AMN Healthcare Services Inc

Good day and thank you for standing by. Welcome to the AMN Healthcare First Quarter 2026 Earnings 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 will need to press star 1 1 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 1 1 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Randy Reese, Vice President, Investor Relations and Strategy. Please go ahead.

Good afternoon, everyone. Welcome to AMN Healthcare's first quarter 2026 earnings call. A replay of this webcast will be available at ir.amnhealthcare.com at the conclusion of this call. 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 relief, 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 gap measures are included in our earnings release and on our financial reports page at ir.amnhealthcare.com. On the call with me today are Carrie Grace, President and Chief Executive Officer, and Brian Scott, Chief Financial and Operating Officer. I will now turn the call over to Carrie.

Thank you, Randy, and good afternoon, everyone. We appreciate you joining us today. The AMN team made important achievements since the start of the year. The first quarter was defined by unusually large labor disruption activities. From an operational standpoint, it was a major milestone for AMN. We successfully supported several large events, two of which for long duration, while continuing to serve the day-to-day showcasing our rapid scaling, disciplined execution, broad and deep clinician network, and high-touch service delivery. This experience also validated the investments we've made over the past few years in our technology capabilities, including our event management system and AI recruitment, technology that enables coordination, compliance, and real-time execution at scale, and it highlighted the strength of our mission-driven teams working across the company. The energy and endurance of the AMN team balancing event-specific needs and driving business as usual were all inspiring, demonstrating all the values and principles that make AMN special. For the first quarter, AMN delivered revenue of $1.38 billion, above our guidance range and consensus. Gross margin was 26.8%, well above our guidance range. Adjusted EBITDA was $166 million, or 12.1% of revenue. The first quarter included $722 million in labor disruption revenue and $656 million in revenue from all other AMM businesses. NERSC and Allied Solutions recorded year-over-year growth in traveler volume, excluding labor disruption travelers, for the first time since 2022. Our nurse and allied staffing businesses performed better than we expected in the first quarter and are on track for continued strong performance in the second quarter. Our international staffing business grew revenue by 17% quarter over quarter and 7% year over year. This was our first quarter of year over year growth in this business since the fourth quarter of 2023. shortly after the State Department implemented visa retrogression. Our leadership search business also returned to year-over-year revenue growth. While the revenues from labor disruption events are hard to predict, our ability to move thousands of clinicians to meet the urgent needs of our strategic clients delivered great value on a scale we could not have done just a few years ago. Our solid performance in the quarter enabled us to pay down our revolver and increase our cash balance, improving our leverage ratio to 1.6 times at quarter end. Our strong balance sheet positions us well in the industry to advance our growth strategy and drive value for our shareholders, clients, and other stakeholders. While we view the labor disruption execution as a defining accomplishment, We remain focused on the underlying drivers that enable our long-term growth plan, broader and deeper client and clinician relationships, scaled service execution, and technology enablement of our solutions. In our solution segment, first quarter revenue for Nurse and Alley Solutions was $1.13 billion, our second highest revenue for the segment in company history. Beyond the labor disruption revenue and international nurse growth, travel nurse revenue grew 13% year-over-year, and allied was up 3%. Bill rates and hours also moved favorably, with average bill rate up 6% year-over-year due to a surge in rapid response placements. Nurse demand has been muted, so demand in recent weeks improved to be flat year-over-year. Allied demand has been growing year over year since 2025. Our teams are executing very well at filling the available demand. For the second quarter, we expect Nurse and Allied Solutions revenue to be flat to down 2% year over year, including a normalization of the segment bill rate. First quarter revenue for Physician and Leadership Solutions was $164 million. lower by 6% year-over-year. Locum Tenant's volume was down 9% year-over-year, and revenue per day filled was up 3%. Interim leadership volume was down, partially offset by an increase in pricing. Our search business was highlighted by strong growth in physician permanent placement and new executive searches. We continue to see Locum's clients focus managing spend by centralizing program management and hiring permanent physicians and we have both a healthy pipeline of locums MSP prospects as well as a new locums MSP client in the quarter we also renewed and expanded the contract with our largest locums client MSP volume was up year-over-year and we are driving toward making MSP a higher percentage of our revenue mix. Overall, locum's demand has been softer, with more demand in a third-party channel, which is more competitive and harder to fill. Our lower fill rates in that channel more than offset our MSP progress. Similar to what we did in our nurse business to improve performance in vendor-neutral programs, we have initiatives in place to tech enable and automate our locums recruiting process to increase speed, as well as adding more recruiters to enable higher fill rates. Leadership Solutions has rolled out refreshed go-to-market approaches for executive and leadership search and interim to align with clients' current challenges, including accelerating healthcare C-suite turnover, rising demand for digitally fluent data-driven leaders, and developing sustainable workforce strategies. Operationally, the team is improving fill rates with AI-enabled candidate matching and enhanced tech and data capabilities to support our search consultants. In the second quarter, we expect position and leadership solutions revenue to be down approximately 6% to 8% year-over-year. Our revenue in technology and workforce solutions was $87 million, down 15% year-over-year, or 10% excluding the business we divested last year. Language Services continued the rollout of our tiered service and pricing strategy, and we are pleased with our progress, including increased new sales wins and gross margin improvements in the first quarter. Our updated model enables us to serve our clients with the broadest set of language access services while delivering superior clients and patient experience and outcomes. On our WorkWise workforce technology platform, we rolled out new AI-driven tools designed to help our customers fill roles faster and improve the quality of candidate matches. We added automated candidate scoring improved search across open orders and available staff, and made it easier to create clear job descriptions, improving speed, and overall hiring efficiency. We already used our AI recruiter to deploy more than 10,000 clinicians in the first quarter. We also introduced supplier performance analytics, which gives clients more transparency into supplier quality, responsiveness, and outcomes. Overall, these updates further differentiate work-wise and reinforce our ability to help healthcare organizations make better workforce decisions and manage staffing more efficiently. Our technology enablement has also strengthened our engagement with healthcare professionals. Our market-leading clinician app, AMN Passport, plays a critical role in how we improve the connection between client needs and the labor force. Over the past year, we increased the features and utility of Passport, and as a result, Passport users are up more than 30% year-over-year, with monthly active users up more than 50%. Based on positive client reception, we are accelerating our go-to-market strategy for WorkWise beyond our current client base, and we expect this acceleration to support new sales heading into the second half of the year. For the second quarter, we expect technology and workforce solutions revenue to be down approximately 14% to 16% year-over-year, which implies an improved sequential trend compared with the past two quarters. Overall, we are encouraged by our start to the year, with some key solutions returning to year-over-year growth and plans for additional solutions to return to year-over-year growth this year and into next year. We remain confident that we are moving toward a business model in which we can sustain long-term revenue growth and grow adjusted EBITDA at twice the rate of revenue growth. Our first quarter performance was a significant demonstration of AMN's capability to scale quickly and deliver at a high level, integrating technology, operational execution, and a mission-driven team under intense conditions. great people are at the center of our mission and our culture. As we celebrate National Nurses Week this week, we are grateful to and for the tens of thousands of nurses we have the privilege of working with who enable continuous, high-quality patient care delivered across a wide range of care settings and locations. With that, I'll turn the call over to Brian to walk through the financial details and outlook considerations.