RN - In-Home Primary Care & Care Coordination (FT)

Mayo Clinic; Faribault (MN); On-site; USD 102,696,000 - 168,270,000; Full time

Benefits offered by this job

Medical plan options

Dental coverage

Vision plan

Pre-tax savings: HSA/FSAs

Competitive retirement package

Job summary

Mayo Clinic in Minnesota is seeking an experienced registered nurse to support patients with chronic conditions as they transition from hospital to primary care. The role emphasizes follow-up calls, home visits, and collaborative care planning with primary care providers.

Ideal candidates bring RN licensure, strong communication, teamwork and leadership, and the ability to work a flexible schedule in a setting focused on high-quality patient-centered care.

Qualifications

• Graduate of a baccalaureate nursing program or equivalent.
• One year RN experience in applicable care setting or LPN experience preferred.
• Current RN license in applicable state; BLS as required by state.
• Ability to work flexible hours including days, evenings, nights, holidays and weekends.

Responsibilities

• Post-hospital follow-up calls for patients at risk of readmission.
• In-home visits for adult medical care coordination after discharge.
• Collaborate with primary care providers to develop and monitor care plans.
• Manage a defined panel of patients with ongoing follow-up and care coordination.
• Educate patients on chronic conditions, treatment plans and medications to promote engagement.

Skills

Communication

Leadership

Critical thinking

Teamwork

EMR

Education

Bachelor’s degree in nursing

Tools

EMR systems

Job description

Mayo Clinic in Minnesota is seeking an experienced registered nurse to support patients with chronic conditions as they transition from hospital to primary care. The role emphasizes follow-up calls, home visits, and collaborative care planning with primary care providers.

Ideal candidates bring RN licensure, strong communication, teamwork and leadership, and the ability to work a flexible schedule in a setting focused on high-quality patient-centered care.