Registered Nurse - Primary Care- Adult Medical Care Coordination - RN

Conduct post-hospital follow-up calls and in-home visits for patients transitioning from hospitalization to primary care, managing medication reconciliation, symptom assessment, and safety evaluations. Partner with primary care providers to develop and monitor individualized care plans while educating patients on chronic conditions like CHF, COPD, and diabetes to promote informed decision-making. Manage a defined patient panel, providing ongoing care coordination and progress monitoring within the Mayo Clinic Nursing Professional Practice Model. This role supports professional nursing practice across the continuum of care, including preceptorship, quality improvement, and delegation based on patient acuity. A subset of employees may be required to drive their personal vehicle.