How Oregon Works: Hospitals face shortages of admin talent
Recruiters create new pathways for administrative talent as demand for workers increases.
Amanda Morris and her Corvallis-based recruiting team at Samaritan Health Services toil in the trenches looking for talent. Not just for physicians and nurses but everything from C-suite leaders on down to coders and billing assistants.
“Job-seekers focused on marketing, accounting, IT, revenue cycle and other administrative occupations, might not think of health care as a first place to apply,” said Morris, employment director for Samaritan Health Services, which operates five medical centers in the mid-Willamette Valley and on the central Oregon coast.
Morris said applicant pools for nonclinical roles have shrunk in recent years. One of Samaritan’s strategies is heavy community outreach. “Any time we have the opportunity to interact with the public, we always discuss the wide range of opportunities for nonclinical professionals within our system,” Morris said.
Their first choice is to find people with experience and education mirroring the needs of employers. Short of that profile, Samaritan considers qualified candidates, regardless of whether they already have care experience.
“Five years ago applicant pools were broader and we could focus on people with the experience,” she said. Today, however, Morris said hiring managers recognize that people with knowledge bases from other industries can train for the role.
Morris is part of a number of health care recruiters who say they are dealing with a host of dynamics making an already complex hiring environment for nonclinical occupations even more challenging.
Topping the list: a strong economy in which more people are accessing care and driving expansion. Coming in a close second: a government-mandated shift to value-based reimbursements that’s creating jobs and reorienting how health systems deliver care.
In 2018, the sector added one of every seven new jobs created in the United States, according to a report in HealthLeaders last January. That amounted to a total of 346,000 new jobs. At the end of 2018, health care employed more than 16.2 million people — nearly 11 percent of all U.S. jobs.
Barring an economic recession, slowing isn’t seen on the horizon. The number of health care positions is projected to grow 18 percent from 2016 to 2026 and add about 2.4 million new jobs, according to the U.S. Bureau of Labor Statistics. The agency forecasts more new health care jobs than any other occupational groups.
The situation is contributing to a shortage of physicians and other providers, the subject of extensive media coverage. Less understood, however, is health care’s scarcity of talent for administrative roles. A poll last spring by Medical Group Management Association indicated 60 percent of leaders had recently experienced a shortage of qualified non-clinical applicants.
Elaina Spitaels Genser, who works with health care clients in Portland, said candidate pools are a fraction of what they were several years ago.
“We used to have robust pools of eight to 10 candidates. Now it’s five to eight or even three to four, and it’s hard for clients to understand,” said Genser, senior vice president with national recruiting firm WittKieffer. She and her team worked with Portland-based Legacy Health last year to recruit a new CEO.
Market pressures affecting health systems across the country have led health systems to restructure themselves with fewer leaders. “We’ve become more cost-efficient, meaning the assistant VPs and others who in the past would have been promoted when someone retires have been eliminated,” Genser said.
In addition to retirements, employers are dealing with a shortage of middle-age workers.
“Folks in the middle generation never came into health care because of the dot-com boom, which was an attractive place to go over health care,” she said.
Oregon’s quality of life and of its health care landscape help attract candidates. “Oregon is great because it is on the leading edge in terms of population health and coordinated care organizations. People want to be part of that,” Genser said.
Portland, in particular, has experienced hiring activity in the wake of mergers and strategic partnerships in recent years. As a result, “with unemployment near historic lows, hiring managers have got to move quickly to make a decision about that individual,” said Louisa Waldman, regional vice president who oversees Portland work for global recruiting firm Robert Half International.
“There is definitely a shortage of talent. We are hearing from larger organizations in the market, and we’ve seen an increase in our business with smaller clinics as well. Everyone is needing more staff to handle people in clinics, and the back office has more to do as well, with verifications, pre-authorizations, questions about benefits etc.,” Waldman said.
Nationally, a high rate of churn keeps hiring managers hopping.
“Annual turnover in health care is up to about 21 percent and is on a steady incline,” said Jeremy Tolley, a spokesperson on recruiting for Society of Human Resources Management. Tolley is chief people officer for CareHere, a Tennessee-based health care provider that co-locates clinics with employers all around the company. CareHere has four employer-sponsored clinics around Portland serving 7,500 people.
“And they’re moving for a dollar more an hour,” he said.
Companies having the most success in hiring highly competitive candidates are “slicing days and hours off” their candidate selection processes, he said.
Legacy Health has recently acknowledged challenges in recruiting for nonclinical jobs, mentioning central sterile technicians and revenue cycle coders as examples.
Yet, two health systems that responded to inquiries for this story denied experiencing a talent scarcity in general for administrative functions. Both Kaiser Permanente Northwest Region and Oregon Health Sciences University, however, said finding the perfect candidate for some specialized administrative roles — such as engineers, product managers and leaders in certain clinical areas — does take an extended search.
Jeremy Tolley – Chief People Officer
There is a consensus that cultivating talent — among existing staff and people on their way to becoming qualified for a health care career — is an investment worth making.
“At Kaiser, we have been working on our internal succession planning and training for promotions, which alleviates the times we have to look outside our own walls to fill a leadership role,” said Brenda Purvis, senior workforce planning consultant. Purvis pointed to opportunities for on-the-job training, as well as classroom learning. Kaiser offers certification for product management and Six Sigma.
OHSU has the benefit of the talent pipelines its academic side provides, which generates a pool of talent, Sabrina Roderick, OHSU talent acquisition manager offered by email.
The organization provides a growing number of internships and fellowships and has partnered with Portland State University to provide a course of study for an MBA focused on health care.
Increasing the supply happens incrementally “because the education, training and experience take time to obtain. Still, the supply of available talent at times is small and the demand is great,” Roderick said.
As a regional system, Samaritan also offers a number of development opportunities that Morris said attracts talent. An administrative fellowship, for instance, accepts one master’s program graduate each year who spends his or her time working on high level projects while rotating through operational departments.
“We’re always looking at how we can create or help support more pathways for individuals who want to enter the field,” Morris said.