Why Authorization Performance Matters More Than Time-to-Fill

Your HR team is measuring time-to-fill. Your CFO is watching recruitment costs. Your tissue services director is drowning in turnover.

Everyone's optimizing for the wrong metric.

When it comes to authorization roles, hiring fast costs you more than hiring slow. Here's why.

The Real Cost of a Bad Authorization Hire

Let's say you hire a Tissue Authorization Specialist in 30 days. Fast! Efficient! The requisition is closed, HR is happy, and your tissue services manager has a body in the seat.

Then this happens:

The Downward Spiral

Month 1-2: Onboarding and Training You invest $8,000-$12,000 in salary, benefits, and training time before they take a single independent call.

Month 3-4: Poor Performance Emerges They start taking calls. Authorization rate: 35%. Team average: 58%. Families are saying no more often. Each declined case = 40-80 potential tissue recipients who don't get grafts.

Month 5: Emergency Coaching Mode Your best performer spends 5 hours/week mentoring them. That's 20 hours/month of lost productivity from someone who should be taking high-value calls.

Month 6: Resignation They quit. Burnout, misaligned expectations, or "This isn't what I thought it would be."

Total Cost Breakdown

Cost Category	Amount
6 months salary + benefits	~$30,000
Training investment	~$10,000
Lost authorizations	3 donors = 120-240 tissue recipients
Coaching time opportunity cost	~$6,000
Replacement recruiting cost	~$15,000

Grand total: $61,000 in direct costs, plus 120-240 people who didn't receive life-changing tissue grafts.

Now compare that to taking 60-90 days to hire someone with a 65% authorization rate who stays for 3 years.

Why Time-to-Fill is the Wrong Metric for Authorization Roles

Time-to-fill assumes all hires are equal. They're not.

In most roles, a mediocre hire who stays 2 years is better than an empty seat. In authorization work, a mediocre hire actively costs you donors.

Every authorization conversation is a zero-sum game. The family says yes or no. If your new hire's authorization rate is 15-20 percentage points below your team average, they're costing you tissue donations every single week.

And if they burn out in 6 months? You're back to square one, except now your team is even more exhausted from covering the gap.

What to Optimize For Instead

Forget time-to-fill. Start tracking these metrics:

1. Authorization Yield (First 12 Months)

What percentage of referred cases result in authorization for new hires in their first year?

Performance Level	Benchmark
✅ Good	Within 5 percentage points of team average by month 6
🌟 Excellent	Matches or exceeds team average by month 9
🚨 Red flag	Still 10+ points below average after 6 months

2. Time-to-Competency

How long does it take a new hire to hit your minimum acceptable authorization rate independently?

Performance Level	Benchmark
✅ Good	90 days
🌟 Excellent	60 days
🚨 Red flag	120+ days (they might not be the right fit)

3. Retention (18-Month and 3-Year)

What percentage of authorization hires are still with you after 18 months? After 3 years?

Performance Level	Benchmark
✅ Good	70% at 18 months, 50% at 3 years
🌟 Excellent	85% at 18 months, 65% at 3 years
🚨 Red flag	Below 50% at 18 months (your screening process is broken)

4. Coaching Hours Required

How many hours of 1-on-1 coaching does each new hire need before they're self-sufficient?

Performance Level	Benchmark
✅ Good	15-20 hours
🌟 Excellent	10-15 hours
🚨 Red flag	30+ hours (wrong competencies from the start)

The ROI of Hiring for Performance

Let's run the numbers on performance-based hiring:

Scenario Comparison

❌ Scenario A: Fast Hire (30 days)

Metric	Result
Time-to-fill	30 days ✓
Authorization rate	35% (below team average of 58%)
Tenure	8 months (burns out)
Total cost over 2 years	~$125,000 (including replacement)
Tissue authorizations in 2 years	~18

✅ Scenario B: Slow Hire (75 days)

Metric	Result
Time-to-fill	75 days ✗
Authorization rate	62% (above team average)
Tenure	3+ years
Total cost over 2 years	~$95,000 (no replacement needed)
Tissue authorizations in 2 years	~36

The Bottom Line

Scenario B costs $30,000 less and delivers twice as many authorizations.

The 45-day delay in filling the role? It's invisible compared to the performance gap.

How to Hire for Performance Instead of Speed

1. Screen for competencies, not credentials

Don't ask "Do you have healthcare experience?"

Ask "Tell me about the hardest conversation you've had with a family in crisis."

2. Use behavioral interviews

Red flag: Vague answers Green flag: Detailed examples with emotional awareness

3. Offer realistic job previews

Let candidates shadow authorization calls. If they're not enthusiastic after seeing the actual work, they'll quit in month 4 anyway.

4. Test for objection handling

Role-play a family saying "I don't trust you." See how they respond.

If they get defensive or fall back on scripts → pass.

5. Prioritize passive candidates from adjacent fields

Target these professionals:

Hospice nurses
Grief counselors
Crisis intervention specialists

They're not actively job-searching, but they have the right competencies.

What This Looks Like in Practice

When you optimize for performance instead of speed:

What Changes	Impact
Time-to-fill	⬆️ Goes up (60-90 days instead of 30)
Cost-per-hire	⬆️ Goes up (~$15,000 instead of $8,000)
Authorization rates	⬆️ Go up (5-15 percentage points)
Turnover	⬇️ Goes down (65% retention at 3 years instead of 35%)
Total cost of talent	⬇️ Goes down (no replacement every 8 months)

What Actually Matters

More families say yes.

More people get tissue grafts.

That's the metric that actually matters.

Ready to shift from time-to-fill to authorization yield? Download our free Authorization Performance Hiring Guide to learn how to screen for the competencies that predict success.