Salary Survey Results-Are you ready to move? Opportunities abound

Salaries, job activity up, recruiters say

The job market for directors and managers of patient access services and patient financial services appears to be hotter than it has ever been. In some cases, hospitals that trimmed their staffs to the bone in response to the Balanced Budget Act (BBA) of 1997 have realized they can't do without the experience and expertise of qualified front-end managers.

Job placement professionals who talked with Hospital Access Management in connection with its annual salary survey report say opportunities abound for good candidates in the field, particularly those who are willing to relocate.

"The activity level has grown significantly," says Doug Smith, MBA, MHA, president of BE Smith Associates in Kansas City, MO. "The BBA thinned staff out, but some [hospitals] overtrimmed." Those facilities have discovered "they don't have a choice" but to have strong personnel overseeing the financial process, he adds. "They just didn't see the value before, and now they do."

There has been an accompanying jump in compensation, Smith suggests. "I have not seen salaries escalate like I have in the past eight to 10 months," he says. "There is a labor shortage, and as hospitals bring in help, they are being more discriminating in who they bring in. They're doing much more thorough background checks and evaluations and only hiring the tops in the field. To get that, they're having to pay for it."

Smith estimates that salary levels have increased about 15% in recent months. "That's huge. [Financial] directors and managers have become very valuable in the marketplace and to the hospitals, which are trying to find every penny they can."

Hospitals are "beefing up the crew but still plan on running lean," Smith adds. "They're just bringing in the [work] horses."

Opportunities exist out there

Gina Seewald, a recruiter for Meridian Executive Search in Atlanta, agrees there are "by all means opportunities out there," with salary levels dependent to a large extent on geographical area. "It's a matter of whether or not someone wants to relocate," she says.

As examples of available salaries, Seewald mentions a position of director of patient financial services for a small psychiatric facility in New York that pays $85,000, and an admissions supervisor job in Atlanta for which the salary range is $38,000 to $45,000. The latter reports to the director of admissions, she adds.

Salaries for managers and directors of admissions, however, tend to be in the $40,000 to $60,000 range, recruiters told HAM, an estimate supported by responses to the salary survey. Some 70% of respondents to the survey said their title was director or manager of patient access. And although respondents reported salaries running the gamut from below $30,000 to as much as $150,000, the heaviest concentration was in the $40,000 to $55,000 range.

Some 25% of respondents said they had worked in the health care field for 25 or more years, and 65% of respondents said they had been in their current position for 10 years or more. Just under half of all respondents were between the ages of 40 and 50, and 34.5% said they had master's degrees.

A growing segment

The 15% or so of survey respondents who said their salaries were between $80,000 and $150,000 are typical of what the recruiters say is a small but growing part of the access profession. Those people, who oversee access services for multi-hospital systems or supervise several departments within a single hospital, "are redefining the whole profession," Smith says. "I don't think the numbers are big yet, but that's where [the field] is going."

Hospital profit margins are so slim now, he adds, "that we will see a higher-level, more expensive, more highly regarded person managing those units."

Directors and managers of access or patient financial services who are looking to move up in the field would do well to gain experience in different kinds of institutions and with different types of computer systems, suggests Roger D. Franck, CHE, MHA, director of Cejka Healthcare Executive Search Services, which has offices in St. Louis and Atlanta.

"A couple of institutional jobs [is a plus], as is having multiple hospital oversight," says Franck, "not just being in one place for a long time."

"Now more than ever," adds Seewald, "there seems to be a need for a certain information system. The client will want the person to be information system savvy. There are a lot of conversions going on right now, so [experience with] multiple systems, different types of systems is needed."

A phenomenon Seewald has noticed recently is the increasing willingness of hospitals to pay top dollar for health care managers who will serve in an interim capacity. "What's interesting is that a hospital will pay just so much money [for a management salary], but will pay a great deal for a person who fills that position for three to six months," she says. Compensation for these interim directors or managers can include full expenses, a weekly flight home, and an hourly rate of $100, she notes.

Although Seewald has seen more examples of this arrangement with professionals who have a patient accounting or hospital information systems background, she believes qualified access managers can become part of that trend. "There seem to be more and more [consulting opportunities] due to the fact that an organization needs someone immediately while searching for a full-time [employee]."

Access managers and directors who have strong financial backgrounds also might want to expand their potential job searches to freestanding medical group practices, Franck suggests.

These large clinics, with as many as 300 physicians, are more prevalent on the country's East and West coasts but also are found in other areas, he notes. Minnesota, for example, is "group friendly," Franck adds, while St. Louis "does not really have that mentality.

"For patient financial services people and directors of patient access services, these are great alternatives," he says. "They are outpatient-focused, with multiple access points. The challenge there will be scheduling problems, and clinics and physician groups at different sites having their computers talk to each other."