Your Opportunity:

Reporting to the Transition Service Manager, the Transition Coordinator (TC) is a clinical, consultative role responsible for supporting safe, timely, and seamless transitions from Acute Care into Home and Community Care, including Continuing Care Homes (CCH). This position ensures that comprehensive assessments, care planning, and coordination activities enable consistent, equitable access to services across the continuing care continuum. The Transition Coordinator provides clinical expertise and system navigation support to clients, families, interdisciplinary teams, and community partners. TCs ensure accurate assessment, effective discharge planning, and alignment with provincial policies, while monitoring waitlisted clients and facilitating transparent, client centered transition processes. Participates in interdisciplinary rounds and offer informal leadership in transition planning. Escalates concerns related to barriers in discharge planning or care coordination. Conducts comprehensive assessments for Continuing Care options using approved standardized tools (e.g., RAI-HC, InterRAI CA). and timely transitions. Completes reassessments and adjusts care plans based on changes in client condition, new information, or evolving needs. Initiates referrals to ALA Home and Community Care, Alberta Health Service (AHS) and Recovery Alberta (RA) services and clinical disciplines as required. Provides consultation and guidance to colleagues on assessment processes and available care options. Actively supports discharge planning for multiple streams, including Home Living, Supportive Living, Continuing Care Homes, Sub-Acute/Post-Acute, Rehabilitation/Restorative Care, and Hospice.

Description:

As a Registered Nurse (RN), you will provide a wide variety of nursing services to patients, families, communities and populations, while taking necessary steps to ensure their safety and well-being. In your role, you will utilize nursing processes, through critical thinking, problem solving and decision making, as well as teach, counsel and advocate on behalf of patients and their families. You will play a leadership role in supporting an integrated and holistic approach to patient care, health promotion and maintenance. You will provide safe, quality patient and family centered care while reflecting the shared vision and values. PLEASE NOTE: Provisional Permit holders will be paid $40.76 to $55.79 per hour. Upon obtaining a full practice permit, the rate of pay will be adjusted to the applicable Registered Nurse rate in accordance with UNA Article 25.02(b)(i) or (ii), as applicable.