Social Worker – Integrated Comprehensive Care

Number of Openings:	1	Division:	Clinical Programs
Full/Part Time/Casual:	Part Time	Program:	Integrated Comprehensive Care Program
Regular/Temporary:	Regular	Location:	HNHB boundaries *This position requires traveling within Hamilton, Burlington, Brantford, Niagara regions and Norfolk county.
Union:	Non-union	Hours of Work:	Days 8 am-4 pm *Average 37.5 hours bi-weekly
Posting Date:	August 6, 2026	Closing Date:	Until Filled
Wages:	$22.98 - $50.62 per hour Dependent on experience	French Language Skill Requirement:	N/A
This posting is for a current vacancy.

POSITION SUMMARY:

The Social Worker - ICCP (SW-ICCP) program will provide psychosocial assessment, counselling/psychotherapy, case management, Patient/family education, supportive care, discharge planning, service coordination and consultation according to best practice standards in order to assist the client in achieving optimum recovery and quality of life.

This role supports Sr. Manager - ICCP in the efficient and effective operations of the program activities, as well as providing leadership in high-risk social situations, program development, advocacy and developing and maintaining strong community linkages. Registered Social Workers will also participate in mentoring community development, teaching, continuous quality improvement and research activities.

Clients are typically individuals who have been discharged from hospital to their own home, but who still require some clinical care for a short period of time. These clients are in process of having long-term care needs assessed, are medically stable, can be of any adult age group, and may require mechanical or 2-person lifts. Clients can have variable care plan timelines.

CORE DUTIES AND RESPONSIBILITIES

Clinical

Maintains current working knowledge of relevant legislation in Mental Health Act, Health Care Consent Act, Substitute Decisions Act, Public Hospitals Act, Long Term Care Act, Child and Family Services Act, PHIPA and Excellent Care for All Act
Maintains expertise in generic social work practice and implements evidence-based practice which includes family/individual and group treatment modalities, case management, crisis intervention and discharge planning
Documents all patient related interventions adhering to the OCSWSSW Standards of Practice and the RSW disciple-specific documentation guidelines
Completes some virtual care visits as per client care plans require
Conducts comprehensive psychosocial assessments from a systems perspective which will include contact information (POA, SDM, NOK), current family/social status, financial situation, community agency involvement, mental health status, psychosocial history, social work analysis, identified issues goals and intervention plans
Identifies and intervenes with high-risk social work analysis, identified issues, goal and intervention plans
Identifies and intervenes with high-risk social situations such as intimate Partner Violence, Child Abuse/Neglect, Elder Abuse/Neglect, Financial Abuse, and others as appropriate utilizing best practise social work guidelines
Provides theory-based counselling which may include crisis intervention and illness adjustment counselling
Provides case management for an assigned client area including the facilitation of client and team goals related to function and discharge, connecting the client and/or family with services and/or resources in the community and ensuring patients and families understand the plan of care post discharge
Coordinated all complex discharges and facilitates program specific case management activities
Assumes the lead responsibility for discharge planning including the identification of client and family needs and resources related to safe patient discharges
Provides mentorship around specific developed areas of expertise to new RSW staff and healthcare providers of other disciplines
Meets the requirements of Ontario Social Work re-certification through continuing education as outlined by the OCSWSSW
Complies with all required Workload Measurements and other statistical data collection expectations
Engages in knowledgeable, sensitive and expert care of seniors, and support of their families
Advocates in the best interests of the clients
Completed regular, mandatory and optional professional development
Engages in self reflection and adaptation to the changing needs of clients

Administration

Working with others in ordering of required supplies and/or equipment
Recording treatment activities in client charts, maintaining on-going support of other interdisciplinary program staff
Developing and presenting reports and/or metrics as requested
Supporting clients in setting up therapy appointments
Supporting referral/intake processes of the program
Providing general assistants to program Managers
Performing general administrative duties related to the role
Participate on committees and program development related to areas of practice.

CORE COMPENTENCIES

Regularly demonstrates our mission, vision and values:
1. Support compassionate care, faith and diversity
2. Deliver quality care, pursue and share knowledge, respect diversity, remain faithful
3. Commit to working everyday with dignity, respect, service, justice, responsibility and enquiry
Ability to work cooperatively with others; sharing information and utilizing the information from others
Actively promotes a healthy, supportive and inclusive work environment
Proactively contributes to initiatives, supporting and encouraging positive change
Ability to demonstrate effective decision making within the scope of the role
Skilled at thinking about creative solutions to everyday problems
Solid team-based approach to everyday work activities
Good communication skills both verbal and written, with an excellent customer service mind set
Positive and professional, with a “can do” attitude
Willingness to regularly go the extra mile and actively support co-workers
Ability to follow direction and listen to instruction
Proven ability to be detailed oriented
Maintaining on-going compliance to corporate policies and procedures, health and safety regulations, and relevant external standards
Participating in both internal and external training requirements
Participating in quality improvement initiatives
Maintaining the privacy and confidentiality of all personal health records (including both client and personal), and following all the privacy and confidentiality requirements of all electronic medical record systems used (including but not limited to Procura and HPG)

QUALIFICATIONS:

Bachelor’s Degree in Social Work from an accredited University, required
Registered with the Ontario College of Social Workers and Social Service Workers, required
Membership with the Ontario association of Social Workers, preferred
Minimum one year recent and related experience, required
Gentle Persuasive Approach training, preferred
Previous experience using mobile tools and devices, preferred
Previous experience or education in Equity, Diversity and Inclusion and/or Indigenous Cultural Awareness, an asset
Previous experience in a Home or Community care setting, preferred

St. Joseph’s Home Care is an equal opportunity employer, committed to equity, inclusiveness, and diversity across all our programs, practices, facilities, and team. AI is not used in our recruitment processes for the selection of candidates.
If you require any accommodations during the recruitment process, such as alternate formats of materials or accessible meeting rooms, please inform the hiring manager before your interview. Should you wish to conduct your interview in French, kindly contact our head office to arrange this in advance.

Social Worker - Integrated Comprehensive Care Program

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