Nurse Navigator – Community Health

About the role

The Nurse Navigator supports clients in accessing, understanding, and navigating health and social services across the community and broader healthcare system. Working within an interdisciplinary team, the role focuses on improving health outcomes and reducing barriers for diverse and underserved populations.

Key responsibilities

• Coordinate client care by facilitating referrals, follow‑up, and transitions across healthcare, social services, and community resources.
• Conduct comprehensive nursing assessments and develop individualized care plans in partnership with clients, families, and the interdisciplinary team.
• Identify and address systemic, social, cultural, linguistic, and financial barriers, providing mental health assessments, brief counseling, and linking to appropriate resources.
• Deliver health education and self‑management support using evidence‑informed approaches to promote health literacy and client autonomy.
• Build collaborative partnerships with physicians, nurse practitioners, specialists, allied health professionals, and community organizations to ensure integrated, culturally responsive care.
• Participate in case conferences, quality improvement initiatives, and program development while maintaining accurate, confidential documentation.

Required profile

• Bachelor of Science in Nursing (BScN) and current registration with the College of Nurses of Ontario (CNO) as an RN.
• Minimum two years of nursing experience in community health, primary care, hospital, public health, or related settings.
• Strong knowledge of community resources, healthcare systems, and social determinants of health.
• Excellent assessment, care coordination, and care planning abilities.
• Commitment to health equity, inclusion, anti‑oppression, and culturally safe care.

Required skills

• Proficiency with electronic medical records (EMR) systems.
• Proficiency with standard computer applications.

What we offer

• Extended health and dental coverage.
• Opportunities for professional development.
• Participation in the Healthcare of Ontario (HOOPP) pension plan.