Smart Hiring in Healthcare

Written by on January 31, 2014 in Practice tips - No comments

Employees are one of the most important parts of any practice.  They are the first faces that a patient sees when they walk through the door and can make a lasting impression when the patient leaves.  They can be a huge asset, however, they can also be your biggest liability.  You hire employees to be the face of your practice and the front line of customer service to your patients. They handle your money and are empowered to make decisions on your behalf.  Would you trust the future of your practice with just anybody?  More importantly, what steps have you taken to ensure that you haven’t already?

Just as there are rules governing every aspect of healthcare, there are rules and guidelines surrounding the employment process.  Many who try to circumvent the process find it can result in a situation that quickly becomes costly, not only in terms of money, but also in terms of lost productivity by other staff members, low morale, legal ramifications, and more.

It’s worth the time and expense to develop a hiring plan and follow it.  A successful hiring plan is comprised of many aspects but the most common are as follows:

  1. Create the Position/Job Description.  You won’t know the type of employee you are looking to hire without fully understanding what role you want them to play in your practice.  The skillset required for a nurse is vastly different than that of a receptionist.  To understand that role and to set the stage for a successful recruiting process, you should create a job description.  Be sure that you create the complete job description. Most small medical practices have roles that overlap and you should consider that when hiring. For example, hiring for a medical biller position that will also include direct contact with patients will be different than one with no face-to-face contact.
  2. Determine your compensation package.  You can waste a good deal of time and effort if you don’t determine the salary range before beginning the recruitment process.  You should know what competing practices pay for similar positions so that you are prepared to offer a competitive package to the right candidate. If you are unsure of the going compensation for certain positions, you should talk to peers, go to websites such as www.salary.com, contact a staffing agency or look in trade publications which typically publish annual wage surveys.
  3. Advertise.  Now that you know what you are looking for and how much you are willing to pay for it, you are now ready to post your position. Ads can be expensive so consider other options such as Craig’s List, member associations, or try to hire from within.  Please note, hiring from within can be an excellent option, except when it’s not. Make sure anyone that you are promoting possesses all of the skills that you have outlined in your job description. If not, and you promote someone that is not suitable for the job, it can have devastating effects on every aspect of your practice, including the overall employee morale.
  4. Screen the respondents.  As resumes are received and reviewed, determine which respondents best fit your job description.  Next, you want to conduct phone screens as the initial contact.  As you speak with each individual, make certain that what you have available, in terms of the job and the compensation, aligns with what the individual is looking for.  In addition to qualifications and cost, it is imperative to make sure that the potential employee is a good fit with the current atmosphere of your practice. Employees in a medical office tend to be a tight-knit bunch, so be careful not to “stir the pot”, unless that is what you intend to do.  Invite those who are qualified for the position and “pass” the criteria of your phone screen in for an in-person interview.  Consider who it is important to involve in this process.  It shouldn’t just be the direct supervisor.
  5. Check out what you are “buying”.  When candidates arrive for their interview, have them complete a job application.  People can and will say anything on their resumes and you don’t have much recourse.  If a new hire is found to have falsified information on your application, however, you have more available options.  For the interview, have a standard set of questions pertinent to the job that you are hiring for.  This same set of questions should be used for each candidate.  If testing would be appropriate, you can do this while the candidate is on site.  Finally, when you find the perfect fit, you will want to check references. Dig and talk to previous supervisors and others who can truly attest to the qualifications of the person you are considering to join your team.  Finally, a background check is an easy and inexpensive way to further protect yourself from unknown liabilities.  People pay to get inspections and reports before making a major purchase, shouldn’t you do the same before investing in your next hire?  If your practice files claims to any federally funded healthcare programs such and Medicare and Medicaid, you will also need to check the employee against the OIG Exclusions List, http://exclusions.oig.hhs.gov/, to ensure that they are not a sanctioned individual.  Anyone who hires an individual on the list may be subject to civil monetary penalties.  In addition to checking the list at hire, you should develop a process to check existing employees against the list on a regular basis.
  6. Prepare a formal offer letter.   When you are ready to make an offer, you can speak to the candidate verbally but you will also want to prepare a formal offer letter.  Include information that outlines exactly what you are offering – position, wages, start date, etc.  Align expectations first thing.
  7. Onboarding.  Research shows that a strong, well delivered on-boarding process leads to more positive outcomes for new employees such as higherjob satisfaction, betterjob performance, greaterorganizational commitment, stress reduction and lower turnover.

There are three areas of the onboarding process that are critical.

The first is that of New Hire Paperwork.  Be sure to include paperwork required by federal and state law along with those specific to your office.  The integrity of your employment recordkeeping is as important as the proper maintenance of tax files and bank records. Know what you are legally required to maintain and report.  The I-9 is a federal form that’s a crucial part of new hire paperwork.  It is an Employment Eligibility Verification Form required to be completed and maintained on file by ALL employers to verify an employee’s identity, and establish that workers’ eligibility to work in the United States.  And as an employer in the healthcare industry, you should strongly consider having all employees sign a confidentiality agreement.

New Hire Orientation allows employees to get started on the right foot by providing new hires with a solid orientation and welcome process.  If possible, have the employee start on a date and time that is not extremely busy. Give them time to interact with your current employees and make sure that they see the entire workflow of the practice, not just the small portion that they will be doing. In addition, some states have laws specific to certain information that must be communicated.  Know the requirements of your state.

Training is important to allow the new employee to perform their duties in alignment with your organization’s protocol.  In the training process, you should educate and communicate.  No employee wants to fail.  Help to ensure they are successful by spending the appropriate amount of time getting them acclimated to your office.  Even if you are extremely busy, and any extra time spent training is an inconvenience, the effort will be rewarded over time. An employee that has not been trained properly is YOUR responsibility and will be extremely costly in the long run, especially if you have to begin the hiring process again.  Some of the different formats for training are job shadowing/on-the-job-training, mentoring, formalized training through presentations, online/computer-based learning, and manuals.  You should determine which communications methodology, protocols and vehicles work for your practice.

Finally, all employees should receive formalized HIPAA training as part of the onboarding process, and then annually thereafter, to minimize your liability as a health care provider.  Not only is HIPAA training a required element of HIPAA Compliance, it also mitigates your liability as a health care provider.

If you made it to the end of this article you might be overwhelmed by the amount of work required to have an effective hiring process. Don’t be. Take it one step at a time and be diligent in your efforts. If you do so, not only will your employees be successful in their positions, but you will reap the rewards in terms of culture, decreased hiring costs, decreased turnover and decreased liability.

By Michelle Durner, CHBME 
Applied Medical Systems, Inc.

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