Complex Care Coordinator

At this time, the South West Local Health Integration Network is seeking one (1) Care Coordinator (Registered Nurse) to work in our Hanover Complex Team. This is a temporary full time assignment for an approximate duration of 24 months.

As a valued member of the Home and Community Care portfolio, the Complex Care Coordinator:

  • Is a Registered Nurse (RN, BSCN);
  • Possesses exceptional communication and organizational skills;
  • Has a strong history of collaboration with community support service agencies in joint service planning;
  • Embraces change and demonstrates enthusiasm for working within new frameworks;
  • Uses their superior assessment skills and sound clinical judgement with a patient-centred approach;
  • Is a natural motivator, leader, and advocate;
  • Demonstrates a willingness to travel;
  • Practices and upholds the values of accountability and “thinking outside the box”.

If you possess the above credentials, skills, and values, we want to hear from you!

What Can I Expect To Do? 

As a Care Coordinator in our Complex Team, you will:

  • Work in close collaboration with all system partners to provide a team approach to care for the Complex Palliative population.
  • Support patients with linkages to the broader health care system with the aim of maintaining the patient’s safety in their own home. Emphasis will be on preventing admission to hospitals or visits to ED and possibly delaying or avoiding admission to Long-Term Care.
  • Provide a RAI-HC assessment within one (1) week of a patient's discharge from ED or hospital and a minimum of every 90 days.
  • Have significant interaction with hospital partners and our LHIN hospital teams to support effective transition of patients from hospital to home.
  • Represent the LHIN on multidisciplinary committees and community agency working groups.

Location: This position is located within Grey and/or Bruce counties, particularly our Hanover area. The Care Coordinator may work in a variety of settings – one of our offices, a hospital, or within the community.

How Do I Qualify?


  • A Registered Nurse (RN, BScN) who has membership in good standing with a regulatory body in Ontario.


  • Minimum of five (5) years’ related professional experience.
  • Comprehensive experience in needs assessment.

Knowledge, Skills, and Abilities:

  • In-depth knowledge of chronic disease self-management and population-based health is required.
  • Sound knowledge of community resources and the long-term care system.
  • Active knowledge of privacy and other relevant legislation (e.g., the Long Term Care Act).
  • Effective planning, organization, and evaluation skills.
  • Superior communication, interpersonal, and conflict resolution skills with high emotional intelligence.
  • Ability to embrace change.
  • Efficient computer literacy in patient health databases and Windows-based environment.
  • Demonstrated ability to balance fiscal responsibilities with patient needs.
  • The ability to travel throughout the Grey or Bruce region is required.
  • Valid driver’s license and access to a reliable vehicle.
  • Must be comfortable working within a hospital environment.

Preferred Qualifications:

  • Proficiency in a second language, particularly French.
  • CAPCE trained.
  • Proficiency with RAI-HC assessment tools.
  • An ambassador of workplace culture.