives; acts as a champion for continuous improvement, and participates in the development of policies, procedures, processes, and tools to improve care delivery
  • Provides education and day-to-day support in the development of staff clinical expertise
  • Participates in the development, implementation and evaluation of new care delivery  initiatives
  • Supports complex and difficult patient clinical issues and complaints which cannot be handled in a routine manner
  • Attends patient home visits and care conferences as required; supports frontline  staff with the development of care plans that are complex as a result of the  identified clinical issues
  • Works with Operations and Program Managers to develop and monitor outcome reports as they relate to specific clinical practice areas
  • Runs and reviews reports as specified by the Manager and/or team

Patient Assessment, Coordinated Care Planning & Engagement

  • Carries a reduced case load; determines capability and assesses patients' potential for health and well-being on the basis of established criteria; determines eligibility for funded services or placement into long term care
  • Responds to inquiries and requests for care in accordance with the patient's needs; identifies risk factors and urgency for care
  • Establishes goals in collaboration with the patient and family/caregiver; ensures goals reflect the patient's desired outcomes
  • Works with system partners, including Service Providers, hospitals, Community Service Sector (CSS), Primary Care, and relevant others to ensure a seamless, coordinated, quality-driven patient and caregiver experience
  • Develops a coordinated care plan that reflects the patient's assessed needs and goals within the resource parameters of the CCAC
  • Collaborates and negotiates transitions of care once the patient's goals and outcomes have been achieved; supports patient and family system navigation to alternate resources, if appropriate


Education, Training & Experience

  • A registered health or social work professional including:  registered nurse, physiotherapist, occupational therapist, speech language pathologist, or social worker
  • A member in good standing with their applicable regulatory body: College of Nurses of Ontario;College of Physiotherapists of Ontario; College of Occupational Therapists of Ontario; College of Audiologists and Speech Language Pathologists of Ontario; Ontario College of Social Workers and Social Service Workers
  • A University degree preferred (or an equivalent combination of education and experience may be considered)
  • Three (3) to five (5) years recent experience in community health
  • Three  (3)  to  five  (5)  years  of  experience  in  specific  clinical  practice  area
  • Knowledge and experience in Care Coordination, including clinical strength in assessment, care planning, system navigation, health outcomes monitoring, direct support (i.e. self-management  principles), collaboration with key system partners
  • A  strong  critical  thinker  with  demonstrated  judgment   and  ethical  decision making skills
  • Effective communication,  collaboration,  and facilitation  skills to  problem solve and resolve conflict
  • Adult teaching experience and/or adult education courses are an asset

Skills and Attributes

  • Adept in the use of MS Office applications (e.g., Word, Excel, Outlook, PowerPoint, etc.)
  • Flexible, adaptable, and responsive to change
  • Passion for  driving clinical  practice  excellence  through  teaching,  mentorship, program development, and system integration
  • A positive confident professional, flexible, adaptable, and embraces change
  • Strong written documentation  skills and verbal communication/presentation skills  that are clear, thorough, concise, accurate, and timely
  • Ability to analyze information, problem-solve, and make good decisions
  • Accountable for own actions and decisions; making decisions within the scope of the position and referring issues/problems/events  to the Manager as required
  • Self-directed with the ability to organize, plan, prioritize, and multi-task
  • Detail-oriented

Thank you for your interest in joining our exceptional team at Mississauga Halton Community Care Access Centre (CCAC)!  

To apply for this vacancy please submit a resume with covering letter referencing FY1617-107 via the following link or visit the Mississauga Halton CCAC Career Opportunity page at 

Please note, only those candidates selected for an interview will be contacted.

Mississauga Halton CCAC is a respectful, caring and inclusive workplace, committed to Employment Equity.  We welcome diversity in the workplace, and encourage applications from all qualified individuals including women, members of visible minorities, aboriginal persons, and persons with disabilities.  We will provide accommodations throughout the recruitment and selection and/or assessment process to applicants with disabilities.  Applicants need to make their accommodation needs known when contacted.  To receive any Mississauga Halton CCAC document required by the Accessibility for Ontarians Disability Act (AODA) and its standards, or to receive any public document on our website in an alternate format, please contact our Communications Department at 905-855-9090 or 1-877-336-9090.

Posting Date: 11-Apr-2017Medical/Healthcare Contract, Full-Time 12 months Open 1 ASAP
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