Registered Nurse - Primary Care - Adult Behavioral Care Coordinator - RN

Mayo Career Site US; Rochester (MN); On-site; USD 65,000 - 90,000; Full time

Job summary

Mayo Clinic is seeking an experienced RN to coordinate nursing care and drive integrated care delivery. The RN will manage patient care plans, participate in interdisciplinary collaboration, and support transitions of care within the Collaborative Care Model.

The role emphasizes leadership, mentoring, and adherence to nursing standards, with sponsorship opportunities for eligible candidates. Strong communication and patient education skills are essential.

Qualifications

• Active RN licensure in the applicable state.
• Strong communication and collaboration with care teams.
• Experience mentoring or teaching junior staff preferred.

Responsibilities

• Coordinate nursing care within the Mayo Clinic Nursing Professional Practice Model.
• Lead care coordination and patient education activities for the IBH/Integrated Care pathway.
• Collaborate with PCPs, psychiatric consultants, and care team members to align treatment goals.
• Support case reviews and contribute to care plan development.
• Demonstrate leadership in quality improvement initiatives and safe transitions of care.

Skills

RN licensure

Excellent communication

Mentoring & teaching

Leadership

Quality improvement

Education

RN licensure

Job description

Care Coordination & Assessment

• Conduct comprehensive assessments for patients referred for IBH care coordination, including mental health screening tools (PHQ-9, GAD-7, C-SSRS, etc.) and medication reconciliation.


• Determine eligibility for IBH care coordination for bipolar disorder and other conditions, consulting with supervising psychiatrists as needed.

Collaborative Care Management

• Serve as the Integrated Behavioral Health Care Coordinatorwithin the Collaborative Care Model, maintaining a patient registry, tracking progress, and ensuring systematic follow-up using validated tools.


• Partner with primary care providers (PCPs) and psychiatric consultants to implement treatment-to-target strategies, adjusting care plans based on patient response.

Patient Engagement & Education

• Utilize motivational interviewing techniques to set goals and support adherence to treatment plans.


• Provide education on mental health conditions, medications, and self-management strategies.

Interdisciplinary Collaboration

• Facilitate communication between PCPs, psychiatric consultants, and other care team members to ensure integrated care delivery.


• Participate in systematic case reviews and contribute to care plan development.

The registered nurse (RN) is accountable for the coordinationofnursing care, including direct patient care, patient/familyeducationand transitions of care. The RN supports professional nursing practice across practice settings and across the continuum of care to meet the needs of the patient and family. The RN will function within the Mayo Clinic Nursing Professional Practice Model, which includes accountability for planning, implementing,evaluatingand communicating all phases of nursing care for assigned patients. The ANA Nursing: Scope and Standards of Practice provide a basis for the practice of the RN. The RN provides leadership through activities such as preceptorrole, informal and formal leadership roles, and quality improvement efforts. The RN delegates patient care according to skill level, experience, patient acuity, fiscalaccountabilityand availability of resources. The RNpossessesexcellent communication skills; is skillful in mentoring and teaching; and mayparticipateoncommittees or projects.A subset of employees may be required to drive their personal vehicle asa partof the responsibility of their role.

This role is eligible for TN sponsorship. Successful sponsorship will require state licensure and completion of theVisaScreenor equivalent certification.