The Hardest Health IT Roles to Fill

IT leaders say the skill they can’t find isn’t AI or security alone, it’s someone fluent in both, illustrating why these represent some of the hardest health IT roles fill requirements hospitals currently face. The job title doesn’t exist on most org charts yet, but two IT leaders who spoke with Becker’s point to the same kind of gap.

Why Rural Hospitals Face Some of the Hardest IT Roles to Fill

For James Wellman, vice president and CIO of Nathan Littauer Hospital & Nursing Home in Gloversville, New York, the gap became clear as the rural facility began rolling out its own AI initiatives. “That is already top of my mind as we have started implementing our AI initiatives. I have been working on this as we try to figure out what we need in the future,” Wellman said.

Defining the Undefined Role

The role he’s struggled most to define, let alone find, is something like an AI solutions architect or clinical AI integration architect, someone who can bridge clinical operations, workflows, AI technology, data architecture, security and change management. “We have plenty of IT professionals. We have very few people who understand both worlds deeply enough to deploy AI safely and effectively. This is compounded for us in rural care,” Wellman said.

Why This Is Among the Hardest Health IT Roles Fill Requirements to Satisfy

The difficulty isn’t buying software, Wellman said. Every AI deployment raises questions that sit at the boundary of IT and clinical practice: Is the underlying data trustworthy? Does the tool integrate with the EHR? Will providers actually use it? Is it HIPAA compliant? Does it introduce bias? Can it be audited? Will it improve outcomes? Does it create new liability?

A Breadth of Skills Rarely Found in One Person

Answering those questions requires fluency across clinical workflows, EHR architecture, HL7/FHIR, data governance, cybersecurity, AI models, regulatory requirements, project management, and change management, not any single one of them in isolation. “Finding one person with all those skills is exceptionally difficult and when/if you do, then be prepared to compensate them accordingly,” Wellman said.

A Related Convergence at Atlantic Health System

At Atlantic Health System in Morristown, New Jersey, Sunil Dadlani, executive vice president and chief information, digital and AI officer, is watching a related convergence play out, this one at the intersection of AI and security rather than AI and clinical operations. “The hardest IT role to fill in 2026 is the hybrid AI/cybersecurity security engineer, someone who can secure clinical systems and govern AI risk, while understanding HIPAA, medical devices, and clinical uptime constraints,” Dadlani said.

New Roles That Didn’t Exist Three Years Ago

The AI angle is now central to the search, he said. Demand has shifted toward people who can operationalize AI at scale, govern its risks, and use it effectively without trusting it blindly, including governance and red-team roles that didn’t exist on hospital org charts three years ago.

Why Hospitals Lose This Talent to Big Tech

“In addition, we lose these people to Amazon, Google, and well-funded tech startups that don’t carry hospital-system overhead, a pay gap most organizations can’t close,” Dadlani said. That competition cuts both ways this year.

How Tech Layoffs Are Widening the Hiring Pool

As big tech companies cut jobs by the thousands in 2026, citing AI investment and automation, some of that same talent has started flowing toward hospitals rather than away from them. Lisa Stump, executive vice president and chief digital information officer of New York City-based Mount Sinai, told Becker’s in June that the layoffs have widened her hiring pool for the same skill sets Dadlani described: cloud, cybersecurity, data engineering and AI/machine learning.

A Shared Problem Across Different Organization Sizes

Neither Wellman’s rural facility nor Dadlani’s multi-hospital system is describing the same job. But both are describing a similar problem. In both accounts, the hardest position to fill in this space isn’t a traditional specialty. It’s a hybrid one that combines domains organizations used to hire for separately.

A Role Still Without a Settled Title

This hybrid role doesn’t yet have a settled title or a standard job description, and in many cases still can’t compete on pay with well-funded tech companies, even now that some of that talent is easier to find.

What This Means for Hospitals Building AI Teams

Given how consistently these two IT leaders, one at a rural facility and one at a multi-hospital system, describe the same underlying gap, this appears to reflect a structural challenge across the sector rather than an isolated staffing problem at either organization. Institutions evaluating their own AI deployment strategies may need to consider whether investing in cross-training existing clinical or cybersecurity staff in AI fluency could prove more feasible than recruiting for a role that, as both leaders describe, essentially doesn’t yet exist as a standard job title.

What to Watch Going Forward

As big tech layoffs continue reshaping the broader talent market, hospitals may find these hardest health IT roles fill requirements becoming somewhat easier to meet, even as the underlying compensation gap between institutions and well-funded technology companies persists. Given that these hybrid AI-plus-clinical or AI-plus-security roles remain undefined across the sector, how individual organizations choose to structure, title, and compensate these positions in the coming year could offer useful benchmarks for others facing the same recruitment challenge.

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