Job applications have been streaming in to the region’s hospitals, which receive thousands of resumes monthly for hundreds of open positions.

Historically major employers, hospitals and health care systems have gained new significance as job creators thanks to industry growth — even as the overall economy slumped, leaving the region and state struggling with high unemployment.

Now, as federal directives and an aging population shape the future of health care, regional systems expect to remain major employers but are seeing shifts to careers focusing on preventive and outpatient care.

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And although hospitals report high volumes of job applications, some health care specialties are in high demand.

Health care systems with hospitals in Atlantic, Cape May and Cumberland counties — AtlantiCare, Shore Medical, Cape Regional and South Jersey Healthcare — employ more than 11,400 full-time, part-time and at-will workers, they reported. Overall they have more employees than they did four years ago, and interest remains strong in many positions, including clinical professionals, security, maintenance and business.

“Just with the economy as it is in the area, nearly all entry-level positions — even without advertising — we get a large number of applicants,” said Alan Beatty, vice president of human resources for Shore Medical Center in Somers Point. “There are some specialty positions in pharmacy and nursing that are more difficult to fill.”

In response to the hospital’s growth in surgical areas, Beatty said, Shore created a school to train registered nurses in the operating room specialty.

Six nurses were selected for the program, which drew nearly 50 applicants, he said.

“To find the right person, the right competency, the training is going to be important for all of us, more so than ever before,” he said.

The U.S. Bureau of Labor Statistics predicts occupations related to health care and personal care will have the fastest job growth this decade, with health care and social assistance projected to create about 28 percent of all jobs.

Registered nurses and home health aides will both add substantial numbers of jobs nationally — more than 1.4 million through 2020, the bureau says.

New Jersey’s 72 acute-care hospitals paid about $7.9 billion in employee salaries in 2011, up 4 percent from $7.6 billion in 2010, the New Jersey Hospital Association reported in October.

“Even in a down economy, hospitals and health care are an important and reliable source of jobs,” said Kerry McKean Kelly, spokeswoman for the Hospital Association, a Princeton-based trade group.

McKean Kelly expects long-term growth to occur on the primary care side — primary care physicians, advanced practical nurses — as well as growth in areas that try to keep citizens healthier and manage chronic conditions before they require hospitalization.

Dietitians, for example, may play a crucial role in treating the obesity epidemic, she said.

As the population ages, health care should remain a growth industry, but one that can be affected by federal policies, she said.

“There’s good news and bad news on the jobs front,” McKean Kelly said. “The good news is hospitals and health care have been a very reliable source of jobs throughout the recession, and there’s been significant growth in health care employment throughout the recession.”

An ongoing concern involves reimbursement rates from Medicare. Typically, New Jersey hospitals can get about a 90 percent reimbursement through the federal program, she said.

That may change next year due to a proposed 2 percent cut in reimbursements stemming from federal deficit talks last year and the Budget Control Act of 2011, she said. Such cuts could result in a $133 million reduction the first year for hospitals, nursing homes, home health agencies and other facilities.

This does not affect Medicare patients but the amount of reimbursement hospitals receive for the care, she said. Ultimately, this could influence job creation across the country and the state.

The largest hospital system in the region is AtlantiCare, which includes AtlantiCare Regional Medical Center’s City and Mainland campuses and a health system with nearly 70 sites in southeastern New Jersey.

AtlantiCare has more than 5,200 employees, about 72 percent of which are full time, and an annual payroll of about $280 million, said Richard Lovering, vice president for human resources and organizational development at AtlantiCare.

The work force has grown by 412 jobs, or more than 8 percent, in the past four years, he said. Nursing represents the largest portion of the work force as a single profession, making up about 28 percent of it, he said.

Lovering said AtlantiCare receives 5,000 to 6,000 job applications a month and routinely carries openings for 200 to 300 positions.

AtlantiCare sees growth ahead in outpatient and urgent care, he said.

“We’ve really geared up care management in the second half of 2011 and are really hitting our stride this year. As we see more and more cases going to the primary care setting, we’ll need more of that work force,” he said. “As the inpatient side stabilizes, this is where we’d have nurses move to care manager settings.”

Shore Medical Center has 1,572 employees, with 31 open positions, Beatty said.

“The delivery of health care is going to be changing. Health care reform is still a work to be decided as to what it will look like in the future, but the delivery of care has already started changing from a few years ago,” he said.

Cape Regional Medical Center employs about 1,200 people, including 824 full-time positions.

The hospital has an annual payroll of more than $50 million, spokesman Tom Piratzky said.

Piratzky said significant growth has occurred in outpatient services. In the past two years, Cape Regional Health System added 14 physicians to Cape Regional Physicians Associates, five advanced practice nurses and 63 nurses and support staff in seven offices in Cape May County. In August, Cape Regional Physical Therapy opened in Cape May Court House and the Seaville section of Upper Township, employing 10 people.

Cape Regional has openings for 19 full-time positions and five part-time ones, Piratzky said. Some of the more difficult positions to fill include nurses with specialty experience, including intensive care and operating, as well as occupational and physical therapists and pharmacists, he said.

The hospital anticipates continued growth in outpatient services as well at Cape Regional Physicians, Cape Regional Physical Therapy, Cape Regional Urgent Care and Cape Visiting Nurse Association, its home health and hospice services, he said.

South Jersey Healthcare employs about 3,400 people, including 2,486 full time. Registered nurses make up the largest group — about 800, said Diana Gervasi, manager of marketing communications.

In 10 years, South Jersey Healthcare has grown from about 2,300 employees.

“Even though we have a high number of applicants, we continue to face challenges when it comes to filling positions in some nursing specialty areas,” Gervasi wrote in an email.

There are 240 open positions at South Jersey Healthcare.

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