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Clinical Care Coordinators, South West Community Care Access Centre

London, Ontario
Deadline July 20, 2015

Community Care Access Centres (CCACs) are publicly funded health care agencies dedicated to getting people the home care and community care they need to stay well, heal at home and stay safely in their homes longer.

The South West Community Care Access Centre (CCAC) serves 60,000 people each year, across a vast region from Tobermory in the north to Long Point and Port Glasgow in the south. Our role is to get people the home and community care they need to stay well, heal at home and stay safely in their homes longer. We also help people transition through the system and to other living arrangements. We do it by working in partnership with clients, families, providers, community organizations, and others.

Clinical Care Coordinators (RNs)
Permanent • Full time • London
Clinical Care Coordinators support a population of patients with a diagnosis of Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF) who are admitted to hospital or present in the Emergency Department.  They work as members of the Acute Home Care Team to provide much needed support to these complex, chronic patients who are transitioning back to the community following discharge.  The Clinical Care Coordinators work with a variety of health care partners to provide clinical assessment and transition plans for these patients, supporting increased self-management and maintenance at home to minimize future hospitalizations.

As a Clinical Care Coordinator you will complete the intake assessment and develop and guide the patients through clinical care pathways while collaborating to create a discharge/transition plan as they progress to self-management. You will also be responsible for: taking action on and connecting with new referrals; gathering information using standardized assessment tools; and providing the patients and their families with recommendations for a wide range of community supports.

In this collaborative model of care, you will play an integral role which focuses on enabling the patient to better manage his/her chronic disease through support of the Acute Home Care team.  
Successful candidates will demonstrate the following:

  • Currently a Registered Nurse (RN) with membership in good standing in Ontario
  • A minimum of five years of relevant experience as a RN (preferably with ICU, ED, Medicine, Respirology and/or Cardiology experience)
  • Current clinical experience or clinical experience within the last three to six months
  • Clinical experience in COPD/CHF care
  • A working knowledge of community resources and community health care coordination models
  • A practical knowledge of relevant health care legislation (Long Term Care Act, privacy legislation, etc.)
  • Strong communication and interpersonal skills
  • Basic computer and keyboarding skills
  • Valid driver’s license and own transportation

For more information on this and other RN positons, please visit or call Heather Lucas at 416-237-1500 or 1-866-598-1500, extension 242.

How to Apply: Please forward your resume and cover letter to by July 20th, 2015.