Healthcare has had a reputation for being one of the strongest industries for generating new jobs. But recent changes in reimbursements and a shift to accountable care models have changed the dynamic in some quarters.

“A lot of the healthcare systems are taking a conservative approach to their hiring right now," said Derek Cunningham, talent advisor at Scripps Health in San Diego, Calif., and president of the National Association for Healthcare Recruitment. "There are so many uncertainties around the Affordable Care Act, and in particular the reimbursements they may be getting from Medicare and Medicaid."

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Recent reports from the U.S. Department of Labor show small declines in the number of jobs at hospitals and nursing/residential care facilities. At the same time, the number of jobs added by ambulatory services more than made up for those declines. When hospitals are hiring, they are looking for more techies and analysts to help crunch the data required by accountable care models.

At Children’s Mercy Hospital in Kansas City, director of employment Molly Weaver is staying “very busy." The hospital, which employs approximately 7,000 staff, is on a "major growth trajectory," Weaver said.

The growth is not a result of a merger or acquisition. It is "all organic," she said. Mercy Hospital consists of a main hospital facility, satellite hospital and four clinics.

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First up on the hospital’s hiring list are skilled nurses, especially advance practice RNs. But some other top spots have little to do with direct patient care. They are clinical research jobs, computer coding and data analytics positions.

Skilled data analysts can in fact be among the hardest positions to fill, Weaver said.

"They are wired very differently,” Weaver noted. "To find people that can truly interpret data and explain it in a direct manner that healthcare providers can understand is not easy."

The hospital also does a lot of physician recruitment. Forty-two new physicians were added to the staff in the past year. Hardest to find were pediatric physicians.

The impacts of all these recruiting efforts have been two-fold, Weaver said. First, the hospital has had to dig deep for salaries that would attract hard-to-fill specialty job roles. That has, in turn, led the hospital to re-evaluate its compensation practices across the board.

Secondly, the hospital has had to become more proactive in its recruiting efforts. The hospital does enjoy the status of being the only independent pediatric hospital in the area, and is viewed as an employer-of-choice, but beyond local city limits, the job gets tougher.

"It’s enticing the talent that is outside the area that is more challenging," Weaver said.

While Children’s Mercy is in the midst of a hiring boom, the broader trend in hiring is backfilling existing positions or opening new positions in ambulatory services.

"We’re all seeing an increase in retirements, and a lot of new services being added – whether it be outpatient clinics, home health, hospice, etc. Because of that, we’re seeing an increase in hiring in those areas. Overall, even though it’s slowing down in some areas, it is increasing in other areas," Cunningham said.

Cunningham agrees with Weaver that the greatest hiring need is in nursing, especially critical care nursing. The U.S. Department of Labor estimates that the number of nursing positions will increase by 19 percent, from 2.7 million nurses in 2012 to 3.2 million positions in 2022.

Another issue driving healthcare hiring is retiring employees, said Cunningham. "For a few years, people [in healthcare jobs] were holding off on when they would retire. We’re slowly starting to see an increase in those retirements."

That has been well documented with the nation’s physician workforce. Cunningham worries the same is in store for other healthcare jobs.

“We haven’t seen a mass exodus yet, but there are some concerns that we will all of a sudden have a lot of people leaving," Cunningham said. "At the same time we are seeing an increase in the numbers of people that need care. So you need more people to cover the care for those folks. You have a bunch of retirements that are happening at the same time. That could be a dangerous mix."