Care Coordinator – Nurse

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About the role

  • Care Coordinator - Nurse providing virtual nursing support at Serefin Health. Join our team to make a meaningful impact in client care and support across various care programs.

Responsibilities

  • Complete intakes and nursing assessments to understand client needs, health history, social supports, caregiver needs, goals and appropriate program/resource pathways.
  • Develop, document and update care coordination plans with clients and caregivers, including priorities, realistic goals, follow-up actions and clear next steps.
  • Support clients, caregivers and families through empathetic education, coaching and motivational interviewing so they understand provider instructions, symptoms, care plans, treatments, records and self-management needs.
  • Navigate healthcare, community, social, benefits, workplace, wellness, travel and virtual resources; support appointment preparation, referrals and follow-up; identify gaps; and advocate respectfully for access, continuity and client preferences.
  • Coordinate and share relevant information with authorized providers, care team members, program partners and internal colleagues in a timely, privacy-compliant manner to support transitions, reduce duplication and improve continuity of care.
  • Provide non-emergency guidance, check-ins and monitoring; recognize changes, symptom concerns, mental wellbeing or caregiver concerns; and escalate for clinical review, provider follow-up or emergency care as appropriate.
  • Use Serefin digital platforms, documentation tools and communication pathways securely to consolidate health information, manage caseload priorities, maintain confidentiality and support high-quality care.
  • Collaborate with colleagues and leaders to strengthen care coordination resources, referral/resource libraries, workflows, digital tools, platforms and communication pathways; participate in meetings, training and quality improvement.
  • Work independently with sound judgement while remaining responsive, team-oriented and aligned with clinical standards, policies and operational needs.
  • Support the organization's operational priorities and contribute to other business initiatives as required.

Requirements

  • Registered Nurse (RN), Registered Practical Nurse (RPN), or Licensed Practical Nurse (LPN) currently registered and in good standing with their respective college.
  • Minimum 3 years of nursing experience in acute care (e.g., Emergency, Medicine, ICU), community care, primary care, complex care, or a related setting.
  • Experience in nursing with the elderly population and individuals with complex needs is desirable.
  • Strong assessment, triage, documentation, teaching, and coaching skills.
  • Ability to support clients, caregivers and families through complex, sensitive or emotional conversations with empathy, professionalism, cultural humility and clear boundaries.
  • Demonstrated problem-solving, decision-making, and critical thinking skills while effectively managing multiple priorities.
  • Works well both collaboratively and independently.
  • Excellent interpersonal and communication skills, both oral and written.
  • Proficiency in English is required. French fluency is strongly preferred; additional languages are an asset.
  • Comfortable using technology, including electronic documentation platforms, Microsoft 365 applications, telephone systems, and other digital tools.
  • Must have a private, secure workspace with a door that can be closed to maintain client privacy and confidentiality.
  • Up-to-date Police Reference Check.
  • The role requires the ability to work regularly on evenings, nights, weekends and statutory holidays.

Job title

Job type

Full Time

Experience level

Mid levelSenior

Salary

CA$85,000 - CA$95,000 per year

Degree requirement

Professional Certificate

Location requirements

RemoteCanada

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