Expected to impact job availability, career advancement and salary expectations, healthcare reform has set the stage for a year full of challenges. As providers and consumers brace for sweeping change, those in the hunt for a new job need to know how to navigate the hiring arena and stand out from the competition.
In addition to providing universal access to healthcare, the Affordable Care Act (ACA) endeavors to control the rising costs of healthcare, expand and streamline healthcare choices, regulate private insurance, and improve the quality of healthcare.
As the law continues to evolve, the healthcare industry is operating in a state of flux. To offset anticipated changes in the delivery of care, healthcare organizations are in dire need of a new breed of highly-skilled and specialized workers that can adapt to technological advances, deliver value-driven care, and create lasting patient relationships.
The U.S. Department of Labor estimates that about one-third of all new jobs in the United States created by 2022 will stem from the healthcare industry, while the salary outlook appears to be matching pace with the overall demand projected in this sector, shared Cynthia Kinnas, executive vice president of Randstad Healthcare, and president of the National Association of Traveling Healthcare Organizations (NATHO).
How to Compete in the Job Market
The population of those age 65 and older in the U.S. is expected to increase from 13% in 2010 to 19% in 2030, according to the World Health Organization. "This aging population is important to note because they generally have higher utilization and longer stays in hospitals," Kinnas observed. "Their regular, complex care needs will contribute to the overall need for healthcare professionals for the foreseeable future."
Because of changes in the healthcare industry, today's hiring managers are looking for employees with different skills, according to Jill Schwieters, president of Pinstripe Healthcare. "The industry can't afford to make the wrong hiring decisions anymore because it weighs on resources and budgets," she said.
Candidates can stand out by making a good first impression, explained Mary Arbogast, BS, RN, CNOR, CST, legal nurse consultant and owner and CEO of Arbogast-Medical-Legal Consulting LLC, and nursing and healthcare outreach coordinator at Alvernia University in Reading, Pa.
Overall, the more healthcare candidates can read and learn about the changing healthcare environment, the better positioned they will be to present themselves as being able to adapt to new expectations. "Professional dress and conduct will get a candidate in the door, but knowing the answers to potential questions in advance is paramount," Arbogast stated. "Today's young professional has all the tools he needs to do some quick, but impressive, research to prepare for an interview."
Advanced certifications and degrees are excellent ways to advance your career, Kinnas told ADVANCE. "Particular credentials applicable to specific units will enhance a candidate's expertise, making her more 'niche' and desirable," she said.
Gaining knowledge in different specialty areas and experiencing hospitals of various sizes are other avenues to get ahead in the healthcare field, Kinnas observed. "Candidates with experience at large teaching hospitals can transfer to virtually any facility they want, assuming their licenses and references are in good standing, and they possess strong clinical skills," she said.
According to Kinnas, the most powerful and competitive combination today is a healthcare candidate with strong clinical, technical and customer service skills. "In addition to being able to provide competent patient care, being well-rounded in areas like billing and patient satisfaction, and even being knowledgeable in the laws that regulate the industry, are extremely attractive to healthcare employers," she said.
Focus and Flexibility: Key Attributes
Today's healthcare worker must be prepared to work in an industry that's focused on controlling costs through the implementation of managed care programs for all patients eligible for Medicare and Medicaid, said Larry Abrams, LNHA, lead administrator at the Workmen's Circle MultiCare Center in Bronx, N.Y.
"The healthcare worker must be committed to providing a high level of customer and healthcare services to patients, and possess an understanding of the financial limitations in this new environment," Abrams explained.
Schwieters is concerned that nurses and physicians are being stretched too thin but are expected more than ever to provide high-quality care. Further, many hospitals are consolidating administrative functions, which puts a strain on the system and ultimately affects the clinical side.
"While services provided to patients are defined by the license or certification that a person may or may not have, everyone needs to open their hearts and do the little things that make people comfortable," Abrams said. "Saying 'that's not my job' will be a detriment to a successful career."
To get ahead in the industry and remain relevant, Schwieters suggests taking on internships, extra work and projects, and getting involved in telemedicine, digital medicine and any other area that is cutting edge.
"The market won't flip in 2014 but workers are building their own toolbox of expertise with extra classes and certifications to prepare for when the market shifts," Schwieters said. "There are so many different venues that workers can work in and broaden their experience. The more tools and experiences you put in your toolbox, the better off you will be."
Flexibility is a true differentiator in the healthcare field, according to Kinnas, and can help candidates stand out from other applicants. A candidate who is flexible in terms of the way he works (contract, temporary or full-time), location, and shift has a much better chance of securing a job than someone who refuses to take on a position that doesn't fit a defined set of criteria, she explained.
"Especially in light of healthcare reform and the emphasis on patient satisfaction, it's not enough to have strong clinical and technical skills," Kinnas said. "A patient-centered perspective is highly desirable and applicants should convey their understanding of that during interviews."
Ideal candidates, according to Abrams, have the necessary qualifications and knowledge of their particular fields and can work well with people. "A person who is compassionate can truly make a difference in the lives of patients and residents," he observed. "This person can prove his value and have a successful career in a healthcare organization."
Other "nice-to-have skills" that will help candidates stand out include multilingual skills, previous success working with a team of physicians in varying specialties, customer service skills, and general management experience, explained Kinnas.
The healthcare industry is always changing; therefore, as a professional in the field, candidates need to be adaptable and ready for change. "Variables like healthcare reform and technological advancements can alter the requirements of a job dramatically," Kinnas said. "Candidates should be prepared, engaged and ready to acclimate to new challenges. This includes becoming more proficient using computers and mastering different types of computerized charting."
Schwieters is optimistic about impending changes to the healthcare job market over the next two-to-three years. "In the meantime, continue to look for incremental changes, remain flexible and serve the patients the best way possible," she said. "The big players will continue to make big moves but the rest of the industry is waiting."
Hot Jobs in 2014
Hospitals and other healthcare organizations are actively hiring nurses, rehabilitation aides, certified nursing assistants, and physicians. The jobs available will be offset by a shortage of workers anticipated to hit the industry within the next three-to-five years, especially for highly specialized nurses and physicians, and those who work in diagnostic areas, according to Schwieters.
"Physicians grow in demand with the population, and we are presently in a shortage, so there are always openings," Schwieters said. "Payers are hiring physicians as well so we need to identify physician needs and how to get ahead of the physician shortage."
Additionally, payers such as Wellpoint and Humana are becoming providers. "They are evolving and adding their own managed care and health plans," Schwieters said. "They are hiring case workers, utilization nurses and experienced nurses, including radiology oncology specialists, to deliver the right level of care at the right time."
Due to a shift in how healthcare is delivered, positions may be created where they once did not exist. Jobs that provide support and care to patients are always in demand, according to Abrams.
The focus on decreasing readmissions will continue this year. CMS bases reimbursements to hospitals on performance, so having patients re-admitted lowers that score or payment level, shared Arbogast. As such, hospitals or private firms may move to hire more home healthcare providers to oversee patients on their post-hospitalization pathway.
"We'll also see patients being kept in nursing homes longer," Abrams shared. "This strategy presents additional challenges because it requires hiring an NP or physician, which then requires the facility to find a way to balance that extra funding."
Similarly, the industry will witness a need for more post-hospitalization home healthcare personnel to ensure patients are on a path to recovery and maintaining health, Arbogast said. "This may involve taking patients to post-operative doctor visits or helping them acquire prescriptions," she said.
With widespread use of electronic health records (EHRs), the need for employees who specialize in healthcare IT and informatics is prevalent in 2014. "There will be a big technology movement in healthcare this year," said Arbogast. "Integrating various systems is at the forefront, and experienced programmers and designers will be necessary to help bridge the gaps."
Implementing healthcare information systems has been a huge undertaking, and now hospitals and other providers are moving quickly to catch up, maintain and even improve delivery of care and data management.
During the next five years, it's expected that 13 million devices will be integrated into wellness plans. Mobile applications such as "MyChart" and "mHealth" are allowing communications between patient and provider to take on a whole new dialogue-one that is both personalized and portable, Kinnas told ADVANCE. "We will continue to see these types of innovations, which not only means more research and jobs in the industry, but increased patient care capabilities," she said.
Today's employees are expected to work to the height of their licensure, according to Schwieters. "More than ever, providers looking to hire an NP or PA, for example, are looking for a high quality employee at a lower cost," she said.
Randstad Healthcare representatives expect to see continued demand for registered nurses, pharmacists, primary care physicians and nurse practitioners this year. "Today, many physicians are choosing to become specialists, over primary care, which has resulted in open positions for primary care physicians and nurse practitioners," Kinnas said.
Although more hospitals are starting to require registered nurses to have a bachelor's degree in nursing (BSN), many will still accept an associate's degree in nursing due to a rise in demand and an ongoing nursing shortage, according to Kinnas. NPs need at least five years of practice as an RN, as well as a master's degree and board certification.
"A licensed professional must have at least a bachelor's degree," Abrams said. "Of course, we prefer a master's degree, just like in any industry, because having a higher degree helps to differentiate one candidate from her peers."
The Money Question
Job seekers should be prepared when the discussion inevitably turns to salary in an interview. There are many points of view on when and how to disclose salary expectations, but most will agree that the subject is best avoided in the early stages of the interview process.
Arbogast believes candidates should not discuss salary specifics on a first interview, but should have an answer prepared when the question is asked. She recommends using phrases when asking about compensation; for example, ask whether the pay is within the "range of market demands."
With a still-struggling economy, 2014 may not be the year to request a raise or expect a bump in salary with a new position. "When a candidate requests a higher salary than we have budgeted, we move on to the next person," said Abrams. "There is always someone else waiting in line for a job."
Abrams believes salaries will remain static this year because dollars coming into healthcare are decreasing. As a result, there simply is no extra money being budgeted for salaries. "The key is to provide a good work environment so that employees are happy, and salary won't make a difference," he said.
"With all the demands and uncertainty in the industry, salary ranges will remain the same for now," Arbogast shared. "Once the industry knows how to navigate through the demands of the PPACA, we will see changes in either direction."
"Salary increases are going to take longer than we want," Schwieters said. "Change is hard and the transition is going to take a while. We all need to hang in there. We are in healthcare for a reason, and we need to push the market to flip."
Rebecca Knutsen is on staff at ADVANCE. Contact: firstname.lastname@example.org