Transitional Case Manager, Elgin

Transitional Case Manager, Elgin
Direct Service - (OPSEU)
Full-Time, Contract (End Date: July 31, 2028)

This posting is the result of a current vacancy.
St. Thomas, Ontario (Elgin Zone)
- Application Deadline: September 29, 2026 -

We believe that everyone has the right to live with dignity, autonomy and independence in our community.

The Transitional Case Management Program embodies this belief by supporting individuals experiencing mental illness and/or addictions to live as independently as possible, while working collaboratively with a Transitional Case Manager to build their support systems.

As a Transitional Case Manager, you’ll also focus on assisting clients with connecting to their community and teaching life skills to help them to achieve their recovery goals. Transitional Case Managers also support the transition from hospital-based care (STEGH) to community services which is often a very critical time in a person’s health journey.

Consider revitalizing your career and making a difference in your community by joining our team!

WHAT WE'RE OFFERING:

• What you'll be making - Starting rate for this role is $27.14per hour (Level 1 – Direct Service), with a wage differential, based on regulation ($30.01 per hour for Level 1 – Direct Service, Regulated):
  • Successful candidates who are registered with one of the designated professional colleges (e.g. OCSWSSW, CNO, COTO, CRPO, CPSO, or CPO) will receive the wage differential for regulation
  • Successful external applicants will start at Level 1, with grid progression based on seniority up to Level 8 ($34.41 per hour for non-regulated, and $37.26 per hour for regulated); for internal applicants, grid level placement will occur as per the Collective Agreement
  • Premiums of $2.00 per hour will be applied for eligible Evening/Night (8:00pm – 7:00am) and Weekend Shifts.
• When you'll work - 70 hours biweekly; Monday to Friday, 8:30am-4:30pm, with a 1-hour unpaid break
• Your pension plan –Immediately eligible for optional enrolment in the Healthcare of Ontario Pension Plan (HOOPP)
• What your benefits will be – 9% in lieu of benefits

HOW YOU WILL BE MAKING A DIFFERENCE:

Assessment -In collaboration with the client:

• Assist with short term crisis management by providing an urgent/emergent response to individuals in need of case management supports
• Engage with clients on a short-term basis to support their immediate needs
• In collaboration with the client, conduct a variety of assessments (skills, functional ability, needs, barriers, etc.)
• Assess the adequacy of resources/supports currently available to the client
• Determine the impact of psychiatric symptoms on functioning
• Identify risk factors related to client and staff safety as well as relapse
• Assess barriers to successful community living (e.g. treatment options, transportation, finances, etc.)
• Obtain information, as needed, from other relevant sources
• Ensure the assessment incorporates cultural and ethnic factors
• Identify areas requiring additional assessment

Individualized Goal Setting and Rehabilitation Planning -Utilizing the information obtained through the assessment process and in collaboration with the client:

• Assist the client to identify their personal goals and preferences and utilize standardized tool (GAIN, OCAN, etc.)
• Design rehab plans based on client needs, goals and preferences
• Assist the client to navigate systems and connect to appropriate resources
• Assist the client to explore options and consequences of different choices
• Build on the client’s personal strengths, abilities and resources
• Help clients work towards their vision of a positive personal future
• Help clients identify practical strategies for achieving their vision
• Ensure issues related to transportation are addressed, incorporated into the rehab plan and are consistent with organizational policies and practices
• Work in partnership with the client in all aspects of planning
• Identify intervention strategies to meet goals
• Establish an intervention plan which includes expectations and responsibilities of the client, Case Manager, other supports (e.g. family) and resources, as well as the frequency and nature of interventions

Hospital Transition, Discharge Planning, and Continuity of Care -In collaboration with the client, hospital care teams, community providers, and natural supports:

• Participate in discharge planning processes for individuals transitioning from inpatient mental health services to community-based care.
• Complete pre-discharge assessments to identify risks, barriers, strengths, and supports that may impact successful community reintegration.
• Develop individualized transition plans that address housing, income, medication management, transportation, community supports, primary care, and recovery goals.
• Coordinate discharge planning with hospital staff, psychiatrists, physicians, social workers, and community service providers to ensure continuity of care.
• Facilitate timely referrals and warm handoffs to appropriate community-based mental health, addictions, primary care, housing, income support, and social services.
• Support clients during the critical post-discharge period through outreach, follow-up contacts, and system navigation.
• Monitor and address factors associated with relapse, crisis presentations, emergency department utilization, and repeat hospitalizations.
• Assist clients in developing relapse prevention, crisis response, and wellness plans that support long-term recovery and stability.
• Advocate for clients experiencing barriers to accessing services and resources necessary for successful community living.
• Support clients at risk of involvement with the justice system by facilitating timely access to mental health, addictions, housing, and community supports that promote stability and reduce recidivism.
• Collaborate with family members, caregivers, and natural supports, where appropriate and with consent, to strengthen community-based support networks.
• Maintain communication with referral sources and partner agencies to ensure care coordination and seamless transitions between services.
• Evaluate progress toward transition goals and adjust interventions as required to support successful community integration.
• Support program outcomes related to reduced recidivism and hospital readmissions, increased community stability, and successful connection to ongoing supports.

WHAT YOU'LL NEED TO APPLY:

Police Vulnerable Sector Check Requirements
Successful candidates must have a Police Vulnerable Sector Check (PVSC) completed within the last six months. In order to avoid delays in beginning a position, interested applicants who are in need of a PVSC are encouraged to apply for one as soon as possible.

We require the following qualifications:

• Diploma or degree in a health, social service or a related discipline (primary proof of credentials will be required during the hiring process i.e. original degree/diploma or official transcript)
• Ontario G Driver’s Licence
• Access to a vehicle for personal transportation
• Transportation of clients in personal vehicle; two million-dollar ($2 000 000.00) liability insurance required
• Current, satisfactory Police Vulnerable Sector Check (PVSC)
• Demonstrated ability to attend work regularly

We prefer the following qualifications:

• First Aid & CPR, WHMIS Training
• Experience working with individuals with a serious mental illness
• Knowledge of serious mental illness and its impact on clients
• Excellent knowledge of community resources
• Bilingual in both official languages, preferred; Une préférence sera accordée aux personnes possédant des compétences dans les deux langues officielles du Canada

INTERNAL APPLICANTS: To be considered as an internal applicant, current staff members are reminded to apply using their @cmhatv.ca or @slwar.ca email address.

Get your application in by – September 29, 2026

Our recruitment process allows us to learn about your previous work experience, your qualifications and your commitment to fulfilling our vision. While we appreciate the interest of all applicants, only those individuals being considered for a position will be personally contacted by someone from the interview team. 

We welcome and encourage applications from all members of our community including persons of any gender, gender identity, gender expression, or sexual orientation, persons with disabilities, Indigenous persons, and members of visible minorities. If you require accommodations related to a disability at any point during the recruitment process, please contact [email protected]

Legal Notifications:

• For legal purposes our full business name is: Canadian Mental Health Association Thames Valley Addiction and Mental Health Services
• Artificial Intelligence is not currently employed in our recruitment processes