From New Hire to Career Navigator: How Recruiters Support Internal Mobility

David Crawford, VP Talent Acquisition, New York-Presbyterian shares how recruiters can act as strategic connectors—guiding internal mobility, clarifying career pathways, and aligning employee growth with critical workforce needs without becoming career counselors. 

Transcript

Angela Pointer 0:00

Hi, I'm Angela Pointer, and welcome to the Hiring Scope podcast from the National Association for Healthcare Recruitment, where we explore the latest trends, insights, and strategies in the ever-changing world of healthcare hiring.

Patrick Kelly 0:12

Hi, I'm Patrick Kelly. Each episode we'll dive deep into the challenges and opportunities facing recruiters, hiring managers, and healthcare professionals alike. Whether you're looking to attract top talent, navigate industry changes, or build a strong workforce, you're in the right place. Let's get started.

Angela Pointer 0:31

I'm excited about today's conversation, and it's one that I've been looking forward to for quite some time. Actually, it kind of stemmed from a conference that the other guest and I were in, and he made a comment that stuck with me, and it actually sparked the entire concept for this episode. So we've been talking this season about what we're calling recruiterships, those relationships that help recruiters do their best work. But one relationship we haven't quite highlighted yet is the relationship between the recruiter and the employee, especially employees navigating their careers inside the organization. So today we're gonna dive a little bit into internal mobility, career pathways, and how recruiters can support employees in making meaningful career transitions without becoming career counselors. So we're joined by someone who has been doing this work at scale, David Crawford, Vice President of Talent Acquisition and New York Presbyterian. Welcome, David, to the hiring scope.

David Crawford 1:26

Angela and Patrick, I'm delighted to be here. Thanks for inviting me.

Patrick Kelly 1:28

Well, thank you, David. We're excited to have you here. We'd love to start with a quick intro for our audience. Tell us about your role at New York Presbyterian and the lens you bring to the internal mobility conversation.

David Crawford 1:40

Sure. Well, with that, first of all, let me tell you a little bit about um New York Presbyterian. So with us, we're all of our hospitals are in New York. We have over 4,000 beds, 11 billion in revenue. This year we'll make about uh 8,500 hires, which includes uh both internal and external, about 45,000 employees, and our 11 hospitals are all magnet. So that's a little bit about New York Presbyterian. As far as me, I run talent acquisition, managing a team of 40 people, but I look at it this way: no different from a coach for football, for basketball, for baseball, for hockey. I'm the person who's not on the field, but giving the direction of what the players need to do. I am so fortunate that I have outstanding players with what that they are doing. I have the cool job about looking at our strategy, our recruiting process, our technology, but I have to rely on our players to make it happen to make those hires for both external people and also internal. And that's why I'm glad we're having this conversation today.

Angela Pointer 2:42

Awesome. So, David, during our conversation at the conference, if you can remember, you mentioned a story that really captured the heart of internal mobility. And I think it was the journey of one of your longtime employees. Can you share a little bit about that with our listeners?

David Crawford 2:56

Sure. Well, this first started with the community-based organization that we've been working with. And with that, the the profile of what he had was this goes back to 2018. So he lived in the Bronx. The industry that he knew about that he was focusing on was in retail, and he did not see opportunities that were available to him as far as pursuing a career that he wanted. So through this community organization that offered training and support and career guidance, he came on board as an intern. Then he was hired as a transporter and eventually moved up to be a lead transporter. But this is where the shift took place. He spoke about how he speaks Spanish. He's Dominican and saw that when there were patients coming through that were not as comfortable using English, he spoke to Spanish to them. And remember, when you're going to a hospital, this is not exactly a desired location. This is not Disney World. You're not planning a trip to come here. You're coming here because you need medical attention. And with that, he was able to comfort people as he performed his role. What he also decided is that he wanted to shift from that particular type of role into more administrative, or as he had explained it, paperwork. So he transferred over to one of our other hospitals as an evaluation clerk, then moved that into a patient registrar role because he wanted to understand finance and financials and to be able to explain things to patients as they were coming through the process. And he was developing a stronger interest in psychiatry and was at our Westchester behavioral health location. He is now enrolled in nursing school and is pursuing a career within psychiatry. So, with that, what I really like about that story is how he wanted something different for himself and he was able to navigate through the organization to find these roles that would speak to who he was and what he wanted to do as it relates to his career. What I like from a quote from him was he had this fear of being afraid. And what he realized is that he had to make fear his friend. So that uh we always talk about feeling uncomfortable. Well, that actually gave him the confidence to move forward uh, you know, above and beyond when he first started as a as an intern.

Patrick Kelly 5:06

David, what I love about your story is that, you know, that wasn't a typical pathway. That's not you come in and go up the ladder in the normal way. He kind of found his own way through coming in through a community partner, wraparound support, and kind of you know, plotting out his own path with the help of your group. What, from your perspective, makes internal mobility so powerful in a healthcare system like yours?

David Crawford 5:29

Well, with internal mobility for him, for Jason, that was easy. He had the career path, he knew what his interests were, and then he pursued along the way. That is not the norm. It's great when I have that success story. Here's what the norm seems to be. People almost approach their career strategy almost as if you were playing the game. And with that game being the wheel of fortune, they spin the dial and they wait to see what's gonna land. They have no clue about what they're really looking for. And that's when they typically send an email to the head of HR, they stand up at the town halls and say, CEO, I've been here for a dozen years, I can't seem to find a job, nothing's happening for me. And that's when it lands on my lap to say, What are you doing about this? That is the the reality of the situation in many cases for internal mobility. With me in my lofty role in what I'm looking for, the game that I'm looking for is for people to be more like Jeopardy, which is, you know, I'll take uh top careers in healthcare for $300. You know, the answer is what is an x-ray tech? All right, that's not reality either, David. It's not all about, you know, finding people know exactly what they want. It's more like if we're staying with the game show, price is right. They know how to participate in the game, but they don't overshoot and they go for where they need to be in order to do that. Back to the whole me being a the coach, the players on my team, the recruiters, have navigated and found a way to speak to that audience that spins the wheel, the wheel of fortune, in order to find their career. And through that, we can talk a little bit more about what that means and how we are increasing our internal mobility for the people who don't know what they want to do.

Angela Pointer 7:03

That is perfect and a perfect segue kind of to the next thing we'll talk about as you mentioned your team, the your players on your team and the recruiter employee relationships. And would you agree that probably so many organizations underutilize internal mobility or they I'm I'm loving now what you're saying about the wheel. And I'm gonna it's gonna be in my head now, David. About spinning the wheel, because that is so true. And one reason I think that employees struggle is they just don't know what they don't know and they don't know where to start. So I remember you we talked a little bit in our prep call about guidance or a roadmap, not just a list of open jobs. So tell us a little bit more about what the role you believe recruiters play in that journey. Because I know I said earlier we're not necessarily career counselors, but what what is the role that the recruiter has in helping employees navigate their next steps?

David Crawford 7:52

I would say to start, the reason people like the Wheel of Fortune is because they think that the more things that they apply to, the better shot that they have, and they think that things are going into this black hole. The reality is, is if you have an applicant tracking system, there's no such thing as a black hole. It's a black box. I know every single position that you apply to. And as a recruiter, if you apply to 150 positions, you know what that says to me? You have no idea what you want, you have no idea where you want to go, and I don't even know if you're serious about your career search. I know that. So this is where we are trying to get to that link to make sure that we're educating the population out there. We're not career counselors, but what we can do is to provide you with a roadmap to figure out and kind of test out what our different jobs are like so that we have a number of these sessions where we're talking in general. It's not about you, Angela, what you want to do with your career, or you, Patrick, what type of job speaks to you. It's here are some things that are out there as far as skills, as far as competencies, as far as experience, as far as the type of work that people are doing, to shed some light on that. And then we are partnering with another company out there to come to be those counselors, to talk about a number of things: being these are what the skills and the competencies are. Here's the education that you should pursue in order to receive a certificate or a registration or a license. And here are some internal opportunities that provide those internships that allow you to get that type of experience to move along that path. So that's what the education piece in providing people that roadmap rather than spinning the wheel.

Patrick Kelly 9:30

That's such an important distinction. I really feel like recruiters, you know, they aren't here to design career paths necessarily. They're here to speak to roles, but they are part of that ecosystem that helps employees feel supported, informed, and seen. Uh, in your work, what approaches have helped employees gain clarity about their next steps?

David Crawford 9:50

Well, we we designed this program and it has an acronym. It's called Achieve. Achieve stands for advancing careers in healthcare through innovation, education, virtualization, and engagement. And with that, the first step is to actually meet with someone. So once you've gone to these broader set sessions that speak to what different career paths are like, so you get a sense of that, is you can meet with a coach to talk about, well, what is that roadmap and how does that work? And if I am interested in pursuing that and I need some type of education, which might take a year or two for me to complete the program and receive that degree, which schools do I go to? Which are online, which are local, what do they offer? And how do I do that through tuition reimbursement? And that's where that's the first step of the program. And then getting people to sign up for those different programs. And on top of that, it's one, it's kind of look at it this way. We're talking right now, and you know, it's the beginning of the new year. Everyone's great with their New Year's resolutions. Where are you in February with that New Year's resolution? So the idea is it seems like a great idea at the very beginning, but we want to stick with people to make sure they don't drop out and that they stay involved in the program. And once they do end the program in a year or two, receive that certificate, that there's an opportunity for them and they don't go back to spin the wheel in order to find a job. That there are managers that are lined up, there are people that they are talking to, that they have a good shot at moving into that role that they've prepared for. So Achieve is a nice acronym, but also it has real meaning about where they're gonna go because you want to achieve a goal and move into that new role.

Angela Pointer 11:32

That's awesome. I'm liking that. And I love acrostics and acronyms. So I'm gonna commit that to memory with Achieve. So thanks for sharing that. Now let's talk a little bit about organizational needs. And you mentioned already the size of New York Presbyterian, all your hospitals. So you shared a little bit about internal employees that want um graduate degrees and different things, but that doesn't always solve the talent gaps because there's sometimes a um maybe a misalignment or a lack of alignment between what the aspirations are and then what the organizational needs. So, like areas like OR tech, surge techs, ultrasound. Any today, I would say anything that has tech and um by it, you know, those specialized clinical support roles. So, how are you balancing employee aspirations with the overall organizational workforce strategy?

David Crawford 12:20

Angela, you are speaking my language here when we're talking about radiology and diagnostic imaging, when we're talking about OR techs, surgical techs, social workers, people in facilities, clinical labs, uh respiratory therapy, rehab. So, with all of those, the thing is we want to basically lay it out there because as people talk about AI and jobs going away, there's some jobs that they will continue to be there. We're in the people business. This is not an organization where every job is remote and you can live and work wherever you are. The thing is, patients have to come to a hospital. 99% of the patients who come to New York Presbyterian have to get a lab test. I mean, that's the reality of this. So, will we have jobs within labs in the future? Of course we will. Will the tests be done exactly the same way from now? No, that's not gonna happen. But the thing is the test needs to get done. So we need people who know how to do this. By laying out the roadmap for all those types of jobs that I just uh described, we have we know that those jobs are gonna be there in the future. And with that, we want people to know that. So as they are trying to reinvent them skills, redefine their skills, rather than using HR speak about upskilling. I don't know what that really means. But redefining their careers, that's what we want people to know about. So we're kind of illuminating this idea of here is a roadmap for you to follow if you decide to choose to go down that path.

Patrick Kelly 13:42

It sounds like internal lovability isn't just good for the employee, it's necessary for the health system's uh sustainability. We've all worked at health systems and we we see the need for getting the right talent and keeping the right talent. How have you seen employee relationships strengthen as a result of mobility work?

David Crawford 13:59

Patrick, you're talking about something that is makes perfect sense because typically managers have a job that's opening on their team. If they don't have anyone who's internal, they're just looking for the outside. And by internal means, they know they want to tap someone on the shoulder. If that's not the case, it's let's go out to the outside. The thing about going to the outside is you see the shiny object that grabs your attention. And how much do you really know about that person anyway? When you think about someone who's within the organization who understands and appreciates the corporate culture, and by that I'll be very specific. The integrity, the ethics, the engagement, the respect, however you define what the corporate culture is, they've got it. People on the outside, maybe, maybe not, you don't know. All you know is that they have certain competencies, they have certain experiences, they have certain skills. That's what gets you the job. We know what makes people leave, how they do the job. And if you have the people who understand how to do the job, you can teach them anything. I was not born to be the head of talent acquisition, you know, at a major uh at a major institution. It's something that I learned over time. But who I am as a person, that doesn't change. So when you have the folks who have been, you know, tried and true and tested and they're part of the fabric of the organization, how do you teach them a new skill? And that's where the lens of it of internal mobility has to come through. Not necessarily I'm forced to take someone who doesn't have any skills. I mean, that's the wrong way to look at it. So this idea of taking the talent and turning them into something else is the right way to go rather than taking someone who has talents and turning them into our culture. That's a lot harder. And that's why first year turnover is something that I really focus on because that's a sad story if someone leaves within a year. Either I made a mistake or you made a mistake, but this relationship is not working out.

Patrick Kelly 15:50

Yeah, essentially the internal mobility needs to be a part of the culture.

Angela Pointer 15:55

It does. It really does. It does. So we're gonna skip down in the show notes, we're gonna go to section five, because we've actually already talked about that amazing story. So, and and going back to the achieve, I'm I'm loving this now. Um now this is gonna be my test, Patrick. Can we remember what achieve stands for? But building this program, so let's get a little bit into the nuts and bolts. Not that you have to tell the secret sauce, but what elements of the um internal mobility program would you say has made the biggest impact?

David Crawford 16:25

I think one, seriously, at the beginning, it comes down to marketing and communication. Because if you are a transporter, if you are a housekeeper, if you are in food and nutrition, you're not doing what I do during the day. But by that I mean I have a computer monitor in front of me. I have my mobile device, and I am focusing that way, right? Versus the people who aren't in front of the computer every day and seeing what's on our main homepage here at New York Presbyterian. So with that, it's getting the word out, and that happens by communication. That is by having physical pieces of paper up in meeting rooms where people are gathering. That means going to town halls, that means attending huddles. That is why our recruiters are out and about talking to people about what is taking place and making sure that they know who we are and we know who they are. So, number one comes down to communication. Then it comes down to what is the program and how does that program work and making sure that there's accessibility. Remember, we work at a healthcare system which is not a nine to five job. We have patients here 24 hours a day. We have days and evenings, and we cannot forget our folks who start their job in the afternoon, who start their job at night, where they might not cross paths with me at all. But the thing is the hospital has to be in operation. So we have to think about running that 24 by 7 availability to our folks and making sure that we get them the information that they need, which is why now we're talking more about um automation and having chatbots available for people when our employees are available and making sure that that information is convenient for them so they can access that and then you know move along the path. Then it comes down to the roadmaps so they can actually see it's almost like a subway about what are the different uh phases of the evolution of someone moving into a spot. So, for example, you might be a security officer and you're interested in emergency medicine. Well, can you become an emergency medical technician? Or maybe you want to become a paramedic, or further down the line, you want to be a critical care paramedic, or maybe you want to shift your path over to be a registered nurse and maybe something in trauma, whatever that is. You need to know what that path looks like in a linear way so you have a vision and a goal of where you want to go.

Patrick Kelly 18:49

That's amazing. I mean, that sounds like an amazing program. Uh, and the ways that you're getting it out is really touching the staff. Obviously, no program is perfect. What barriers still show up, either for employees or for recruiters, and how do you navigate them?

David Crawford 19:03

Part of it comes down to getting on-site managers to think more broadly about folks. That is why we have offered internships. So, the same way that I was talking at the beginning of an internship, it's kind of a try-by situation where people going through clinical rotations. That's another opportunity for the I'll call students to get a flavor, a taste of what's going on in the department in a safe way. And then also at the same time for our managers to become more familiar with the people who are coming through. We're in the people business. The problem is that we start off with two, I'll call it pieces of paper. One is the job description, the other is the resume. The reality is the job description, whether it be at New York Presbyterian or one of the other healthcare systems, they all read the same. Let's be honest about it. And then as a good recruiter, what you do is you read through the job description, say to the manager, what are the three top things that I need to know? Because there's always unique situations that come up. Do you need someone with more experience? Do you need someone with less? Is this a step-up opportunity? Do you need someone who already has experience doing this? You have to have that conversation. Then we're talking about the pieces of paper. The pieces of paper being the person. You know, most people don't know how to write a resume or speak to the skills that they want. And what I always say to people is don't spend a lot of time putting things on your resume that you can do that you don't want to do. Because if it's there, I assume you want to do it because it's there for the taking. So de-emphasize those things and play up the things that can be transferable and the things that sing to your heart that you want to do in your next job. So by doing that, we have to make sure that people are talking, that they're out there, that they're having, you know, more conversations, rather than AI taking over to doing a match to figure out which piece of paper matches another piece of paper better.

Angela Pointer 20:48

Oh, that's awesome. So let's bring it all together now. I want to go back to something you said earlier that employees don't need opportunity. They need guidance. Yes. They need someone to help them interpret what's possible. So if you could give one piece of advice to organizations trying to do what you guys have done at New York Presbyterian and their in internal mobility efforts, what would that one piece of advice be?

David Crawford 21:11

I think get your folks, and again, not just the senior people, but could be individual contributors, panel discussions, webinars, educating people about what their jobs are like, even podcasts, so that they can speak about what they like about their jobs that they're doing, what their challenges are, how they got to where they are, so that they're more relatable. And I think that piece is important. So by using technology through a podcast or a webinar, something like that, and then also live panel discussions that are taking place where people can actually be in a room and meet and mingle. Obviously, all of that stopped during COVID, but since then, and you know, COVID is a memory, but it's not a distant memory. We're encouraging people to regroup, to get together, to have conversations, and that's where the magic does. Does happen. So that's something that I would definitely recommend that people do. Make your folks visible. And what I'm talking about isn't necessarily a TikTok, which is very short-lived, it's very brief, and it doesn't give people the opportunity to have a full discussion about what's going on.

Patrick Kelly 22:19

Let's take it one step further down since this is probably what most of our listeners are looking for. What's one thing you want recruiters to take away from this conversation?

David Crawford 22:29

I would say kind of the way that I have approached it. I had a conversation with one of my recruiters just recently about internal mobility because unfortunately, you know, I'm guilty of this. And here I am saying this, looking towards the end of the podcast here. I'm a job snob. And by that is, I extract people to have their acts.

Angela Pointer 22:48

Oh wow.

David Crawford 22:48

I have people I expect people to have their acts together as I'm trying to figure out of the five, 10, 20, 500 people who apply to the job, who's the one? Where's the shining moment of making the one person happy about moving them into their dream job? The unfortunate thing about recruiting is you have to turn everybody else down. Or maybe there's an enroll for them or you keep them warm or find something else for them. So with that, the recruiters on my team ground me and remind me that there's this value of that that people have. Maybe they were just matched to the wrong job. Maybe there was just the chemistry that didn't exist, or there was something else that existed with another candidate there. What recruiters should take away is don't forget the humanity about this. And also don't waste people's time. And by that I mean with candidates. Don't do something as a courtesy. If it looks like the person's not right for the job, especially if the person's internal, don't treat it as giving them hopes and expectation that they're going to land in that job, but treat it as giving them an opportunity to showcase their skills and their experiences to someone who might not ordinarily talk to them about what their future is. And that the takeaway is more of a career development discussion and not just as a candidate for that job. I've seen that there are a number of people who have gone through that conversation and they feel empowered. They feel that more confident in what they want to do, so that they have that insight that they didn't have beforehand. They're not going to get the job, but they have a better perspective and understanding about where their gaps are, what they need to do, which is giving them an assignment and a takeaway to move in that direction on a much better state, you know, standing position. So the advice I'd have to recruiters is don't forget the humanity of the people who are applying for the job, but think about what will speak to them so they are better off at the end of the process and not just disgruntled or disappointment, but actually empowered.

Angela Pointer 24:51

That is powerful, David. As you were just saying that, that one piece of advice, which is amazing. I thought about these courtesy conversations. I've heard people say, well, let's just, you know, have have that conversation, have them interview. I think it's important what you share to be open and honest. No, this job is not a match for you, but let's have further conversations. So I appreciate you sharing that. So, David, how can listeners connect with you or learn more about this awesome internal mobility work that's happening at New York Presbyterian?

David Crawford 25:21

I think the easiest way is to follow me on LinkedIn because I do put things out there. Whether you connect or decide, you know, to send me a connection, it's not about that. I think it's about following. And with that, through the posts that I have out there, you'll also start seeing the posts from my team. Because it's not just about here's a job that we're looking to fill, it's more about the culture, who we are, the activities that we're doing in order to focus on talent acquisition. So uh I would say that LinkedIn right now is uh probably the best approach.

Patrick Kelly 25:53

That wraps up this episode of the Hiring Scope from the National Association for Healthcare Recruitment. Thank you for joining us as we tackle the evolving landscape of healthcare hiring.

Angela Pointer 26:02

And if you enjoyed today's conversation, don't forget to subscribe, leave a review, and share it with your network. Or you can check us out at NAHCR that's n a h cr.com for more content. Until next time, keep pushing the boundaries of what's possible in healthcare recruitment.