John Tricas said he heard opportunity knocking and learned networking software two decades ago, when it was the "next big thing." Now he senses a similar opening as the health care overhaul law takes effect.
In September, the 56-year-old information-technology worker took a job troubleshooting issues doctors, nurses and other users are having with a new government-funded electronic-records system at a Raleigh, North Carolina, health care company.
"Normally I wouldn't have taken this, because I have done things at a higher level," Tricas said of the recruiting call for the position. "But I said, 'I'll take it' because that gets my foot in the door."
With President Barack Obama's re-election ensuring that his 2010 law will be implemented, companies are scouting for workers like Tricas to fill hundreds of thousands of jobs in everything from running records systems to creating and servicing new insurance exchanges and entering thousands of additional codes for health care treatments.
The federal government projects that under the law, 30 million more Americans will start getting coverage in 2014 through expanded state Medicaid programs or private insurers, or pay a penalty. A study published this month in the Annals of Family Medicine found that the newly insured will contribute to rising demand for medical services, requiring an estimated 8,000 more doctors over 12 years. They also will create jobs for workers in support fields such as IT, already in short supply.
"It's across the entire landscape," said Guillermo Moreno, vice president in Kissimmee, Florida, at Manpower Inc.'s Experis Healthcare Practice unit. "It's a growing concern and a growing issue. There's huge fracture at all levels."
On the IT front, health care systems, data companies and other industries in need of talent all are competing for the same workers, he said. The U.S. economy may create as many as 758,800 new computer and IT jobs, a 22 percent increase, from 2010 to 2020, the Bureau of Labor Statistics said in its outlook on job growth, released in March.
A growing portion of those tech positions will be in what the BLS calls "health care and social assistance," which will account for about 28 percent of all new jobs in the U.S. economy by 2020. The industry, which includes public and private hospitals, nursing and residential-care facilities, and individual and family services, may increase by a third, or 5.7 million new jobs, twice as many as any other industry, the report said.
Looming deadlines and federal funding add urgency. The shift to electronic medical records is being driven by $20 billion in stimulus spending. In 2015, Medicare reimbursement rates will be cut by 1 percent for doctors not meeting the federal standards for those records.
Responding to demand, the industry is re-educating workers for the new IT requirements, said Norma Morganti, executive director of the Midwest Community College Health Information Technology Consortium. Morganti, based at Cuyahoga Community College in Cleveland, coordinates one of five regions in an 82- school federally-funded national effort.
The program is designed to train at least 10,500 new specialists in a curriculum that typically can be completed in six months or less.
The Midwestern consortium, which coordinates 17 community colleges from Minnesota to Ohio, has enrolled 6,700 students, Morganti said. More than 3,700 have graduated, toward a goal of 5,000 by March 31. Data is not yet available on placements.
Many of the students already had more than 10 years' experience in either health care or information technology and are using the classes to get the expertise they lack in the other area, Morganti said. Of those students, 17 percent had a master's degree and 39 percent had a bachelor's degree.
Insurance exchanges slated to come online in 2014 are adding demand for IT and other workers, said Les Funtleyder, president of Poliwogg in New York, who has written a book on investing in health care.
The online marketplaces, which will link customers to insurance plans, will need computer programmers to build them, and customer support staff to run them, he said.
States must say by Dec. 14 whether they will set up their own insurance exchange or rely on the federal government, and have until Feb. 15 to join a hybrid state-federal exchange.
"The second these exchanges go up, they are going to need to hire," Funtleyder said. "This could create a ton of jobs."
Companies such as International Business Machines Corp. and Xerox Corp. are looking to build states' insurance exchanges. Armonk, New York-based IBM is working with Maryland and Minnesota on theirs and acquired Curam Software Ltd. of Ireland last year for technology to help develop the programs. Xerox, based in Norwalk, Connecticut, said in September it won a $72 million contract from Nevada. Neither company would comment on how many employees they are adding or have working on the health-insurance exchanges.
Accenture Plc of Dublin won a $359 million contract in June from California to create its program.
Among other companies staffing up is Maximus Inc., said Bruce Caswell, president of the Reston, Virginia, company's health care segment, which provides administrative support to government health plans. Maximus expects to begin adding employees next year to help states manage their exchanges, he said.
Once the insurance marketplaces begin operating in October 2013, thousands of customer-service and administrative workers will be needed, Caswell said. As many as 900 call-center jobs per state will be needed, particularly for those with a high number of uninsured, he said. Caswell declined to say how many workers Maximus plans to hire. Employment in the company's health-services unit rose 16 percent to 5,634 at the end of September from the same period a year ago.
Workers would have to be more skilled than typical call- center employees, Caswell said. They will need to answer questions about various insurance plans and terminology, help customers pick the right plan, speak multiple languages and deal with complex family and income situations.
The need for positions probably will taper off in 2016 when most people are expected to have purchased an insurance plan, he said.
The annual market for providing customer support for the exchanges could be worth $500 million, he said. There could also be an additional $200 million a year in business for helping states expand their Medicaid programs.
Another requirement under the law, the switch to a more sophisticated method of coding for reimbursement of care, is also creating new jobs, said Drea Howze, health care product manager in Bayville, New Jersey, for staffing company Kelly Services Inc. The industry is changing from a standard that used 17,000 codes to a new system with 141,000 codes.
"If you can't bill for services, you can't get paid for services," she said. "We're seeing a huge increase in need for coders from insurance companies."
With the demand for new coders, IT professionals and the clinicians and trainers needed to support them, the shortage of workers may be more than 300,000, said Melisa Bockrath, vice president, Americas Product Group for IT at Troy, Michigan-based Kelly Services.
The shortfall already is growing. A 2012 survey by Ann Arbor, Michigan-based professional association, the College of Healthcare Information Management Executives, found that 67 percent of respondents are having difficulty finding employees, an increase from 59 percent in 2010.
The shift in health care will mean changes from the back office to the corporate corner office, said J. Larry Tyler, chief executive officer at health care recruiter Tyler & Company in Atlanta. Titles such as "chief health enabler" and "chief transformational officer" will proliferate, and medical personnel such as doctors may be elevated from staff jobs to help with the transition, he said. "A lot of the ways we are doing things are just developing."
Tricas said he's been watching the health care industry evolve for several years and pursued an eclectic range of projects in IT, trying to shift to new areas as they opened up.
"You're at an early growth curve," he said. "This is the ground level. You can kind of make your own opportunities."