BACKGROUND: Care coordination is important for patients with complex needs; yet, little is known about the factors impacting implementation from the care coordinator perspective. PURPOSE: To understand how care coordination implementation differs across clinics and what care coordinators perceive as barriers and facilitators of effective coordination. METHODS: Nineteen care coordinators from primary care clinics in Minnesota participated in interviews about their perceptions of care coordination. A team of analysts coded interviews using inductive thematic analysis. RESULTS: Four major themes emerged: variety in care coordination implementation; importance of social needs; necessity for leader buy-in; and importance of communication skills. CONCLUSIONS: Described differences in care coordination implementation were often logistical, but the implications of these differences were foundational to care coordinator perceived effectiveness.