Pay raises are based on a percentage, which actually puts those that start their career there at a disadvantage compared to those that come in from other companies.
Performance reviews have no bearing on pay increase, advancement opportunity, or anything of significance. They are pretty much just a pat on the back or a request to do something better.
Very political. If you meet the right people and do your best to woo them, you'll do well. However, if you prefer to be rewarded for performance and dedication to your job, you will be extremely disappointed.
Lack of communication from management. Everyone below management level is on a need-to-know basis...bordering on deception.
Benefits are mediocre at best. As an employee you are the guinea pig for the company; especially in regard to your health coverage. Now you only have a choice between various levels of high deductible health plans. Meanwhile, in the same market, PPO's and sometimes even HMO's are offered.
Sleepless nights. If you want to work in healthcare to help people, avoid the private payer. All decisions ultimately come down to the bottom line impact. It has a very dehumanizing effect.
You will be solicited to contribute to charities, Political Action Committees (PAC), or any other program that has little benefit to you unless you have vested interest.