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Having trouble hiring practice staff? It might be time to update job descriptions

MGMA Stat - November 10, 2022

Recruitment & Hiring

Compensation & Benefits

Performance Management

MGMA Staff Members
As recruitment challenges persist for healthcare organizations, the tactics used to address staffing shortages ranged from boosting salaries and wages, updating employee benefit packages, and offering sign-on bonuses to get workers in the door and keep them there.

But there’s an element of the recruitment process that sometimes gets overlooked in the hustle to get someone hired: Ensuring the job description and duties for a position is accurate, reflective of the changes to staff workflows during the COVID-19 pandemic and the ongoing labor shortages.

Nov. 8, 2022 MGMA Stat: 58%25 of medical groups updated job descriptions/duties in the past year to improve staff recruitment.

A Nov. 8, 2022, MGMA Stat poll found that more than half (58%) of medical groups reported updating job descriptions or duties in the past year to improve staff recruitment, while 42% did not. The poll had 479 applicable responses.
Among organizations that made changes, the most commonly updated jobs with updated descriptions or duties were:

Medical assistants

Previous MGMA Stat polling from July 2022 found most medical groups turned to hiring alternative staff when they were unable to hire for open medical assistant (MA) positions. As one of the most-difficult clinical support roles to recruit in recent years, MA job descriptions often have been updated to clarify less administrative work to entice more potential applicants to take interest. In conjunction, some medical groups created new clinical assistant positions to handle the nonclinical back-office tasks to free up MAs to focus on being more focused on efficiencies in clinical work.

Other poll respondents noted they worked to standardize MA job descriptions across the organization in the past year.
Additionally, several medical group leaders pointed to developing a career ladder and on-the-job training opportunities to give MAs opportunities for raises throughout their training. Those new promotional opportunities required updating existing job descriptions.

Remote and hybrid positions

One major update to several job descriptions across organizations was the addition of language about expectations about remote and hybrid positions.

A Feb. 9, 2022, MGMA Stat poll found that a majority of medical groups had shifted work to permanent remote or hybrid positions in the past year, especially in billing/coding, scheduling and administrative positions. Several respondents to the latest MGMA Stat poll noted they created remote-only roles to cast a wider net in their recruiting efforts, as well as hybrid roles for schedulers/receptionists, triage/floor nurses and billing staff.

Front desk, patient contact and care coordination positions

Lower-wage, patient-facing roles historically have had higher turnover rates in medical groups, and the labor market shifts in 2020 and 2021 led to unprecedented competition from other industries for those healthcare workers. An Aug. 16, 2022, MGMA Stat poll found that front desk staff, call center staff and other miscellaneous clinical support staff had some of the highest turnover rates (besides MAs and nurses) in the past year.

The pressure to boost wages and salaries for these roles has prompted compensation analyses, often coupled with updated job descriptions to better reflect expectations for these roles. Some practice leaders said these updates prompted them to make reviews of these job descriptions an annual exercise.

Additionally, recent joint MGMA-Humana research on investments to support the transition to value-based care pointed to a focus on hiring care coordination and care management positions. (Read more about this later in this article.)

COVID-19 updates

A smaller share of respondents to this week’s poll noted they did an organizationwide update to job descriptions for notes about COVID-19 vaccination requirements for those who still have them; in some cases, previously updated job descriptions have dropped language around vaccine requirements as government mandates have lapsed in the past year.
  • Not sure where to start in your review? The MGMA Career Center has sample job descriptions for office managers, operations, medical staff, quality assurance/risk management staff, executives and administrative/clerical jobs.

How others are faring

Among the respondents to this week’s poll who did not make changes to job descriptions or duties for their posted vacancies, 39% said their recruitment efforts worsened in the past year, while 38% noted they stayed the same, and 23% said those efforts improved.

Slow growth in hiring

According to Bureau of Labor Statistics (BLS) data, it took until September 2022 for the healthcare industry to return to pre-pandemic levels of employment, led by significant gains in ambulatory clinic hiring. However, increasing care demands — from newly eligible Medicare beneficiaries, patients who gained coverage through ACA market plans, and patients who delayed/deferred care in the worst months of the pandemic — mean that getting back to February 2020 levels is just the start of ensuring enough healthcare workers nationwide.

The latest BLS jobs report, released last week, found that the healthcare industry gained about 52,600 jobs in October, down from more than 60,000 jobs added in September.

Improving recruiting for care coordination, value-based care

Editor’s note: The following is adapted from the October 2022 joint Humana-MGMA research report, Shifting to Value amid Pandemic and Staffing Challenges.

In February 2021, Amy Scanlan, MD, joined as medical director of UCHealth Coordinated Care Colorado, a clinically integrated, physician-led organization composed of more than 600 clinicians across the Front Range of the Rocky Mountains.

With a centralized accountable care organization (ACO), the organization has small and large medical groups and even a few solo practitioners participating in its value-based arrangements, which has meant tailoring investments in staffing to support those varied provider organizations.

“Most of the investments that we’ve made … have to do with care coordination” and building a care management team, Scanlan said. Medical coding also requires investment around education and auditing to ensure accurate data to be used by the central data and analytics team.

Helping HR embrace new staffing needs

Tackling new approaches to care delivery has meant incorporating some elements of concierge medicine, Scanlan said, and having navigators to help patients move through the health system effectively.

The organization is piloting an RN-led annual wellness visit (AWV) program with care managers, allowing them to focus on the needs of patients with high-complexity care needs and better manage their care experience.

When it comes to hiring for those types of positions, it means working more closely with human resources team members when recruiting, as these roles are not “going to fit any of the job descriptions” that HR has previously used, Scanlan said.

That need to customize also extends into the training for a newly hired provider who may not have been trained for the outpatient space. “The RNs come to us thinking that they’re going to be like case managers at a hospital, which is not what we’re asking them to do,” Scanlan said. In the coming year, Scanlan said the medical group is building upon an academy for medical assistants (MAs) to create a care management academy. For many new hires, “there’s very little understanding of what it takes to be a good care manager,” she added, emphasizing that they want to ensure those workers understand the broader continuum of care and “in-between spaces.”

These programs are especially important to mitigate the impacts of some of the bigger challenges facing medical groups. Bringing in new providers can be difficult in areas that have struggled with high turnover and burnout among staff. But the hurdles of technology — especially managing multiple EHRs — is beginning to ease as there’s less immediate focus on the pandemic and more time and energy to focus on using technology to support value-based care. “I think that kind of went by the wayside during COVID, and the focus is now coming back,” Scanlan added.

A major challenge is still finding a way to get providers and payers to agree on judging quality and whether the right metrics are being measured. “I think that’s an ongoing conversation,” Scanlan said, “but I don’t think anybody questions the need to be held accountable for quality. … We have to get back to paying doctors to keep people healthy, and I think this is how we do it.”

Do you have a recruiting success story to share? Email us at connection@mgma.com.

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Our ability at MGMA to provide great resources, education and advocacy depends on a strong feedback loop with healthcare leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit mgma.com/stat. Polls will be sent to your phone via text message.

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