Hot hiring areas driven by big healthcare industry changes

In 1982 when Lester Gyongyosi began his career as a pharmacist, Time magazine heralded the personal computer “Machine of the Year.” But there were no computers in the pharmacy where he worked.

As information technology gained ground in healthcare, so did demand for clinicians with an aptitude and interest in computerized information. Gyongyosi saw an opportunity but had little idea where it would lead. Three decades later, he spends all his time in front of a computer as a pharmacy systems analyst with Albuquerque-based Presbyterian Healthcare Services.

“If you would have told me in 1982, 'You won't even touch a drug, you will be sitting in front of a computer screen all day,' I would have probably said you're a little crazy.”

Gyongyosi's data-analysis skills are now in high demand in the healthcare labor market as the industry adapts to policy and market changes. But lots of other changes in healthcare also are strongly affecting the type of skills and experience employers are seeking, say recruiters, human resource executives and consultants.

Much of this flows from the trend for payers to reward providers for preventing disease and managing the chronically ill to avoid hospital admissions. These include shifts in how providers are paid, where care is delivered, the types of services that are incentivized and how information is processed as well as increasing consolidation among providers. Medical care is increasingly delivered outside of hospitals in homes, clinics and retail outlets. These changes have affected the industry's workforce from entry level to the C-suite, where new executive titles have been created.

“Now we have jobs for just about every setting there is,” said Ralph Henderson, president of healthcare staffing for AMN Healthcare, a healthcare staffing and recruiting company for physicians, nurses and allied health workers.

Jobs for the industry's already sought-after professionals—pharmacists, nurses, physicians—are changing in response to demand for skills and experience in information technology, care coordination and specialty care for the most acutely ill patients. Hospital hiring from other industries, such as information technology and insurance, is also on the rise.

Staffing agencies and employers are investing to create new certification and training opportunities to better prepare the newest hires for new workforce demands. Even hospitals' top administrative jobs have undergone transformation, with the addition of executive-level roles that never before existed, such as chief medical information officer, chief population health officer and chief patient experience officer.

Beyond technical expertise, ongoing innovations in the industry have put a premium on finding people who are able to adapt to continuous change. Recruiters prize those who learn from their experience—including failures—and thrive on team collaboration. “The conditions under which we operate and the challenges we face change daily,” said Elizabeth Conrad, chief human resources officer for Lahey Health, a three-hospital system in Burlington, Mass. “We are looking for people who are very nimble.”

Healthcare's late adoption of digital information networks and electronic health records has spurred a recent surge in demand for technology experts to install, upgrade and maintain IT infrastructure. The College of Healthcare Information Management Executives found that a growing number of hospitals could not hire IT workers fast enough to meet demand in 2012, with 67% of surveyed hospitals reporting a shortage, up from 59% in 2010.

For example, Montefiore Medical Center in New York City is struggling to find qualified IT professionals who have experience with Epic EHR systems as the hospital undertakes a three-year program to install its new patient record system, said Freddy Cabrera, Montefiore's senior vice president and chief human resources officer. Montefiore must compete with other hospital systems also installing EHRs for a limited supply of experienced IT professionals.

New hardware and software are merely the beginning. Clinical and financial data from these new systems create an information trove that can be analyzed to improve quality and efficiency. That requires people who have the skills to lead that analysis.

Beyond IT, the increased focus on better coordination of care for patients with chronic conditions has created strong demand for home health aides, behavioral health professionals, social workers, registered nurses and care managers. This results in part from the Patient Protection and Affordable Care Act, its expansion of accountable care, and the growth of Medicaid managed care for chronically ill patients. “That's opened up a whole realm of positions,” said Frances Roy, senior vice president and chief talent officer of Ascension Health, the nation's largest not-for-profit health system.

That is reflected in the rapid growth of certified case managers. Certification has increased 35% in the past five years. More than 34,000 case managers were certified in 2013; of those, 90% were registered nurses.

Care coordinators also include social workers and other types of staff who help patients manage their own health, coaching them and their families at home, during clinic visits or as they prepare to leave the hospital. They also are in greater demand.

There is a rush to create new care coordinator roles, said Jennifer Stewart, managing director of research and insights for the Advisory Board Co.

Clients increasingly ask for social workers to manage patient cases, AMN's Henderson said. “We've dabbled in social workers in the past, but it's never been a large part of our business.” That has changed. The firm is now recruiting social workers to meet the demand.

“The whole premise of the ACA is engaging the patient as much as possible,” said Christie Pearson, chief operating office for human resources at Orlando (Fla.) Health.

As fewer patients need to be hospitalized, those who are admitted are increasingly complex. So there is greater demand for clinicians able to care for the most acutely ill, such as intensivist physicians and nurses trained to care for critically ill patients. “The patients who occupy the beds are much sicker,” said Tina Filoromo, vice president of human resources for Catholic Health East/Trinity Health, which is projecting an ongoing need for intensive-care nurses.

The growing shift of care to settings outside the hospital likely will require retraining nurses, physician assistants and others for different jobs. CHE/Trinity may do so with rotations and internships across various settings, Filoromo said. But there continues to be demand for nurses in hospitals, at least for the near future. “For the next three to five years we're going to have to be concerned with staffing hospitals,” Filoromo said.

Demand for new skills is apparent across the healthcare job market.

Montefiore will soon complete a management training program for 40 RNs, with two more classes of management-trained nurses to follow. The training, which includes communication and conflict-resolution skills, is designed to move nurses into leadership roles.

Lahey Health is seeking grant funding to train its primary-care workforce to operate as a care team as the system expands its patient-centered medical home model.

A growing number of hospitals and other healthcare employers are focusing on recruiting physicians for leadership roles because of the authority doctors bring to clinical improvement efforts, said Pam Kinsella, senior search consultant for Cejka Search, an executive and physician recruiting firm based in St. Louis. “A physician can speak to a physician.”

But Dr. Andrew Ziskind, managing director and clinical solutions leader for Huron Consulting Group's healthcare practice, said there is a high rate of failure in recruiting physicians who are effective in management roles.

There are new job descriptions in the C-suites as well, as hospitals have added roles for chief of medical information, patient experience and population health. CHE Trinity Health recently was trying to fill the newly created role of chief population health officer. It was looking for “an innovative physician leader” and “seasoned, balanced leader” with experience in health informatics, analytics and program development.

Mark Madden, senior vice president executive search for recruiter B.E. Smith in Kansas City, Mo., said he's seen growing demand in the past two years for chief executives to monitor and oversee patient satisfaction and experience, which now factor into how payers reimburse hospitals. “It really reflects where our industry is going and where it's going to be,” Madden said.

Consolidation also has created specialized new C-suite demands. The Scottsdale Lincoln Health Network, created by the 2013 merger of Scottsdale (Ariz.) Healthcare, and the Phoenix-based John C. Lincoln Health Network, is searching for a chief information officer with the strategic, technical and communication skills to merge two separate IT systems, said Tom Sadvary, CEO of the new system. “I shudder to see what we're going to have to pay, but it's going to be worth it,” he said. “Finding all those qualities is not inexpensive.”

Specialized expertise isn't the only sought-after quality among industry recruiters. The industry's rapid changes have put a premium on workers able to solve problems, learn from failure and redesign processes to adapt. Those qualities are particularly sought among physicians, but not just physicians. “All clients are looking for a dynamic, go-getter personality” who works well in a team, said Maureen Jamieson, senior search consultant for Cejka Search. “It's so competitive, with so much consolidation, that being a good doctor is not enough.”

Tenet Healthcare Corp. recruits from the nation's top schools in engineering and business administration for “progressive thinkers” to bring new ideas to its operations, said Cathy Fraser, senior vice president of human resources at Tenet. The hospital chain also works closely with the military to recruit veterans who understand large organizations' operational processes.

“It isn't enough for us to post a job and wait for the right credentials to apply,” Lahey Health's Conrad said. “It's that ability to respond quickly, to adjust, to be agile, to understand that the old ways are sometimes the best ways, but sometimes they're not.”

Follow Melanie Evans on Twitter: @MHmevans