Reporting to the Manager of the Satellite Health Facility, the Transitional Care/Discharge Specialist is a health professional who takes a leadership consultant role in the development and implementation of comprehensive plan of community care for complex cases and quality improvement work related to our ALC work plan with HCCSS and HHS. The role provides clinical consultation around complex discharge planning.

Other responsibilities include: constantly evaluating the community care needs of patients within an interdisciplinary framework in order to achieve an individualized, secure and well-coordinated discharge plan; determining ongoing medical, technological, rehabilitative, psychosocial and financial resource needs; negotiating with community service providers to ensure optimal delivery of community resources; evaluating outcomes to ensure quality and continuity of care; and effectively utilizing resources to achieve cost-effective health care.

The Transitional

Care and Discharge Specialist integrates research and practice and creates, utilizes and disseminates knowledge.

- Regulated Health Care Skilled with varied experience in acute,



long term and community programs
- Minimum 5 years of related clinical experience including: clinical expertise, resource management, quality improvement, case management and discharge planning
- Computer office support software knowledge including databases, spreadsheets and presentation software
- Basic knowledge of utilization management including CMG's, EDD, LOS, and benchmarking
- Demonstrated knowledge of adult education principles
- Established network of internal and external resource contacts
- Excellent communication, presentation, time management and organizational skills
- Excellent critical thinking, problem solving, decision making and conflict resolution skills
- Strong leadership, interpersonal, negotiating, consensus-building and teaching skills
- Demonstrated willingness and ability to learn new skills and support change management
- Demonstrated dedication to continuing education, the continuous improvement process and evaluation
- Masters level degree preferred

📌 Discharge Specialist (Canada)
🏢 Hamilton Health Sciences
📍 Canada