Position: Case Coordinator (OHT System Navigator)

Position Description: The Case Coordinator works in our programs serving individuals with problematic substance use/concurrent disorders. The Case Coordinator has primary responsibility for providing care to an identified case load of clients, but also provides group and individual interventions for other clients as required. The Case Coordinator works as part of a team (the Comprehensive Care & Integration Specialist Team along with staff from other partner agencies, including Woodgreen and Cota). The population served in this team are individuals with complex barriers to living effectively in the community leading to repeated and extended hospitalizations, including individuals with substance use, mental health, and/or cognitive functioning challenges.

The key responsibilities of the Case Coordinator include:

• being the case manager with primary responsibility for an identified case load of clients with substance use, mental health and/or other disorders;
• accepting referrals from Ontario Health Team partners
• working with the system navigator team across multiple partner organizations as part of the Comprehensive Care & Integration Specialist Team;
• working with clients and other health services in developing, modifying and implementing individual Coordinated Care Plans;
• conducting formal assessments in the areas of substance use and other health issues as required;
• working with physicians and other medical providers to ensure continuity of medical care;
• utilizing Pirouette to its full capacity for admission, case notes, discharge and management of the client file;
• providing leadership as part of the St. Michael's Homes team in relation to OHT-based system navigation;
• participating in CCIST and other OHT system navigator meetings;
• participating in at least one of the East Toronto Health Partners Primary Care Team Hub meetings on a weekly basis;
• regular participation in the emergency on call rotation as scheduled.

Additionally, the Case Coordinator responsibilities include, but are not limited to:

• informal assessment;
• brief interventions;
• individual counseling;
• assisting clients with challenges related to the social determinants of health;
• information/health promotion; referral;
• assisting clients with their medications; and,
• liaising with community and allied services, resources, partners and referral sources.

Knowledge, Skills and Abilities

• Comprehensive knowledge of issues related to addiction, concurrent disorder, mental health, trauma and recovery.
• Knowledge and understanding of community addiction and mental health case management services.
• Knowledge of the spectrum of harm reduction and abstinence approaches to problematic substance use.
• Understanding of and commitment to health equity, diversity and inclusivity.
• Experience utilizing various approaches such as cognitive behavioral therapy, psycho-educational, and SMART Recovery models.
• Strong skills with Catalyst.
• Knowledge and experience with the principles of adult education.
• Demonstrated ability to integrate current best practice and research evidence to support professional practice decisions and actions.
• Demonstrated ability to integrate and evaluate pertinent data (from multiple sources) to problem-solve and make decisions effectively, using a systems approach.
• Extensive knowledge and skills in assessment, supportive counseling, case coordination/management and brief-intervention skills.
• Experience and skills working with individuals affected by poverty, violence, homelessness, institutionalization (incarceration), stigma, racism and/or homophobia/transphobia.
• Knowledge of the impact of social/cultural/economic factors on the determinants of health.
• Knowledge, understanding and sensitivity to the complexity of issues arising for individuals who have experienced homelessness, addictions, poverty and/or mental illness.
• Ability to work collaboratively within and across interdisciplinary teams and community partners.
• Ability to work with clients presenting with a wide range of mental health issues.
• Demonstrated flexibility, sound judgment, initiative and creativity.
• Demonstrated capacity to thrive and engage in a dynamic and changing work environment.
• Experience working within an anti-oppression and trauma informed framework.
• Excellent interpersonal and communication skills.
• Proficiency in the use of computers and various software applications.
• Experience working in a residential setting is an asset.

Qualifications

• University Degree in Social Work (BSW) or equivalent education and related work experience.
• Registration in good standing with a regulated health profession, including the Ontario College of Social Workers and Social Services Workers (RSW), the College of Registered Psychotherapists of Ontario (RP or RP Qualifying) is required.
• Demonstrated experience in screening and assessment, supportive counseling, case coordination/management and brief intervention.
• Demonstrated experience in motivational interviewing and cognitive behavioral therapy.
• Demonstrated experience with group development, facilitation and evaluation.
• Additional training in screening, assessment and treatment related to concurrent disorder and trauma an asset.
• Certification in GAIN Administration, STOP, and SMART Recovery facilitation an asset.
• Proficiency and ability to work in both French and English is an asset.
• Ability to work in a language in addition to English is an asset.

St. Michael's Homes is an equal opportunity employer committed to diversity and inclusion and are pleased to consider all qualified applicants for employment. Accommodations are available on request for candidates throughout the recruitment process.

St. Michael's Homes thanks all applicants for their interest, however only those candidates chosen for an interview will be contacted.