How Do You Save $100M in Staffing Costs? Ask Franciscan Health

In 2020, Franciscan Health spent $131 million on outside agency labor. It wasn't a strategy; rather it was a symptom of challenges many healthcare systems face. A vendor integration that kept breaking meant candidates couldn't complete applications, and the talent acquisition (TA) team was fielding up to 50 calls a week from people trying to get through. With 3,000 positions open and no reliable way to fill them, recruiting had stopped functioning as a function.

For a faith-based health system marking its 150th anniversary this year, that gap between mission and operational reality was hard to ignore. At IAMPHENOM 2026, Director of Talent Acquisition Ellen Page shared how $101.6 million in staffing costs is possible when you fix the foundation first.

Watch the full session here, or explore the highlights below.

Why Did Franciscan Health Hit Reset on Recruiting?

Franciscan’s recruiting challenges didn't happen in isolation. A major Workday implementation went live in December 2020, introducing a new Applicant Tracking System (ATS) just as the pandemic reshaped everything about how people work and where they look for jobs. Their recruitment marketing vendor in place at the time wasn't built for that integration; when the connection kept breaking, their solution was to charge more for work already paid for. The result was a career site candidates couldn't use, a TA team buried in help desk tickets, and no clear path to filling roles at scale.

"You can't innovate a broken system," said Page. The attempt to fix broken processes by moving them into new technology hadn't worked — and until the foundation was solid, nothing upstream would either.

How Did They Rebuild Their Recruiting Foundation?

The 2023 internal tagline said it all: back to basics, recruitment 101. Before anything else, the team needed a career site that candidates could actually use. What they found in Phenom was a solution with Applied AI woven throughout, even when they weren't ready to think about AI yet. Phase one addressed the fundamentals — a talent CRM to organize and re-engage talent pipelines, a new application that cut time-to-apply from 20 minutes to eight, and a career site designed to simplify job discovery. Automated work-in-progress reminders were layered in to recover incomplete applications, following up with candidates two to three times before a potential hire could slip away.

Page admitted she didn't initially want a chatbot, thinking a 24/7 chat tool wasn't necessary for nursing candidates. But candidate behavior quickly proved otherwise. It soon became one of the most valuable parts of the experience. Nurses working 12-hour shifts aren't browsing open positions during business hours, and having a tool available at the exact moment someone is ready to engage turned out to matter enormously. "That chatbot has probably been the most incredible option that we ever picked," she said.

Each year brought a new layer of capability as the team grew more comfortable putting Phenom's AI to work. Phenom Intelligent Sourcing (an aggregated database of clinician profiles drawn from job boards, professional networks, and licensing records) replaced external sourcing licenses entirely. Upgrading to a bidirectional Workday integration restored recruiter adoption rates that had lagged when teams were toggling between systems.

Related: Royal Bank of Canada’s Workday-Phenom Integration for End-to-End Hiring

In addition, Phenom Design Studio gave the team direct control over branding across their career site, email campaigns, and job posting presentation.

What Results Did Franciscan Health See After Three Years?

Three years of building on a solid foundation produced results that go well beyond the headline number.

$101.6M saved in agency spend — down from $131M in 2020 to $30M by 2025
37% increase in applications received
60% decrease in average time to apply
83 NPS score from candidates engaging with the career site, up from 64
25,600 eligible clinical leads sourced through Phenom Intelligent Sourcing

Fixing the hiring infrastructure with a functional career site, a working ATS integration, and AI tools that let recruiters source faster and more accurately made outside agencies a relief valve rather than a lifeline. The NPS improvement adds another dimension. Moving from 64 to 83 in a market where anything above 50 is considered strong reflects a candidate experience people would actively recommend to colleagues.

What Does Hiring Look Like After Fixing the Foundation?

The shift from volume hiring to precision sourcing has changed what the TA team actually does day to day. Career events that once drew 550 people into a hospital lobby have given way to targeted virtual sessions where Intelligent Sourcing identifies pre-vetted candidates for a specific service line or credential type, managers interview back-to-back, and on-spot offers go out the same day.

In 2026, Franciscan Health began rolling out Phenom X+ Screening to take that precision further. After applying, candidates receive a role-specific screening invite combining video responses, dropdown menus, and free-text questions. Recruiters review on their own time, advance strong candidates, and route others to better-fit openings before a phone screen ever happens. On the horizon: deeper chatbot refinement based on real candidate questions and more targeted talent CRM campaigns for hard-to-fill nursing specialties.

The downstream effect on the recruiting team has been just as significant. Page is building specialized teams by function, separating sourcers from generalists and giving people space to develop the skills they're actually good at. "Their job title is talent acquisition advisors, and they've started to move into that consultant role, which we never had the opportunity to do before," she said. Three years ago, the team was answering ticket queues. Today they're consulting with hiring managers on which roles to prioritize and what the candidate pool actually looks like.

That’s what “fixing the foundation first” makes possible.

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Branka Nikolic

Branka’s a marketer with flair, a teacher turned Phenom player. She loves products that shine, making candidates’ paths fine and turns job hunts into a winner.