AMN Healthcare Services Inc

Good day, and thank you for standing by. Welcome to AMN's Healthcare's fourth quarter and full year 2023 earnings conference call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you'll need to press star 11 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 11 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Randall Reese, Senior Director of Investor Relations. Please go ahead.

Good afternoon, everyone. Welcome to AMN Healthcare's fourth quarter and full year 2023 earnings call. A replay of this webcast will be available at ir.amnhealthcare.com at the conclusion of this call. Various remarks we make during this call about future expectations, projections, trends, plans, events, or circumstances constitute forward-looking statements. These statements reflect the company's current beliefs based upon information currently available to it. Our actual results may differ materially from those indicated by these forward-looking statements because of various factors in cautionary statements, including those identified in our most recently filed forms 10-K and 10-Q, our earnings release, and subsequent filings with the SEC. The company does not intend to update guidance or any forward-looking statements provided today prior to its next earnings release. This call contains certain non-GAAP financial information. Information regarding and reconciliations of these non-GAAP measures to the most directly comparable GAAP measures are included in our earnings release and on our financial reports page at ir.amnhealthcare.com. On the call today, are Carrie Grace, President and Chief Executive Officer, and Jeff Knutson, Chief Financial Officer. I will now turn the call over to Carrie.

Thank you, Randy. AMN Healthcare finished 2023 with a solid fourth quarter and a stabilizing outlook for the first quarter of the new year. Last year, we successfully balanced two objectives. We worked through the largest cyclical reset in industry history, partnering with clients to help them optimize their workforce mix to meet their strategic and financial objectives. At the same time, we positioned AMN for stronger growth in technology-centric total talent solutions for healthcare. Throughout the history of our company, AMN has excelled at innovating to support healthcare professionals and clients during changing times. In 2023, saw our team members pull together to transform AMN as clients' needs shifted during the pandemic. While we navigated a declining staffing market, AMN initiated a wide-ranging series of initiatives to accelerate our agility and align our value proposition with the increasing needs for innovative solutions to solve significant healthcare workforce challenges. From the beginning, Our strategy has been guided by four pillars. Be the preferred partner to help healthcare organizations optimize their workforce strategy. Be the preferred employer for healthcare professionals and team members. Build on and digitize our unmatched portfolio of total talent solutions for healthcare. And be good stewards of capital, investing prudently for the short and long term. We're at the middle of last year. We were just getting started adapting to market changes and developing our operational plan for growth. I am now pleased to report the AMN has made progress on all these objectives. We made ourselves a better partner and elevated our total talent solutions by moving to integrate our solutions, our systems, and our brands. Going to market truly is one AMN. In addition, we restarted our sales organization to pursue growth opportunities in all segments of our market. As healthcare leaders made workforce management a top strategic priority, we developed the flexibility to deliver a comprehensive range of solutions through our technology platform. We took the best new technology and made our services more powerful, easier to use, and faster to deploy. We have the breadth and depth of solutions to serve clients in any model they choose, ranging from direct staffing to vendor neutral and master vendor MSP to recruiting solutions and workforce management technology or a hybrid of models. Our ability to broadly serve the market is enabling us to grow our sales pipeline across all service lines. Becoming more agile meant speeding up the pace of IT and operational transformation at AMN, and we have completed some of the largest improvement projects in company history. These included moving nine nursing allies and three physician and leadership brands under the AMN Healthcare brand and into one AMN front door for healthcare professionals. important milestones for getting the benefits of operating as a total talent solutions organization. Brand recognition for AMN is already testing at an all-time high, and candidate traffic and applicants have outpaced expectations. This quarter, we are on track to move Nurse and Allied to the new cloud version of our proprietary front-end platform. Last quarter was the debut of ShiftWise Flex, the cloud-enabled version of our industry-leading VMS software, which we also have extended to a mobile app, enabling on-the-go workforce management. ShiftWise Flex has an embedded market insights and analytics dashboard available as a standard feature. Addressing the critical need for actionable, transparent market intelligence, this solution provides our MSP and VMS customers with daily updates on clinical labor trends and market rates, supporting informed decision-making and strategic planning. We also are deploying embedded market rate analytics that can project bill rates at the work order level as far as 90 days out. Our investments in shift-wise flex are being validated by the broader market reception and competitive renewals with our existing VMS relationships. We are deploying ShiftWise Flex to current clients and new MSP clients as well. And we have completed API integrations with client systems to automate work order entry, clinician onboarding and offboarding, timekeeping, and invoicing. These changes at AMN have strengthened our ability to serve healthcare professionals. OneAMM branding is an important element of how we support an increasing number of workers through our industry-leading AMM Passport mobile app. Passport has expanded from its start in nursing to encompass allied and soon physicians and advanced practices. AMM Passport now features AI-driven enhancements to our proprietary matching algorithm. Clinicians receive opportunities that best match their skills and preferences, and they can book for themselves, further personalizing and optimizing their Passport experience. AMN Passport has become an important tool for engaging the workforce, enabling self-service and giving professionals an always-on connection to AMN. Our development work is making it easier for professionals to find the career options they want and manage not just their assignments, but their careers. AMM Passport and ShiftWise Flex are also central to our powerful solution that enables clients to manage internal resource pools, internal agencies, and direct sourcing. Passport's acclaimed clinician experience is essential for clients to attract the best people at the best cost in less time. Our change initiatives also have provided exciting opportunities for our corporate team members. We have automated labor-intensive tasks and enabled around-the-clock credentialing, praying our team members to be more productive and focus on higher impact activities, such as time with clients and clinicians. Our team receives a valuable experience of working with the latest technology. And our entire go-to-market has been reshaped to be more customer-friendly and efficient, which will empower our team members to make even a bigger difference in the continuum of care. As proof points, our team member engagement scores last year ranked at the top of our industry and above the Gallup benchmark for best practice organization. We improved team member retention. Becker's named AMM one of the best healthcare places to work, and we are recognized by numerous organizations for our strong culture of inclusion and diversity. Along with what I have noted, we have reinforced our total talent solutions in other ways. Our 1AMN brand consolidation is only part of the heavy lifting that we have done to integrate the sales and delivery of our solutions, simplifying and speeding service to new and existing clients. On the front end, We have built on our 39 years of experience to provide advisory services under the leadership of Chief Business Officer Meredith LaPointe and Chief Growth Officer Pat McCall. And last quarter, we acquired MSDR to expand our scale and diversification in locum tenants. This acquisition was our first major deal since 2020 and a large part of the investments we made last year. AMN generated $372 million of operating cash flow in 2023, enabling us to invest a record high $104 million in capital expenditures. We also used our strong balance sheet to repurchase $425 million of our stock, which we continue to view as an attractive investment opportunity. Early in 2024, we see a mixed picture in our markets. Our allied staffing business expects sequential revenue growth in the first quarter. Interim leadership and search show signs of stabilization and a sense of reaching the bottom. Our sales pipeline continues to both grow and progress, and recent new client wins in staffing include the largest win we have seen since 2019. In the direct and third-party staffing market, We have early signs that our technology and process changes are making us more competitive across the entirety of the market. We continue to expect organic growth in a solid market for locum tenants. And with our recent acquisition of MSDR, our annualized revenue run rate in locums is now more than $600 million. Language Services continues to be one of our strongest growing businesses with its strongest pipeline of prospects. Offsetting these positives, our Q1 guidance assumes slightly lower nurse and allied segment revenue than fourth quarter levels. First quarter guidance assumes zero labor disruption revenue, and the typical cancellations of some winter needs orders happened earlier in the quarter than usual. The overall labor backdrop is favorable, and this year's 30% increase in ACA marketplace enrollment indicates that the insured population is growing, which we expect will fuel demand utilization. We are encouraged by the green shoots we see from our total market growth strategy and are pleased with our accelerated progress. Our strategy will unfold over multiple years, and we expect our initiatives to have an increasingly positive impact on our business later in 2024 and beyond. Now, I'll turn the call over to Jeff who will review our latest financial results and outlook.