Is it possible for an existing company to fill nearly 400 open positions for high-demand jobs in a state where the monthly unemployment rate hovers around 3 percent and employers advertise thousands of job openings on a daily basis? Fargo-based Noridian Healthcare Solutions LLC (formerly Noridian Administrative Services) is about to find out. The health care administrative services firm, which already employs about 1,000 people throughout several locations in North Dakota and around the country, was recently awarded a five-year Medicare claims processing contract earlier that will more than double its volume of federal business. The contract, which was awarded through a competitive process, makes it necessary for the company to add about 500 employees in a variety of positions, including customer service representatives, nurses, accountants and information technology professionals, most of whom will be hired to fill new roles at North Dakota locations.
President and CEO Tom McGraw, who himself just joined the company last fall, says that despite hearing reports detailing North Dakota’s shortage of workers and recruitment challenges, he doesn’t think Noridian will struggle to find the qualified workers it needs. “You would think I would be [concerned], but Noridian is considered a very good company to work for so I think we’ve been getting excellent candidates,” he says. “Everybody has told us we are getting a stronger pool of applicants than one might have anticipated.”
By early June, Noridian had already hosted several job fairs in Fargo, including one in late March specifically for employees that had been displaced after PRACS Institute’s unexpected closure. In June, the company attracted 500 potential applicants to a job fair in Fargo. By September, McGraw says Noridian expects to have 375 new employees in North Dakota — 300 in Fargo, 50 in Jamestown, 15 in Leeds and 10 in Grand Forks. Other staff will be added at the company’s facilities in Bloomington, Minn., and in California. Noridian will take over the Medicare contract in two phases, Part A in August and Part B in September, so the company will stagger its hirings accordingly, with the first wave of new employees expected to be in place late this month.
According to McGraw, potential new hires represent a mix of local residents and interested parties willing to relocate from elsewhere in the country, although he says most of the applicants at its June job fair were locals. Until hiring is complete, it’s difficult to estimate how many of Noridian’s new employees will represent new residents, and therefore new members of the state’s workforce, but local health care providers will most certainly be keeping a watchful eye on Noridian’s hiring process and the impact it has on their staff numbers. The last time Noridian expanded its workforce, at least one Fargo hospital lost a significant number of nurses to the company and had to spend the next year aggressively replenishing with new hires. McGraw says he sympathizes and hopes that doesn’t happen this time around, but adds that the nurses Noridian hires are generally looking for a way to get out of the clinical setting anyway. “Our nurses are primarily doing medical review-type work, so a lot of times they can do it from home,” he says. “It’s very steady work, but maybe not as high stress [as clinical or hospital settings].” Currently, 10 percent of Noridian’s workforce is nurses.
It’s possible for Noridian to utilize remote workers for several types of positions within the company, but McGraw says Noridian is among those companies that have moved away from the belief that telecommuters can be based anywhere and now prefer to hire workers who are located near a company office. “I think companies believe that even with telecommuters you’re far better off hiring in your local area so that they can come in for group trainings and things along those lines,” he says.
Medicare and More
Noridian currently processes more than 102 million medical claims annually for more than 290,000 health care providers located in all 50 states. Three-quarters of the company’s business volume comes from federal contracts; Medicare contracts now account for 15 percent of the company’s total business.
Noridian’s roots in Medicare contracting stretch back four decades to the program’s very beginning. When Medicare was launched in 1966, Blue Cross Blue Shield of North Dakota provided administrative services for the program. In 1998, BCBS of ND became Noridian Mutual Insurance Co. and in 2002 Noridian Administrative Services was spun-off as a separate entity to carry out Medicare contract work. Noridian is now one of only 10 government Medicare and Medicaid claims contractors in the country and has extensive experience in the administrative services process, but the company is able to provide a list of other health care-related services as well and has recently begun an effort to promote its broader capabilities. The company changed its name in May, from Noridian Administrative Services to Noridian Healthcare Solutions, in order to emphasize this expanded focus, which includes care and delivery management solutions to improve care while decreasing its cost, medical review services to reduce fraud and abuse, data analysis and the development, support and administration of health insurance marketplaces. “We’re more than a claims administrator, and ready to help states, federal government and business meet the new challenges they face in health care information, systems and support,” McGraw says.
The utilization and analysis of data is an area of growing importance for health care providers. In the past, claims data was the only source of data analyzed for health care purposes, according to McGraw. But that is changing. In the future, data including electronic health records, family histories, genomics, and even types of purchases and places of residence will be analyzed and used by providers, including Medicare and Medicaid programs, to help determine criteria for care. Noridian wants to expand its role in compiling and making sense of all that data. “We see a role for us there, primarily bringing our expertise in Medicare and clinical expertise,” McGraw says. “For a company that is doing the kind of Medicare administrative work that we’re doing, we have an unusually large number of statisticians, including Ph.D and master’s level statisticians. We think we can help bring a lot of that expertise to the field.”
The Affordable Care Act has proven to be a boost for Noridian’s business already and the company plans to continue growing that aspect of its services. The company is serving as the contractor for the Maryland Health Benefit Exchange and has spent the past year building the system for the state-based health insurance exchange, which is scheduled to open for enrollment on Oct. 1. Building that type of system is an extremely complex task because the exchange must not only display different insurance options and be able to enroll individuals, it must also have the ability to obtain information to determine an individual’s eligibility for federal health care subsidies, according to McGraw. “We have to get the information and validate it against a bunch of different sources and determine if that individual is qualified for a subsidy and, if they are, how much of a subsidy,” he says. “So an individual can choose between different health plans, but we have to tell the help line how much is coming from insurance and how much is coming from the federal government.”
Maryland is one of only a few states, including Minnesota, which has opted to create its own health care exchange in advance of the Affordable Care Act’s Jan. 1 start date. The majority of the states will at least begin complying with the law by using a federal exchange system. McGraw anticipates that will change in the future, however, and Noridian is positioning itself to be a provider of exchange systems and related services for states as needed. “We expect that a number of states that are using the federal exchange initially will want to build their own exchange,” he says. “The other thing we want to be doing with states is providing other services [such as call centers and communications with payers]. We would love to be doing those types of services for them.”
Services related to the Affordable Care Act clearly represent an area of growth for Noridian’s state-based business. On the federal side, McGraw expects Medicare and Medicaid programs to focus on providing more cost-effective care and he believes Noridian can impact that goal through its care and delivery management and program integrity services. Long-term, he anticipates the company will continue to grow, although he says it is currently difficult to speculate at what rate and in what specific areas. “In health care, it’s so dramatically changing that it would be hard to do that, but we have grown substantially in the last couple of years and we anticipate continuing of that growth.”
