Systems Navigator - Pinecrest-Queensway Community Health Centre

Mar 12, 2021
Ottawa, Ontario
Job title:                             Systems Navigator
Status:                                Contract until March 2022  
Hours:                                 35 hours/week
Benefits and Eligibility:     3% in lieu of group benefits, HOOPP pension eligibility, two weeks leave
Application deadline:        Until filled

Who are we? 

Pinecrest-Queensway Community Health Centre is an innovative community based, multi-service center. We strive to meet the needs of the diverse communities we serve. We work in partnership with individuals, families, and communities to achieve their full potential, paying particular attention to those who are most vulnerable and at risk. PQCHC is an equal opportunity employer and values diversity in its workforce. If at any stage in the selection process you require an accommodation due to a disability, Please let us know the nature of the required accommodation.


Job Summary

The Systems Navigator is the first point of contact for many new clients.  The Navigator’s overall objective is to assess client needs and connect the client with the resources to meet those needs within PQCHC and/or in the broader health care community. 

The Navigator performs a comprehensive intake assessment to enable appropriate referral and works to develop client engagement in referral plan development.  The Navigator works in collaboration with Pinecrest -Queensway Community Health Centre /South Nepean satellite staff as well as the external community, healthcare, and other support services.  He/she also has solid experience and knowledge of the Centre’s population including its social, cultural, and demographic pattern.  

The Systems Navigator will also support clients who have been referred through the Health Links process where appropriate.



The  responsibilities of this position may evolve based on the changing guidelines related to the COVID 19 pandemic and emerging needs of the community. 


  • Respond to enquiries and referrals from individuals, service providers and external agencies.
  • Complete assessments working with the client, family and other members of the team, to identify client needs.  Strive to provide the appropriate level of service based on the intensity of need.
  • Assist clients to develop self-sufficiency and resiliency to meet their own needs by understanding their options and the resources available.
  • Consult with clients to match them with and refer them to the most appropriate available services and supports, using information obtained through the screening and assessment processes.
  • Encourage clients to engage in treatment/services and motivate them to seek helpful community resources while waiting for treatment/services.
  • Establish and maintain inclusive and respectful therapeutic relationships with clients to facilitate commitment to adhering to care plans.
  • Collaborate with clients to enhance motivation to engage in and follow-up on the referral process.
  • Record all clients’ interactions in an objective and accurate manner that reflects organizational protocols and established regulatory practices.
  • Identify clients who may be at risk of suicide, self-harm, harming others or where child safety is of concern to refer them accordingly.
  • Adhere to protocols and agreements between the Navigators Team and other relevant agencies and organizations.
  • Function as an information resource for clients, families, health care providers and other community partners.
  • Perform any other related duties as assigned.

Health Links Care Coordination

  • Facilitate the development and implementation of the health link care co-ordination plans as appropriate.
  • Liaise with clients, caregivers, and other health services providers in the development of client –driven coordinated care plans.  

Client Referral

  • Serve as a point of contact for referring professionals, clients, caregivers and health and/or social services organizations.
  • Monitor referral status of clients.
  • Prepare referral reports with sufficient clarity, accuracy and level of details for agencies to make an informed decision.
  • Participate in clients case conferences with specific challenges in matching clients’ needs and services. 
  • Maintain a network of referral sources appropriate to the clients’ needs.
  • Advocate with referral agencies on behalf of clients when appropriate.
  • Ensure client follow-up until they are referred to appropriate services or agencies.

Collaboration and External Partners (Outreach)

  • Conduct outreach and establish constructive relationships with a broad range of external services, such as Community Houses, immigrant serving agencies, and addiction and mental health services, and use these relationships to facilitate clients’ access.
  • Work collaboratively with CHT staff and external partners to support clients to achieve their goals and participate in case conferences where appropriate.
  • Work closely with the Professional Practice Leader to refine and improve processes, identify gaps in service and potential solutions. 



  • Degree in health or social sciences from a recognized university or an equivalent combination of education and experience.
  • At least five years’ experience working with disadvantaged, vulnerable or at-risk clients.
  • Demonstrated experience working across the continuum of community services in the Champlain region.  
  • Demonstrated experience and expertise in interviewing and assessing client needs.
  • Experience with application of a variety of screening and assessment procedures and tools.
  • Experience with care coordination.
  • Experience working in neighborhood-based settings.
  • Professional certification or relevant membership to a professional organization is a strong asset.
  • Other languages, in particular French, Arabic and Somali, are an asset.
  • Must possess a car and a valid driver license to perform assessments at different locations within the community.
This job is from CharityVillage
How to Apply