How Per-Diem Healthcare Staffing Works in Arizona

"Per-diem" is Latin for "per day," and in healthcare staffing it means exactly that: you're paid for the individual shifts you work, not a salary or a guaranteed weekly schedule. For Caregivers, CNAs, Behavioral Health Technicians, Medication Technicians, LPNs, and RNs, per-diem work has become one of the fastest-growing ways to work in assisted living and behavioral health care - and Phoenix, Arizona has one of the tightest healthcare staffing markets in the country for it.

How a per-diem shift actually gets filled

A facility - an assisted living community, a memory care unit, a behavioral health center - has a coverage gap: someone called out, census went up, or they need extra hands for a specific shift. Instead of calling a staffing agency and waiting on a recruiter, the facility posts the shift directly to a marketplace like Nexora: role needed, date and time, and the exact hourly pay rate.

Verified professionals see that shift immediately. If you're credentialed for that role and available, you claim it - first eligible claim gets it, no negotiation, no back-and-forth. You show up, clock in (often GPS-verified so both sides know the shift actually happened where it was supposed to), do the shift, and clock out. A timesheet generates automatically recording your exact hours, which the facility reviews and approves - since you're an independent contractor, not a Nexora employee, the facility pays you directly at the rate you saw before you claimed the shift.

How it's different from a traditional staffing agency

A traditional agency puts a recruiter between you and the facility. They negotiate your rate, they decide which shifts you hear about, and they take a cut you usually never see the size of. A per-diem marketplace removes that layer: the facility's posted rate is your rate, shown to you before you ever claim anything, and there's no recruiter deciding what you get offered.

It's also different from a permanent job. There's no minimum-hours requirement and no schedule commitment - you work the shifts that fit your life, and nothing else. That flexibility is the entire point: per-diem is a tool for people who want control over when they work, not a downgrade from a "real" job.

How pay and classification work

In Arizona, per-diem healthcare shifts are typically structured as 1099 independent-contractor work under the state's Direct Independent Business Support (DIBS) framework (A.R.S. Section 23-1601) - a legal safe harbor specifically built for this kind of on-demand, claim-your-own-shift work. That means you're not an employee of the facility or the marketplace; you're an independent professional choosing which engagements to accept.

This is different from being a W-2 employee, and it comes with real tradeoffs worth understanding - you handle your own taxes as a 1099 contractor, for one. But it also means nobody can force a schedule on you, and the marketplace can't take a cut of your posted rate without your knowledge.

Getting started

To work per-diem shifts through a marketplace, you'll typically need: a government-issued photo ID, your role's license or certification (a CNA certification, an RN license, etc.), a state fingerprint clearance card, a negative TB test, current CPR/First Aid certification, and - in Arizona - a Food Handler card. Every credential gets verified once, then reused across every facility you work with on the platform.