National vacancy and turnover numbers are usually the first slide in any workforce update. Registered nurse turnover sat at 16.4% nationally in 2024. The country is on pace to be short more than 78,000 RNs by the end of 2025. Those numbers are real, and they belong in a board deck. But they describe an average, and an average is built to hide the market you're actually recruiting in.
Ask two health system TA leaders how long it takes to fill the exact same clinical role, one recruiting in a dense metro like Chicago and one recruiting in a small border market like Del Rio, Texas, and you will get two very different answers. Neither one is wrong. They're just describing different labor markets that a national number was never built to capture.
Picture an outpatient RN opening in both markets.
| Chicago (dense metro) | Del Rio, TX (rural/border) | |
|---|---|---|
| Candidate supply | Large regional talent pool, spread across dozens of health systems, academic medical centers, and ambulatory groups | Small local pool concentrated around one or two anchor employers and a regional hospital |
| Competitive set | Every major health system, several academic centers, and a deep bench of ambulatory and urgent care operators, all recruiting from the same pool | A handful of local employers, plus federal and cross-border demand pulling on the same small labor market |
| Licensure | Illinois is not yet a Nurse Licensure Compact member, so an incoming RN typically needs an Illinois-specific license before starting | Texas is a full NLC member, so a compact-licensed RN can often start practicing with far less lead time |
| Comp expectations | Higher cost of living pushes base pay expectations up, and dense competition means candidates routinely field multiple offers | Base pay expectations track lower, but thin supply means a single missed offer can stall a req for months, not weeks |
| Time-to-fill | Driven by offer competition and speed of response among many comparable options | Driven by whether a qualified, licensed candidate exists within a reasonable relocation radius at all |
Same job title, same job description, same day the requisition opened. Completely different reasons it's still open in week six. A recruiting process built for one of these markets and applied to the other isn't a lighter or heavier version of the same problem. It's the wrong tool.
Most internal TA functions, and more than a few RPO providers, run a single national process and flex effort up or down based on role difficulty. That works until the market itself is the variable, not just the role. Four things need to flex by region, not just by job:
Sourcing channels. The channels that produce candidates in Chicago (professional networks, competitor talent pools, academic medical center alumni) barely register in a market the size of Del Rio, where relocation messaging, compact-license outreach, and hyper-local community relationships do the real work.
Licensure and compact-state nuance. As the table above shows, the same credential can mean a two-week start date in one state and a multi-month wait in another. A national process that doesn't track compact status by state is quietly adding weeks to time-to-fill in every non-compact market it touches, and Illinois is far from the only one.
Comp benchmarking. National salary survey data smooths out exactly the variation that determines whether an offer gets accepted. A benchmark built for "RN, Midwest metro" tells you very little about what it takes to win a candidate in a micropolitan border market with a completely different cost of living and competitive set.
Employer brand. The story that resonates with a candidate choosing between five comparable health systems in a major metro is not the story that resonates with a candidate deciding whether to relocate to a smaller community at all. One employer brand, delivered the same way everywhere, will always underperform in at least half your markets.
This is where the data pillar of a well-built talent acquisition function earns its place. Of the five pillars that support high-performing TA (people, process, technology, marketing, and data), it's data that tells you which of the other four need to flex, and where.
In practice, regional intelligence means your TA function can answer, market by market: What does the real candidate pool look like here, not the national pool? What's the compact and licensure status our recruiters need to plan around? What does a competitive offer actually require locally? And which employer brand message is going to move a candidate in this specific community?
Without that layer, "process," "technology," and "marketing" are just guesses applied uniformly, hoping they land. With it, they become decisions made market by market, backed by data instead of a national assumption.
This is exactly the gap a segmented, Hybrid RPO model is built to close. Rather than handing an entire national requisition load to one undifferentiated process, Hueman manages recruiting, sourcing, screening, and offer management for a defined set of openings, segmented by location, job type, or business unit, while your internal team retains control of the broader function.
That means your Chicago reqs and your Del Rio reqs can run on genuinely different playbooks: different sourcing mixes, different compact-licensure workflows, different comp positioning, different employer-brand messaging, all under the same accountable partnership and the same reporting line. You get regional flexibility without having to build five regional recruiting functions from scratch, and without losing the visibility a single, accountable partner provides.
The organizations that reduce agency dependence and hit time-to-fill targets in 2026 aren't the ones with the best national process. They're the ones who stopped treating "national" as a strategy and started building recruiting capacity around the markets they actually operate in.