Continuing Care Coordinator, Permanent Full-Time (1.0), Home & Community Care

Requirements

• Degree in Nursing, Physiotherapy, Occupational Therapy, Speech-Language Pathology, Social Work or Dietetics (Essential)
• Current registration with the appropriate regulatory College (Essential)
• At least two (2) years of related professional experience (Essential)
• Five (5) years of related experience (Preferred)
• Related experience in a community-based setting (Prefe

Benefits

Additional Information

Compensation Pay Range: $46.02-$56.91 Job Description: If you are a current CHEO employee with access to Workday, please apply to this posting via the Workday application as an internal applicant using the Jobs Hub. To successfully apply for this position, please submit your application by 11:59 pm the day before the advertised closing date in the posting to ensure your application is received. Ottawa is built on un-ceded Algonquin Anishinaabe territory. The peoples of the Algonquin Anishinabek Nation have lived on this territory for millennia and we honour them and this land. Their culture and presence have nurtured and continue to nurture this land. CHEO also honours all First Nations, Inuit and Métis peoples and their valuable past and present contributions to this land. CHEO is one of the few stand-alone, global leaders in pediatric health and is home to more than 6,500 staff, clinicians, scientists and researchers, as well as volunteers - all of whom work together to help children and youth achieve their best lives. Within its own walls and through partnerships with community providers, CHEO has transformed from a 20th century acute care hospital into a 21st century integrated child and youth health system. Ranked in the top 1% of Canadian hospitals for the digitization of its clinical infrastructure, CHEO combines excellence in clinical care, research, and education to advance seamless care that's provided where, when, and how it is needed. CHEO's Research Institute is dedicated to world-class clinical, translational, and basic science research covering a wide range of children's health concerns. CHEO has been named Canada's best health-care employer by Forbes in 2024, 2025 and 2026 and is ranked second among Canadian hospitals on its list of Canada's Best Employers for multiple consecutive years. For the 14th consecutive year in a row, the editors of Canada's Top 100 Employers has recognized CHEO as a top employer in the National Capital Region. Every year CHEO helps more than 500,000 children and youth from Eastern Ontario, western Quebec, Nunavut and Northern Ontario. POSITION SUMMARY As a Care Coordinator supporting children and youth, you play a key role in delivering connected, accessible, and family‑centred care across home, school, and community settings. You are responsible for coordinating admissions to Home and Community Care (H&CC), including referrals from hospitals, other regions, and the community, as well as supporting smooth transitions following discharge from CHEO. In this role, you work across the full continuum of care-conducting comprehensive assessments and reassessments, determining service eligibility, developing and implementing care plans, coordinating services, and evaluating outcomes. You collaborate closely with children, youth, families, caregivers, interdisciplinary health care teams, schools, and community service providers to ensure timely access to appropriate supports and continuity of care. Grounded in a commitment to family‑centred and culturally responsive care, you bring a collaborative, evidence‑informed approach to supporting children and youth in their homes and communities. Availability for after‑hours on‑call support is required. This is a hybrid position requiring on-site presence at times based on operational needs. MAIN RESPONSIBILITIES Conducts comprehensive assessments and reassessments of children and youth, working closely with patients and families/caregivers to identify care needs and determine eligibility for services. Develops, implements, and regularly evaluates individualized care and service plans that support needs across home and school settings. Supports safe and effective transitions from hospital to home by collaborating with CHEO teams, families, and service providers. Promote early identification of patient needs and implement discharge plans that optimize hospital and community resources. Maintains ongoing communication with patients, families, interdisciplinary teams, and service providers to monitor progress and adjust care plans as needed. Conducts follow-up to assess outcomes and ensure care plans remain responsive and effective. Completes documentation and maintains appropriate EPIC and CHRIS patient records in accordance with the employee's respective regulatory College and CHEO policies and procedures. Attends and participates actively in team meetings and general staff meetings. Attends case conferences as required. Assumes responsibility for maintaining professional knowledge and updated skills. Will support other duties as assigned.

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