Job Description:

CARE AND BE CARED FOR – THIS IS YOUR HOME

Are you an experienced registered nurse, physiotherapist, occupational therapist, social worker (RSW), dietitian, or speech language pathologist seeking a rewarding career that cares for others, in a professional practice that cares for you? You’re looking in the right place.

Whether you work in our office, in the community, or a health care facility – you will play a lead role in providing connected, accessible, patient-centred care – and be supported by our collaborative team that includes over 9,000 regulated health care and other professionals.

As a valued team member, your mission will be to help our patients be healthier at home, while you benefit from our supports for professional growth, personal wellness and work-life balance.

What will you do?

Under the general direction of the Manager, Patient Services and in accordance with provincial and Ontario Health atHome standards, legislation, policies and guidelines, the Geriatric Assessor (GA) will be responsible for performing multi-dimensional assessments based on referrals from external and internal health care professionals and ensuring the appropriate follow-up is completed in a timely manner. The Geriatric Assessor is committed to the health and independence of seniors in the Champlain region and is the gateway for the admission of patients into local geriatric clinics. He/she also regularly co-ordinates and communicates with the Regional Geriatric Program of Eastern Ontario.

Primary Responsibilities:

• Based on a referral from a primary care physician or other health care provider, conduct pre-assessment via a telephone triage process to determine eligibility for programming and book a follow-up home visit if required.
• Perform a multi-dimensional assessment in the patient’s home which includes, but is not limited to: sensory pre-assessment, social and physical environment checklist, medical history report, medication review, functional (ADLS/IADLS), cognition, and caregiver concerns.
• Prepare suitable preliminary recommendations for services based on the outcome of each assessment and when necessary, facilitate a pre-consult with Geriatrician via telephone to obtain recommendation for services.
• Provide resulting assessment documentation to appropriate external contacts for admission to pre-arranged Geriatric Clinic(s).
• Support Geriatric Clinic and patient by attending the clinic with the patient and conducting appropriate follow-up calls and/or visits post clinic visit.
• Link and facilitate contact on behalf of the patient to appropriate community supports and services outside the scope of Specialized Geriatric Services.
• Discharge non-complex patients with little need for follow up from the GA caseload and advise them of the recall process.
• Process recall referrals via Telehealth as needed.
• Participation on internal and external committees as required.

Department: Geriatric Team

Hours in a Biweekly Period: 8:00am – 4:00pm (35hrs/week))

FTE: 1.0

Salary Range :$44.480 - $47.517

Reports To: Manager, Patient Services

Union Affiliation: OPSEU

Location: Cornwall

What must you have?

• Registered Nurse (BScN or diploma) with a current Certificate of Registration from the College of Nurses of Ontario; or

  • Degree or diploma in Physiotherapy and registered with the College of Physiotherapy of Ontario; or
  • Degree or diploma in Occupational Therapy and registered with the College of Occupational Therapy of Ontario; or
  • Degree in Social Work and registered with the Ontario College of Social Workers and Social Service Workers.
  • A GNC certification is considered an asset
  • A minimum of four (4) years’ experience in a community care setting that includes client counseling, case management and discharge planning with at least one year providing related geriatric assessment services
  • Experience working with, collaborating and linking with other community health and social service agencies

What would give you the edge?

Knowledge:

• Knowledge and understanding of the broader health care delivery system and community resources specific to Geriatric Services within the Champlain region

  • Good knowledge of primary care services and other community resources in the Ontario Health atHome, as well as the roles of health care professionals
  • In-depth knowledge of tools, systems, and databases used in client service delivery and management (e.g. UPP database; Internal Physician and client data base etc.)
  • Knowledge of health care delivery system and community resources within the Champlain region
  • Medical conditions and cognitive/psychiatric disorders
  • Client centered, multi-disciplinary team approach to client care
  • Proficient in the use of computerized processes including the use of mobile (laptop) technology

Skills and Abilities:

• Demonstrates effective time management and organizational skills
• Effective decision-making and problem-solving in crisis situations
• Ability to negotiate and implement an effective goal-oriented, client-centered care plan
• Team player with ability to accept and adapt to change
• Ability to maintain a positive attitude in stressful situations
• Ability to organize daily workload in the presence of frequent interruptions
• A valid Ontario driver’s license (or provincial equivalent) and access to a vehicle is required
• Fluency in English and French is required

Hours of Work

Monday to Friday – 8:00am to 4:00pm (35hrs/week)

We offer flexible work options, this position will have a hybrid model of work with a combination of in-office and telework.

What do we offer?

We know wellness is supported with work-life balance. In an inclusive culture committed to support your passion for continuous learning, growth and innovation, we offer:

• Attractive comprehensive compensation packages and benefits
• Valuable development opportunities
• Membership in a world class defined benefit pension plan
• Salary Range :$44.480 - $47.517

Who are we?

We are Ontario Health atHome, ready to serve every person in Ontario. We partner with patients and caregivers, family physicians, hospitals, long-term care and retirement homes, service providers and Ontario Health Teams, to deliver responsive, accessible, integrated, patient-centred care.

Why join us?

If you’re interested in driving excellence in care and service delivery, and seeking an unparalleled opportunity to lead and learn, partner and connect, care and be cared for, this is your home.

Equity, Inclusion, Diversity and Anti-Racism Commitment

Ontario Health atHome is committed to a culture of equity, inclusion, diversity and anti-racism. We are committed to attracting, engaging and developing a workforce that reflects the diverse communities we serve. We welcome and encourage applications from all qualified applicants. Accommodations for persons with disabilities required during the recruitment process are available upon request.

We thank all applicants for their interest; however, only those selected for an interview will be contacted.