Drawing on comparative employment relations literature, this article explores how employment relations (ER) institutions support the ‘care coordinator’, a new role tasked with aiding the exchange of information between health and social services in the United States and the UK. Findings show that in both countries, multi‐employer collective bargaining facilitated this role by providing good working conditions and a stable work environment; additionally, the new role performed better in England due to the broader scope of bargaining and supportive management practices. The article advances a comparative institutional perspective on the creation of new tasks focused on sub‐national (sectoral and regional) ER.