Horizon Health Network (Canada): Careers, Hospitals & Hiring (2025)

Horizon Health Network (Canada): Careers, Hospitals & Hiring (2025) Horizon Health Network is New Brunswick’s largest English-language health authority, running regional hospitals and over 100 facilities across the province. If you’re a nurse, physician, allied health professional, or support worker—especially an internationally educated nurse (IEN)—this guide walks you through Horizon’s hiring process, what working here actually looks like, and the immigration realities nobody advertises.

Let’s be upfront: Horizon recruits heavily internationally because it can’t retain staff. New Brunswick is Canada’s poorest province; winters are brutal, many facilities are rural and isolated, and pay is lower than in other provinces. But for some people—especially those struggling to break into Canadian healthcare elsewhere—it’s a viable entry point.

Just know what you’re signing up for.

What is Horizon Health Network?

Horizon is one of two provincial health authorities in New Brunswick. The other is Vitalité Health Network, which serves primarily French-speaking populations.

Horizon delivers acute care, primary care, community health, and mental health services across multiple cities and rural communities in the southern, central, and parts of northern New Brunswick.

Major Regional Hospitals

Saint John Regional Hospital (SJRH):
Provincial tertiary referral center with Level 1 trauma, cardiac surgery, oncology, and neonatal intensive care. Largest and busiest hospital in the network. Urban setting in Saint John (port city, about 70,000 people).

The Moncton Hospital (TMH):
Regional acute care and specialty services. Moncton is New Brunswick’s largest city (about 80,000 people, 150,000 in the greater area). More services and amenities than smaller centers.

Dr. Everett Chalmers Regional Hospital (DECRH), Fredericton:
Regional acute care with strong women’s and children’s programs. Fredericton is the capital (about 60,000 people). University town, more educated population, provincial government jobs.

Miramichi Regional Hospital:
Regional acute care for the Miramichi area (about 18,000 people). Smaller city, aging population, significant rural catchment. More isolated than the big three centers.

Upper River Valley Hospital (URVH), Waterville:
Regional site serving the upper Saint John River Valley. Very rural. Waterville itself is tiny (under 1,000 people). Serves scattered small towns across a large geographic area.

Horizon also runs dozens of community hospitals, health centers, clinics, and mental health facilities in smaller towns across the province.

Where Horizon Health Network Operates (And What That Actually Means)

Horizon’s footprint covers southern, central, and parts of northern New Brunswick. If you’re used to cities, understand: outside of Saint John, Moncton, and Fredericton, you’re in small towns or rural areas.

What “regional hospital” means in New Brunswick:
It’s the main hospital for a large geographic area, but the population served is small compared to other provinces. A “regional” hospital here might have 200 beds and serve 100,000 people scattered across hundreds of kilometers.

What “community hospital” means:
Very small facility (maybe 10-30 beds), limited services, stabilize-and-transfer model for anything complex. You’re the only nurse on night shift covering the entire building.

If you’re targeting a specific city or unit, check Horizon’s facilities directory before applying. Don’t assume “regional hospital” means what it would in Ontario or BC.

Careers at Horizon: Who They Hire (And Why They’re Always Hiring)

Horizon recruits across 150+ career paths, but nursing is the chronic shortage area. They’re constantly hiring nurses—especially IENs—because retention is terrible.

Nursing Roles

RN (Registered Nurse): ICU, ED, OR, medicine, surgery, mental health, community health, public health
LPN (Licensed Practical Nurse): Long-term care, medical units, community settings
Nurse Practitioner: Primary care, specialty clinics
Patient Care Attendant (PCA): Direct patient care, often entry point for IENs completing licensing

Physicians and Hospitalists

Family medicine and various specialties. New Brunswick has chronic physician shortages, especially in rural areas. Incentives exist, but retention is still a problem.

Allied Health and Diagnostics

Respiratory therapy, medical laboratory technology, medical imaging (ultrasound, X-ray, CT, MRI), rehab (physiotherapy, occupational therapy, speech-language pathology), pharmacy, social work, psychology.

Support and Administration

Facilities management, IT, finance, scheduling, food services, environmental services (housekeeping), clerical and registration, leadership roles.

Why They’re Always Hiring

Low pay: New Brunswick nurses earn significantly less than Ontario, Alberta, or BC. An RN in New Brunswick starts around $30-32/hour. In Ontario, it’s $33-38. In Alberta, $37-40+. Over a career, that’s hundreds of thousands of dollars difference.

High workload: Chronic understaffing means you’re often working short, mandatory overtime is common, and burnout is high.

Retention problems: People take jobs at Horizon, get Canadian experience and provincial licensing, then leave for higher-paying provinces within 1-2 years. Horizon knows this and accepts it—they’re a revolving door.

Rural isolation: Many positions are in small towns with limited amenities, services, and cultural diversity. If you’re from a big city, the adjustment is brutal.

Harsh winters: New Brunswick winters are long, cold, snowy, and dark. November through March is miserable if you’re not used to it.

How to Apply to Horizon Health Network(The Process)

Horizon’s recruitment is centralized and online. No paper applications.

Step 1: Search and Shortlist

Go to Horizon’s official careers portal. Filter by profession, location, and employment type (full-time, part-time, casual, temporary).

Reality check: Many postings are casual or part-time because full-time positions with benefits are expensive. Read carefully—”casual” means no guaranteed hours, no benefits, called in as needed.

Step 2: Create Your Profile

Set up an online account. Upload:

Current résumé or CV
License and registration documents (or proof you’re in process with NANB/ANBLPN)
For IENs: NNAS reports, exam results, registration pathway documentation

Step 3: Apply Online

Complete each posting’s application. Tailor your résumé to emphasize relevant experience—ventilator management, trauma, triage, perioperative certifications, whatever matches the unit.

Tip: If you’re open to multiple sites (Fredericton AND Saint John, for example), apply to each separately. Geographic flexibility increases your chances.

Step 4: Screening and Interviews

Recruiters and unit managers screen for license eligibility, experience, and availability. Interviews are often virtual (video call).

Some roles require skills assessments or scenario-based questions. They’re testing both clinical knowledge and how you handle stress.

Step 5: References and Offer

Provide professional references—supervisors, charge nurses, clinical educators. They will be contacted.

Successful candidates get a conditional offer (pending final clearances) or a firm offer outlining site, unit, FTE (full-time equivalent—1.0 FTE is full-time, 0.5 is half-time), and start date.

Step 6: Onboarding and Clearances

Occupational health assessment, criminal background check, e-learning modules (infection control, workplace safety, etc.), site-specific orientation.

Keep current: CPR/BLS certification, immunization records (COVID, flu, MMR, TB screening), any specialty certifications required for your unit.

For international hires: This is also when you’re finalizing your work permit if it wasn’t already in place.

Internationally Educated Nurses (IENs): Your Pathway

Horizon actively recruits IENs because they can’t fill positions locally. Here’s the typical sequence:

1. Register With the IEN Navigation Service

This is the official provincial entry point for IENs coming to New Brunswick. You’ll get guidance on documentation and potential financial supports (though don’t count on much money—New Brunswick is broke).

2. Start Your Regulatory Pathway

For RNs: Register with the Nurses Association of New Brunswick (NANB). You’ll likely need:

NNAS (National Nursing Assessment Service) advisory report
Jurisprudence exam (NB healthcare law and ethics)
Language proficiency (IELTS or CELBAN, minimum scores required)
Competency assessment—written exam (NCLEX-RN for most) and/or clinical assessment (OSCE)

For LPNs: Register with the Association of New Brunswick Licensed Practical Nurses (ANBLPN). Similar process—documentation review, exams, competency assessment.

Timeline reality: This takes 6-18 months minimum, often longer. NNAS alone can take 4-6 months. Exam scheduling adds months. Clinical assessments have limited capacity and waitlists.

3. Apply to Horizon Health Network Roles Matching Your Stage

If you’re not yet licensed: Some IENs start as Patient Care Attendants (PCAs) while completing registration. It’s lower-paid, unregulated work, but it gets you Canadian experience and a foot in the door.

If you’re already licensed: Apply directly to RN or LPN postings.

4. Receive an Offer and Complete Licensing

Offers are often conditional on completing outstanding registration steps. Keep your recruiter updated on where you are in the process so timelines stay realistic.

The catch: You can’t start working as an RN or LPN until you’re fully licensed with NANB or ANBLPN. If your licensing gets delayed, your job offer might evaporate.

5. Work Authorization (Immigration)

Most internationally recruited candidates need an employer-specific work permit tied to Horizon. Your job offer and HR documentation are essential parts of your IRCC (Immigration, Refugees and Citizenship Canada) application.

Critical: The job title and duties on your work permit must match your license and the actual job. Mismatches cause problems.

Documentation to Prepare Early (IENs)

Passport valid for at least 2+ years
Education credentials and registration proofs (NNAS reports, NANB/ANBLPN documentation, exam results)
Evidence of recent clinical practice (reference letters, logbooks, competency lists, pay stubs)
Current BLS/ACLS/PALS certifications if required by your target unit
Immunization records (complete and up to date)
Criminal record checks—must be recent and from all countries you’ve lived in for 6+ months

Reality check: Gathering and translating these documents is expensive and time-consuming. Budget $2,000-5,000 and 3-6 months minimum.

Immigration and Work Authorization (The Messy Reality)

This is a brief overview. Always check IRCC’s website for current rules—immigration policy changes constantly.

Employer-Specific vs. Open Work Permits

Employer-specific work permit: Tied to Horizon Health Network, often to a specific site or unit. This is what most internationally recruited healthcare workers get. You can’t just quit and work somewhere else—you’d need a new permit.

Open work permit: Not tied to one employer. Examples: spouses of certain skilled workers (eligibility tightened in 2024-2025, check current rules), some youth mobility programs, protected persons. If you already have an open permit, you can apply directly and start once onboarding is complete.

What Most International Recruits Should Expect

Online IRCC application with biometrics (fingerprints, photo at a visa application center)
Medical exam (required for most healthcare workers—costs $200-400, not covered by anyone)
Temporary Resident Visa (TRV) or eTA (electronic Travel Authorization) issued with your work permit, depending on your nationality
Processing time: IRCC advertises 8-16 weeks. Reality is often 3-6 months, sometimes longer if there are issues with documentation

If you’re already in Canada on a different status (visitor, student, different work permit), you can apply to extend or change conditions. Filing before your current status expires preserves “maintained status”—you can keep working under your current conditions while the new application processes.

But: Processing times are unpredictable. You could be in limbo for months.

Family Considerations

Spousal open work permit: Eligibility rules changed significantly in 2024-2025. It’s no longer automatic for all skilled workers’ spouses. Check IRCC’s current criteria carefully before assuming your spouse can work.

Dependent children: School-age children typically need study permits for post-secondary education, but K-12 in most provinces (including New Brunswick) doesn’t require separate permits if they’re accompanying a parent on a work permit. Verify current rules—they keep changing.

The hard truth: Bringing family adds complexity, costs (visa fees, medical exams for everyone, IHS-equivalent where applicable), and stress. Some people come alone initially to establish themselves, then bring family later.

Living and Working in New Brunswick (The Reality Nobody Advertises)

Let’s talk honestly about what living here is actually like.

The Cities (And What That Means Here)

Saint John: Population ~70,000 (city proper). Historic port city with oil refinery and paper mill. Industrial economy, working-class roots. Housing stock varies wildly—beautiful historic neighborhoods and rough areas. Winter is harsh (wind off the ocean). Research commute routes to the hospital (Millidgeville area) before choosing housing.

Moncton/Dieppe/Riverview: “Tri-city” area, about 150,000 total. New Brunswick’s commercial hub. Bilingual (French and English). Airport with flights to Toronto, Montreal, Halifax. More services and amenities than elsewhere in the province, but still small by Ontario/Alberta standards.

Fredericton: Capital city, population ~60,000. University town (UNB). Government and public-sector jobs. More educated population. Quieter and more genteel than Saint John or Moncton. Winters are cold and snowy. Housing market is tight.

Miramichi: Population ~18,000 (city), ~40,000 (region). River city with strong community identity. Aging population, economic struggles since mill closures. More isolated—90 minutes from Moncton or Fredericton. If you’re from a big city, this will feel remote.

Upper River Valley (Waterville/Woodstock area): Waterville is tiny (under 1,000 people). Woodstock is bigger (~5,000). Very rural, agricultural economy, scattered small towns. This is true countryside. If you want urban amenities, forget it.

Cost of Living (And Why It Matters Less Than You Think)

New Brunswick has Canada’s lowest cost of living. Rent is cheaper than Toronto, Vancouver, or Calgary.

But:

Pay is also the lowest. You’re earning 10-20% less than in Ontario or Alberta, and income taxes in New Brunswick are higher than some other provinces. Your take-home is disappointing.

You need a car. Public transit is minimal to nonexistent outside downtown Moncton and Fredericton. You’re driving everywhere. Car payments, insurance (expensive in Atlantic Canada), gas, winter tires, maintenance—it adds up fast.

Heating costs are brutal. Winter heating bills can hit $300-500/month or more for a house. Add that to your budget.

Limited services mean higher costs for some things. Fewer options for shopping, dining, entertainment. You’ll drive to Halifax (3-4 hours) or fly to Toronto/Montreal for things you can’t get locally.

The calculation: Yes, a 2-bedroom apartment in Moncton is $1,000-1,200/month vs. $2,000+ in Toronto. But your salary is $10,000-15,000 less per year, and you’re spending more on transportation and heating. The savings are real but not as dramatic as recruiters suggest.

Winters (This Matters More Than You Think)

New Brunswick winters are long, cold, snowy, and dark.

November through March is winter. Temperatures regularly hit -15°C to -25°C (5°F to -13°F). Snowstorms dump 20-40cm (8-16 inches) overnight. Roads are icy. You’ll shovel your driveway multiple times per week.

Daylight in December/January: sunrise around 8 AM, sunset around 4:30 PM. It’s dark when you go to work and dark when you leave.

If you’re from a warm climate (Philippines, India, Nigeria, Middle East), this is a brutal adjustment. Seasonal affective disorder (SAD) is real. So is the isolation of being stuck indoors for months.

Cultural Adjustment (Especially for Visible Minorities)

New Brunswick is one of Canada’s least diverse provinces. Outside of Moncton and Fredericton, you might be the only person of your ethnicity in your workplace or neighborhood.

What this means:

Staring. People aren’t necessarily hostile, but visible minorities attract attention because you’re unusual here.
Casual racism and microaggressions. “Where are you REALLY from?” “Your English is so good!” (even if you’re a native speaker). Assumptions about your competence.
Limited cultural community or support networks. No temples, mosques, or ethnic grocery stores in small towns. You’re isolated culturally.
Workplace dynamics. Some Maritime-born staff resent internationally educated nurses or doctors. “Taking our jobs,” even though locals won’t take the jobs at the pay offered.

It’s not universally hostile. Many people are welcoming. But isolation is real, especially in rural areas.

Why People Leave (The Retention Problem)

Horizon has a revolving door. Here’s why people don’t stay:

Low pay. Once you have Canadian experience and provincial licensing, you can get hired in Ontario, Alberta, or BC for 15-25% more money.

Better opportunities elsewhere. Bigger cities, more career advancement, specialized training, professional development—all limited in New Brunswick.

Isolation and winters. People burn out on the cold, the darkness, the limited social and cultural opportunities.

Family reasons. Your spouse can’t find work in their field (limited job market). Kids struggle with limited schools or extracurriculars. You want to be near extended family or cultural community.

Burnout. Chronic understaffing, mandatory overtime, toxic workplace dynamics—people hit their limit and leave.

Horizon Health Network knows this. They accept 1-2 year average tenure for many internationally recruited staff. You’re a temporary solution to a permanent problem (low wages and poor working conditions that they won’t fix).

Horizon Health Network: Hospital Working Conditions (What Recruiters Won’t Tell You)

Staffing Shortages

You’ll work short regularly. The “recommended” nurse-to-patient ratio is ignored constantly. You’re covering 6-8 patients on a medical unit when it should be 4-5. In ICU, you’re alone with 2-3 vented patients when it should be 1:1 or 1:2 max.

Mandatory Overtime

You’ll be mandated to stay late or come in on days off. “Mandatory” means you can’t refuse without consequences (disciplinary action, being labeled unreliable). This happens weekly in some units.

Horizon Health Network: Rural vs. Urban Hospitals

Urban (Saint John, Moncton, Fredericton): Higher acuity, more resources, some specialty services. Still understaffed and stressful, but you have colleagues and backup.

Rural (Miramichi, Waterville, community hospitals): You’re often alone or with minimal staff. Sicker patients get transferred out, but you’re stabilizing them first. Limited equipment and support. Terrifying if you’re not experienced.

Horizon Health Network: Toxic Workplace Dynamics

Some units have clique-ish veteran staff who haze new people, especially internationally educated nurses. Bullying, exclusion, undermining. Management often ignores it.

Not every unit, not every site. But it happens enough that you should ask about workplace culture during interviews.

Horizon Health Network: Contract vs. Permanent Positions

Many job postings are “temporary” or “casual” because Horizon doesn’t want to commit to full-time permanent positions with benefits.

Casual: No guaranteed hours. Called in as needed. No benefits, no paid time off, no job security.

Temporary: Fixed-term contract (6 months, 1 year). May or may not be renewed. Limited or no benefits.

Permanent full-time: What you actually want. Salary, benefits, vacation, sick leave, job security. Harder to get.

Read the posting carefully. Ask directly in the interview: “Is this position permanent full-time, or temporary/casual?”

Incentives, Programs, and Referral Rewards for Horizon Health Network

Referral Reward Program

Horizon pays bonuses if you refer someone who gets hired and stays a certain period. Amounts vary by role—higher for critical care and emergency nursing.

Check Horizon’s website for current details (who can refer, who can be referred, payout timelines). The program exists to address chronic vacancies, which tells you everything about retention.

Student and Graduate Pathways

SNAP (Student Nurse Accelerated Program) and similar programs for new grads. Some financial support, mentorship, orientation.

Good for new nurses, but doesn’t solve the underlying pay and retention problems.

Relocation Support

Some positions come with relocation assistance—moving costs, temporary housing, etc. Ask your recruiter explicitly. Get it in writing.

Don’t assume. Many postings have zero relocation support, and moving to New Brunswick from overseas costs $5,000-15,000 (flights, shipping, initial housing deposits, furniture, car).

Horizon Health Network: Language and Culture (Bilingualism Matters)

New Brunswick is Canada’s only officially bilingual province. Horizon is the English-language health authority, but services are provided in both English and French.

Vitalité Health Network is the primarily French-language authority. If you’re Francophone or bilingual, you can apply to both—Vitalité has similar vacancies.

If you speak both English and French fluently, you’re gold. Bilingual staff are in high demand and sometimes get hiring preference or pay premiums.

FAQs (Real Answers)

How do I find nursing jobs at Saint John Regional Hospital?

Filter the careers portal by location (Saint John) and profession (RN, LPN, NP, PCA). Apply to each posting that matches your scope.

Does Horizon hire internationally educated nurses directly?

Yes. They recruit IENs heavily because they can’t retain local staff. Depending on your licensing stage, you might start as a PCA while completing requirements, or go straight into RN/LPN roles once registered.

What’s the difference between Horizon Health Network and Vitalité?

Both are provincial health authorities. Horizon serves primarily English-speaking populations. Vitalité serves primarily French-speaking populations. Job postings and application processes are separate.

Does Horizon Health Network support immigration paperwork?

They provide job offers and HR letters needed for your work permit application. You’re responsible for submitting to IRCC (and paying all fees). Some positions might include limited onboarding support, but don’t count on handholding.

How long does RN licensing with NANB take?

6-18 months minimum, often longer. Depends on your country of education, NNAS processing speed, exam scheduling, and competency assessment waitlists. Start immediately.

Can I apply to multiple hospital sites?

Yes. Create one profile and submit separate applications for each site or unit you’re interested in (ICU Moncton, Med-Surg Fredericton, ED Saint John, etc.).

Are there referral bonuses?

Yes, but amounts and eligible roles change. Check Horizon’s current referral rewards page before submitting.

Are there bridging or orientation roles while licensing is pending?

Some sites hire IENs into PCA roles while completing registration. Ask your recruiter about availability at your target site.

What documents do I need for the application?

Résumé, license or proof of registration pathway (NNAS, NANB, ANBLPN documentation), references, certifications (BLS, ACLS, specialty certs), immunization records, government ID. International candidates also need passport, police clearances, medical exam, and immigration documents.

What are benefits and professional development like?

Depends on whether you’re permanent, temporary, or casual, and which union contract applies (if any). Ask HR during the offer stage. Get specifics in writing.

Is the pay worth it?

Honestly? If you’re comparing to other Canadian provinces, New Brunswick pays the least. But if you’re currently unable to break into Canadian healthcare elsewhere, or you’re in a country with even worse wages and conditions, it’s a stepping stone. Just plan your exit strategy.

How to Apply to Horizon Health Network (5 Steps)

Search Horizon’s careers portal by site, unit, and profession
Create profile and upload licenses and registration documentation
Submit applications online (tailor each one to the specific unit)
Complete interviews, provide references, pass any assessments
Accept offer and finish onboarding, clearances, and (for international hires) work permit process

Final Word

Horizon Health Network hires constantly—especially nurses—because they can’t retain staff. New Brunswick is Canada’s poorest province with the lowest wages, harsh winters, rural isolation, and limited opportunities for career advancement or cultural community.

For some people, it’s still worth it: Entry into Canadian healthcare, pathway to licensing, stepping stone to better opportunities elsewhere.

For others, it’s a trap: Low pay, brutal conditions, geographic isolation, and years stuck in a place you hate because you can’t afford to leave.

If you’re domestic (already in Canada), think hard about whether New Brunswick is where you want to be long-term. If you’re international, understand that this is likely a 1-3 year stepping stone, not a permanent destination.

Go in with open eyes. Get everything in writing. Plan your exit before you arrive.

And remember: the reason they’re hiring internationally isn’t because New Brunswick is a great place to work—it’s because Canadians won’t take these jobs at these wages. That tells you everything.