Comprehensive Care Specialist (2025-545-CC) at WoodGreen Community Services

Toronto, Ontario, Canada -

Full Time

Start Date

Immediate

Expiry Date

19 Mar, 26

Salary

72298.5

Posted On

19 Dec, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Social Work, Crisis Intervention, Case Management, Mental Health, Addictions, Therapeutic Approaches, Client-Centered Care, System Navigation, Crisis Assessment, Documentation Skills, Interpersonal Skills, Organizational Skills, Team Collaboration, Cultural Competence, Advocacy, Community Resources

Industry

Community Services

Description

Competition: (2025-545-CC) Comprehensive Care Specialist (2025-545-CC) Employment Type: (12-month Contract) Contract Salary, Bargaining Unit (1 Vacancy) Work Hours: 37.5 hours/week, Monday - Friday, 9am - 5pm Work Setting: Onsite – Limited Opportunities to Work Remotely Salary: $72,298.50 Application Deadline: January 04, 2026, by 11:59 pm Who We Are WoodGreen is a team of diverse and innovative change makers working together to make a difference in our communities. A United Way Anchor Agency with a proven track record and an entrepreneurial mindset, we continuously seek to develop solutions to critical social needs while striving to become a Centre for Equity. Visit www.woodgreen.org to learn more about who we are and to review our Equity Statement. We are committed to building an inclusive and diverse workforce, representative of the communities we serve. We encourage, and are pleased to consider, applications from Indigenous peoples, racialized persons/persons of colour, women/women identifying, persons with disabilities, 2SLGBTQIA+ persons, and others who contribute towards promoting innovative ideas and solutions. Program Overview – Mental Health & Addictions, Community Care This position is accountable to the Supervisor, Comprehensive Care and Integration Specialist Team at WoodGreen Community Services and offers social work/case management support to clients who are part of the MGH2Home program, which is a partnership between WoodGreen, Michael Garron Hospital, Spectrum and VHA Home Healthcare. This is a unique position supporting East Toronto Health Partners’ (ETHP) strategy to improve client transitions. This short-term transitional program (up to 90 days) involves supporting earlier discharges of adults with higher needs to reintegrate into their home and community. This multi-disciplinary team works as “one team” along with the client and designated family to address their complex health and social needs. What You Will Do Build trust and rapport with clients, families, caregivers, and hospital staff to identify individuals who would benefit from social work and transitional care supports. Collaborate with hospital teams to support referrals and intake into the program, including follow-up with referral sources to gather relevant clinical and social information. Work closely with central intake, supervisors, and program managers to identify clients with frequent hospital or ED use who may benefit from coordinated intervention. Maintain client flow-through and actively prepare clients for discharge and transition from hospital to community-based care. Participate in case conferences, clinical meetings, and team calls to ensure continuity of care and smooth transitions. Conduct comprehensive psychosocial, psychological, and/or geriatric assessments. Develop client-centered care plans and/or Coordinated Care Plans (CCPs) in collaboration with clients, families, caregivers, and service providers. Provide short-term case management and intensive care coordination (up to 90 days), including system navigation, planning, follow-up, and advocacy. Deliver clinical and/or supportive counseling using evidence-informed and client-appropriate therapeutic approaches. Link clients to internal programs and services as well as external community resources to address social, health, and practical needs. Facilitate access to services, including arranging interpretation support when required. Work proactively to prevent avoidable emergency department visits, hospital readmissions, and Alternative Level of Care (ALC) placements. Conduct preliminary risk assessments in crisis situations and develop intervention and action plans in consultation with appropriate partners. Provide crisis intervention and practical assistance to clients and/or caregivers in hospital, home, and community settings. Work closely with supervisors, interdisciplinary team members, hospital staff, and community partners to ensure coordinated and responsive service delivery. Share expertise with colleagues, provide input to other specialists, and participate actively as a member of the care coordination team. Contribute to program development by identifying opportunities to expand referral sources while balancing service capacity and operational considerations. Support or facilitate onsite programming, social groups, or support groups as required. Provide services that are culturally responsive, linguistically appropriate, and aligned with principles of equity, diversity, inclusion, and belonging. Maintain accurate, timely documentation and collect required data for program accountability and reporting. Ensure compliance with organizational policies, procedures, and professional standards. Maintain up-to-date knowledge of community resources and service systems. Participate in supervision, performance appraisals, team meetings, training, and ongoing professional development. Provide mentorship, training, and/or supervision to students and volunteers as assigned. Represent the program on internal and external committees when required. Perform other related duties as assigned. What You Bring to the Team Masters of Social Work or post-graduate degree in relevant field MSW or Post-Graduate degree in a related area with 2+ years of extensive crisis/complex seniors experience or BSW with 5+ years of extensive crisis/complex/seniors’ experience Registration in good standing with the Ontario College of Social workers and Social Service Workers or another relevant regulatory body in Ontario (e.g. CPRO or COTO). Minimum of 3 years related experience in mental health, addictions, and/or social work. Demonstrated experience facilitating psycho-social groups and supporting individuals with significant mental health and/or addictions issues, cognitive impairment (e.g. dementia), and chronic health issues from a harm reduction, trauma informed, and mental health recovery approach is required. What Will Set You Apart Ability to support complex adults and senior populations including individuals who have considerable health challenges Demonstrated ability in system navigation, service planning, implementation, and coordination, therapeutic or supportive counselling. Demonstrated ability in working effectively in a multi-disciplinary team Proven working knowledge of theories of addiction and evidence-based treatment models Knowledge of and experience with a brief therapy modality, such as Narrative, Solution-Focused, Cognitive-Behavioural Therapy, Motivational Interviewing and Trauma-Informed approaches, Comprehensive understanding of mental health, addictions, health and community sectors. Strong assessment, clinical and intervention skills. Effective oral, written communication skills and documentation skills. Effective interpersonal, time management and organizational skills. Proven ability to apply and practice anti-oppression, anti-racism, trauma-informed and harm reduction principles, and strategies. Ability to be self-directed, independent, flexible and exercise good judgment. Ability to work from a client-centered approach. Applied computer skills (MS word, excel, Internet) and ability to use client information systems. Ability to communicate in a second language (Greek, Spanish, Bengali, Urdu, Tamil, Persian, Tagalog, Arabic, Mandarin, or Cantonese) is a strong asset. Capable of fulfilling the physical and psychological demands of the job. Accommodation for disabilities provided upon request. Demonstrated skill in using computers including using technology-based solutions for service delivery, documentation, and viewing screening and assessment data. WoodGreen is an equal opportunity employer. We are committed to providing an inclusive and barrier-free selection process and work environment. If contacted in relation to an employment opportunity, please advise our People & Culture representatives at careers@woodgreen.org of the accommodation measures required. Information received relating to accommodation will be addressed confidentially. This public job posting uses AI-powered tools to screen, assess, or select applicants.

Responsibilities

The Comprehensive Care Specialist provides social work and case management support to clients in the MGH2Home program, focusing on improving client transitions from hospital to community care. Responsibilities include building rapport with clients, collaborating with hospital teams, and developing client-centered care plans.