SERVICE NAVIGATOR – JOB DESCRIPTION

Location: Multiple Sites | Job Type: Part-Time, Permanent (Hourly)
Compensation: $31.40 per hour
Schedule: 18 hours per week
Apply to: hiring@hrfht.com or apply through Indeed

ABOUT US

Since 2011, the Humber River Family Health Team (HRFHT) has partnered with over 43 physicians across six sites to deliver high-quality, comprehensive care to our community. Our interdisciplinary team, including nurse practitioners, registered nurses, social workers, dietitians, chiropodists, and a pharmacist, works collaboratively to provide inclusive, culturally responsive health services. We are committed to improving access to care, health equity, and the social determinants of health.

POSITION OVERVIEW

The Service Navigator works closely with patients, caregivers, and the interprofessional healthcare team (IHP) to facilitate seamless transitions across health and social service systems. With strong knowledge of community-based services and resources, the Service Navigator supports patients in making informed decisions about their care and improving overall health outcomes. This role emphasizes education, coordination, and patient advocacy.

QUALIFICATIONS

• Post-secondary education in Social Work, Social Service Work, Community Services, or a related field.
• Knowledge of community health, social services, and government benefit programs.
• Experience supporting individuals with complex social needs, including those navigating poverty, housing insecurity, and healthcare access.
• Familiarity with primary care and patient-centred service delivery.
• Understanding of trauma-informed, anti-oppressive, and culturally responsive practices.
• Excellent communication, advocacy, and conflict-resolution skills.
• Strong organizational skills and ability to manage multiple priorities.
• Proficiency in electronic medical records and Microsoft Office.

KEY RESPONSIBILITIES

• Assist patients and caregivers in understanding and navigating health, social, and community services.
• Provide referrals to community resources, including housing, financial assistance, legal aid, medical care, and mental health support.
• Support patients experiencing complex social needs, including end-of-life care planning, long-term care placement, and advanced care directives.
• Conduct needs assessments, develop action plans, and monitor progress.
• Liaise with external agencies, gather feedback, and ensure coordinated care.
• Participate in interdisciplinary care planning and service intake processes.
• Maintain accurate records in the EMR and contribute to data collection and reporting.
• Implement and organize the delivery of community-based support programs as required.

ORGANIZATIONAL DUTIES

• Contribute to team meetings, program planning, and interdisciplinary collaboration.
• Uphold HRFHT policies, procedures, and professional standards.
• Maintain confidentiality in accordance with FIPPA and PHIPA legislation.