About Us

At Home Together is a growing aged care and disability support provider delivering high-quality, personalised in-home care services throughout Canberra, Queanbeyan and surrounding regions.

We are passionate about helping older Australians maintain their independence, dignity and quality of life while remaining safely and comfortably in their own homes.

Our philosophy is simple: Care begins at home – together.

About the Role

We are seeking a compassionate, experienced and highly organised Aged Care Coordinator / Care Partner to join our growing team in Canberra.

We have a solid preference for candidates who are qualified Enrolled Nurses (ENs) or Registered Nurses (RNs), particularly those with experience in community aged care, care coordination or nursing.

The successful candidate will manage a portfolio of aged care clients, overseeing their care journey from initial enquiry and onboarding through to ongoing service coordination, care planning and regular reviews.

This is a client-facing and coordination-focused position that combines aged care knowledge, relationship management, service coordination and community engagement.

You will work closely with clients, families, healthcare professionals, support workers and external providers to ensure services are delivered safely, effectively and in accordance with each client’s individual needs and preferences.

Key Responsibilities

Client Management & Care Coordination

- Manage an allocated portfolio of aged care clients receiving services under the Support at Home program.
- Act as the primary point of contact for clients, families and authorised representatives.
- Conduct initial assessments, onboarding appointments and regular client home visits.
- Develop, implement and review individualised care plans, service agreements and risk assessments.
- Monitor clients’ wellbeing, changing needs and satisfaction with services.
- Complete monthly client wellbeing check-ins and maintain accurate records.
- Identify clients requiring additional support, clinical assessments or reassessments.
- Coordinate referrals to nursing, allied health and other healthcare professionals where required.

Service Delivery & Care Planning

- Coordinate home care services, including personal care, domestic assistance, transport, social support, gardening, home maintenance and allied health.
- Work closely with rostering and operations teams to ensure appropriate staffing and continuity of care.
- Assist clients and their representatives in understanding their available services and care budgets.
- Monitor service utilisation and assist with managing individual client budgets.
- Liaise with external service providers, hospitals,



GPs and other healthcare professionals.
- Respond promptly to service concerns, requests and changes in client circumstances.
- Ensure services remain aligned with individual care plans, assessed needs and client preferences.

Clinical Awareness & Client Wellbeing

- Use nursing knowledge and clinical experience, where applicable, to recognise changes in client health and wellbeing.
- Identify potential health risks, deterioration, falls risks and other care-related concerns.
- Escalate clinical concerns appropriately and coordinate further assessments or referrals.
- Promote safe, person-centred and evidence-informed care practices.
- Support clients and families in understanding available care options.

Compliance, Documentation & Quality

- Maintain accurate, complete and up-to-date client records using ShiftCare and other organisational systems.
- Ensure care plans, risk assessments, progress notes and service documentation are maintained to a high standard.
- Support compliance with the Aged Care Act, Aged Care Quality Standards and relevant organisational policies.
- Identify, document and escalate incidents, complaints and safeguarding concerns.
- Participate in quality improvement activities and assist with maintaining audit-ready client documentation.
- Maintain confidentiality and professional boundaries when handling client information.

Business Development & Community Engagement

- Build and maintain professional relationships with hospitals, GP clinics, retirement villages, allied health providers and community organisations.
- Represent At Home Together at community events, networking opportunities and aged care expos.
- Identify potential referral opportunities and support the growth of our aged care services.
- Assist prospective clients and families with enquiries and onboarding.
- Promote At Home Together’s services throughout Canberra and surrounding communities.

Qualifications & Experience

Highly Desirable

- Qualification as an Enrolled Nurse (EN) or Registered Nurse (RN) with current AHPRA registration.
- Previous experience in community nursing, aged care coordination, care management or home care services.
- Experience working with the Support at Home program or previous Home Care Packages arrangements.
- Knowledge of My Aged Care,



care planning, client assessments and aged care service delivery.
- Experience managing a portfolio of aged care clients and coordinating multidisciplinary services.

Essential Requirements

- Demonstrated experience in aged care, care coordination, community services or a related field.
- Excellent communication and interpersonal skills, with the ability to build strong relationships with clients and families.
- Strong organisational skills and the ability to manage multiple clients and competing priorities.
- Ability to work independently, demonstrate initiative and follow through on responsibilities.
- Strong attention to detail and confidence maintaining accurate documentation.
- Competency using computers and digital care management systems.
- Current Australian driver’s licence and willingness to travel locally for client visits.
- Ability to obtain and maintain relevant police checks, worker screening clearances and other employment compliance requirements.

Experience using ShiftCare or similar care management software will be highly regarded.

What We Offer

- Permanent full-time employment in a growing aged care organisation.
- Supportive, collaborative and professional team environment.
- Office-based position in Phillip, ACT, with regular community engagement and client visits.
- Access to a company vehicle for approved business-related travel, subject to availability.
- Opportunities for professional growth and career development.
- Competitive remuneration based on qualifications, skills and experience.
- The opportunity to make a meaningful difference in the lives of older Australians.

Why Join At Home Together?

At Home Together is committed to building a team of dedicated professionals who genuinely care about the people they support.

We value initiative, accountability, compassion and teamwork. As our aged care services continue to grow, you will have the opportunity to contribute to the development of our organisation while building meaningful relationships with clients and the wider community.

We particularly encourage applications from Enrolled Nurses and Registered Nurses who are looking to apply their clinical knowledge in a care coordination and community-based role.

How to Apply

If you are passionate about supporting older Australians, have strong care coordination skills and enjoy working in a client-focused environment, we would love to hear from you.

Please submit your resume and a brief cover letter outlining your relevant qualifications, experience and suitability for the position.

Join At Home Together – Care begins at home, together.

📌 Aged Care Coordinator / Care Partner (EN or RN Preferred) (Phillip)
🏢 At Home Together
📍 Phillip