Halton@Home Patient Care Navigator
Core
Coordinate transitions for patients with complex health and social needs from hospital to home, ensuring seamless discharge and community support.
Role type
Patient Care Navigator (Case Management)
Builds
Personalized care plans and coordinated community support networks
Domain
Healthcare / Community Health / Geriatrics
Required skills
Case management, discharge planning, care coordination, geriatrics, chronic disease management, regulatory compliance, EMR systems, stakeholder liaison
Preferred skills
Masters degree in Health Discipline, experience with Meditech and CHRIS, program design, resource development
Technologies
Meditech, CHRIS, Microsoft 365
Responsibilities
Identify and assess patients eligible for the Halton@Home Program, Develop and monitor personalized care plans, Act as a liaison between patients, families, and community service providers, Build relationships with community organizations and primary care providers, Contribute to program growth through feedback and collaboration
Seniority
Mid-level (2–5 years experience)