Hot hir­ing ar­eas driven by big health­care in­dus­try changes

Modern Healthcare - - NEWS - By Me­lanie Evans

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.”

“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.”

Lester Gy­ongyosi, right, phar­macy sys­tems an­a­lyst with Al­bu­querque-based Pres­by­te­rian Health­care Ser­vices

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 ex­ec­u­tivelevel 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 two-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 dab- bled 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

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.

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.”

“It’s so com­pet­i­tive, with so much con­sol­i­da­tion, that be­ing a good doc­tor is not enough.” Mau­reen Jamieson, se­nior search con­sul­tant for Cejka Search

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