Certified Registered Nurse Anesthetist (CRNA) Full-Time, Direct Hire We are seeking an experienced Certified Registered Nurse Anesthetist (CRNA) to join a dynamic healthcare team in a full-time, direct-hire position. This role offers competitive compensation, excellent benefits, and opportunities to work in a collaborative environment with a diverse patient population. Why You ll Love This Role: <ul> <li> Work with a supportive anesthesia and surgical team </li> <li> Administer anesthesia in a variety of settings, including OR, outpatient procedures, and specialty cases </li> <li> Competitive salary with potential sign-on, retention, and relocation bonuses </li> <li> Standard or flexible schedules depending on facility </li> </ul> Responsibilities: <ul> <li> Provide anesthesia care for surgical, obstetric, and procedural patients </li> <li> Perform pre-anesthesia assessments and develop individualized anesthesia plans </li> <li> Monitor patient vital signs and adjust anesthesia as needed during procedures </li> <li> Collaborate with surgeons, anesthesiologists, and other healthcare providers to ensure optimal patient outcomes </li> <li> Maintain accurate documentation and comply with all regulatory and quality standards </li> </ul> Qualifications: <ul> <li> Active CRNA license in the state of practice </li> <li> Current BLS, ACLS, and PALS certifications </li> <li> Strong clinical judgment, attention to detail, and communication skills </li> <li> Previous anesthesia experience preferred; new grads may be considered at select facilities </li> </ul> Benefits: <ul> <li> Comprehensive medical, dental, and vision coverage </li> <li> Retirement plan with employer contributions </li> <li> Paid time off and continuing education support </li> <li> Professional growth opportunities in a collaborative environment </li> </ul> For more information or to apply: Send your resume to or call/text .<img src="https://www.jobg8.com/Tracking.aspx?%2bAR%2f2DOE%2bxtgg41p8%2fCJKQq" width="0" height="0" />

**Certified Registered Nurse Anesthetist (CRNA)**

We are seeking an experienced Certified Registered Nurse Anesthetist (CRNA) to join a dynamic healthcare team in a full-time, direct-hire position. This role offers competitive compensation, excellent benefits, and opportunities to work in a collaborative environment with a diverse patient population.

**Job Description**

- Work with a supportive anesthesia and surgical team
- Administer anesthesia in a variety of settings, including OR, outpatient procedures, and specialty cases
- Provide anesthesia care for surgical, obstetric, and procedural patients
- Perform pre-anesthesia assessments and develop individualized anesthesia plans
- Monitor patient vital signs and adjust anesthesia as needed during procedures
- Collaborate with surgeons, anesthesiologists, and other healthcare providers to ensure optimal patient outcomes
- Maintain accurate documentation and comply with all regulatory and quality standards

**Requirements**

- Active CRNA license in the state of practice
- Current BLS, ACLS, and PALS certifications
- Strong clinical judgment, attention to detail, and communication skills
- Previous anesthesia experience preferred; new grads may be considered at select facilities

**Benefits**

- Comprehensive medical, dental, and vision coverage
- Retirement plan with employer contributions
- Paid time off and continuing education support
- Professional growth opportunities in a collaborative environment

Certified Registered Nurse Anesthetist - CRNA

Job Description:Supplemental Health Care is currently hiring Physical Therapists with previous OASIS experience for home health contracts in Webster, New York, and the surrounding areas. Home Health Physical Therapist Contract Details:<ul><li>$2,106 - $2,324 per week </li><li>13-week contract</li><li>Paid by the hour - not by the visit</li><li>Physical Therapist will have a designated territory of coverage with a set amount of patients</li><li>Home Health contracts with SHC require previous experience with OASIS/Medicare Certified Visits</li><li> Estimated weekly payment may include both taxable wages and tax-free reimbursements for meals, housing, and incidentals. Please speak with a recruiter for details.</li></ul>We know that at-home health care is a very different environment and requires specialized knowledge and support for our Physical Therapists to be successful. We offer the benefits, career guidance, and round-the-clock assistance that you want from your home health employment partner.If you'd like more detail on these home health Physical Therapist assignments or are ready to get started with the placement process, please apply online now. Requirements:<ul><li>Graduate of an accredited PT program.</li><li>Licensed as a Physical Therapist in New York</li><li>CPR Certified or ability to obtain</li><li>Previous experience with Computer Charting</li><li>6 months of previous Home Health Care experience</li><li>Valid U.S. Driver's License and reliable transportation</li></ul>Supplemental Health Care is an Equal Opportunity Employer, including disabled/veterans. SHC is committed to providing reasonable accommodation to, among others, individuals with disabilities and disabled veterans. If you need an accommodation because of a disability to search and apply for a career opportunity with Contractor, please send an e-mail to or call to let us know the nature of your accommodation request and your contact information.Supplemental Health Care will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable local, state, or federal law (including San Francisco Ordinance , Los Angeles Municipal Code 189.00, the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act). For this type of employment, Kentucky state law requires a criminal record check as a condition of employment.For a copy of the Supplemental Health Care Privacy Policy, please visit <img src="https://www.jobg8.com/Tracking.aspx?C1pmPT30GY%2fMoleLrPlh3wv" width="0" height="0" />

**Physical Therapist**

Supplemental Health Care is currently hiring Physical Therapists with previous OASIS experience for home health contracts in Webster, New York, and the surrounding areas.

**Job Description**

- $2,106 - $2,324 per week
- 13-week contract
- Paid by the hour - not by the visit
- Physical Therapist will have a designated territory of coverage with a set amount of patients
- Home Health contracts with SHC require previous experience with OASIS/Medicare Certified Visits
- Estimated weekly payment may include both taxable wages and tax-free reimbursements for meals, housing, and incidentals. Please speak with a recruiter for details.

We know that at-home health care is a very different environment and requires specialized knowledge and support for our Physical Therapists to be successful. We offer the benefits, career guidance, and round-the-clock assistance that you want from your home health employment partner.

**Requirements**

- Graduate of an accredited PT program.
- Licensed as a Physical Therapist in New York
- CPR Certified or ability to obtain
- Previous experience with Computer Charting
- 6 months of previous Home Health Care experience
- Valid U.S. Driver's License and reliable transportation

Therapist / Physical Therapist / New York / Home Health Physical Therapist Job

Job Title: Respiratory Therapist (RRT/CRT) Job Type: Full-Time Overview: We are seeking a skilled and compassionate Respiratory Therapist to join our healthcare team. The ideal candidate will provide high-quality respiratory care to patients of all ages in a dynamic clinical environment. This is an excellent opportunity for a motivated professional to grow their career while making a meaningful impact on patient outcomes. Responsibilities: <ul> <li> Assess, treat, and care for patients with cardiopulmonary disorders. </li> <li> Administer respiratory therapies, oxygen, and aerosol medications per physician orders. </li> <li> Manage mechanical ventilation and monitor patients in critical care settings. </li> <li> Educate patients and families on respiratory care and disease management. </li> <li> Collaborate with the interdisciplinary healthcare team to ensure optimal patient outcomes. </li> <li> Maintain accurate and timely documentation of treatments and patient progress. </li> </ul> Qualifications: <ul> <li> Current RRT (Registered Respiratory Therapist) or CRT (Certified Respiratory Therapist) license. </li> <li> Associates or Bachelor s degree in Respiratory Therapy or related field. </li> <li> Strong clinical skills and knowledge of respiratory care equipment. </li> <li> Excellent communication and patient care skills. </li> <li> BLS/ACLS certification required; PALS or NRP preferred. </li> </ul> Benefits: <ul> <li> Competitive salary and shift differentials (if applicable). </li> <li> Health, dental, and vision insurance. </li> <li> Retirement plan with employer match. </li> <li> Paid time off and holidays. </li> <li> Continuing education and professional development opportunities. </li> </ul> Why Join Us: <ul> <li> Work in a supportive and collaborative team environment. </li> <li> Make a direct impact on patient care and outcomes. </li> <li> Opportunities for career advancement and specialized training. </li> <li> Enjoy a healthy work-life balance in a welcoming community. </li> </ul> How to Apply: For more information, please send your resume directly to or call/text .<img src="https://www.jobg8.com/Tracking.aspx?ZqYXhYOh%2fNukZ%2ff5%2b5WOrAg" width="0" height="0" />

**Respiratory Therapist (RRT/CRT)**

We are seeking a skilled and compassionate Respiratory Therapist to join our healthcare team. The ideal candidate will provide high-quality respiratory care to patients of all ages in a dynamic clinical environment. This is an excellent opportunity for a motivated professional to grow their career while making a meaningful impact on patient outcomes.

**Job Description**

- Assess, treat, and care for patients with cardiopulmonary disorders.
- Administer respiratory therapies, oxygen, and aerosol medications per physician orders.
- Manage mechanical ventilation and monitor patients in critical care settings.
- Educate patients and families on respiratory care and disease management.
- Collaborate with the interdisciplinary healthcare team to ensure optimal patient outcomes.
- Maintain accurate and timely documentation of treatments and patient progress.

**Requirements**

- Current RRT (Registered Respiratory Therapist) or CRT (Certified Respiratory Therapist) license.
- Associates or Bachelor's degree in Respiratory Therapy or related field.
- Strong clinical skills and knowledge of respiratory care equipment.
- Excellent communication and patient care skills.
- BLS/ACLS certification required; PALS or NRP preferred.

**Benefits**

- Competitive salary and shift differentials (if applicable).
- Health, dental, and vision insurance.
- Retirement plan with employer match.
- Paid time off and holidays.
- Continuing education and professional development opportunities.

**Why Join Us**

- Work in a supportive and collaborative team environment.
- Make a direct impact on patient care and outcomes.
- Opportunities for career advancement and specialized training.
- Enjoy a healthy work-life balance in a welcoming community.

Respiratory Therapist

West Ridge Obstetrics and GynecologyUniversity of Rochester Affiliate Physician Credentials:<ul><li>New York State Medical License eligible</li><li>Bord Certified or Bord Eligible in Obstetrics and Gynecology</li></ul>Practice details:<ul><li>2 outpatient offices located in Greece and Webster</li><li>Large group of physicians (12) and 4 Nurse Practitioners</li><li>4 day work week</li><li>Call 1:11</li><li>Locally competitive salary</li><li>6 weeks vacation/CME time</li><li>CME stipend</li><li>Epic EMR</li><li>Malpractice coverage</li><li>Medical, vision and dental plans offered</li><li>Retirement Benefits 401K</li></ul>West Ridge Obstetrics and Gynecology, a University of Rochester affiliate, is looking to recruit a board certified/board eligible Ob/Gyn physician. Come join our large family! We have 12 physicians and 4 nurse practitioners many of whom have been with the group for years reflecting our strong, collaborative culture and commitment to long-term, high-quality patient care. We have 2 offices, one in Webster, NY and one in Greece, NY. Deliveries are at Strong Memorial Hospital. Our surgeries are done both at the hospital and the outpatient surgery center and there are robotics available at both. We have 2 board certified Urogynecologists who part of our group.We are looking for a full time or part time physician. Full time physician schedule is 4 days per week. Call is 1:11. We offer 6 weeks vacation/CME time as well as malpractice coverage, benefits and a retirement plan. Rochester, NY is a great place to raise a family and has affordable cost of living. There are many summer festivals, numerous beautiful lakes to visit and great schools.Compensation Information: $250000.00 / Annually - $350000.00 / AnnuallyDetails: Competitive local salary<img src="https://www.jobg8.com/Tracking.aspx?9NRMGh5nV%2b5DFg9wI3MOxAj" width="0" height="0" />

**Obstetrics and Gynecology Physician**

West Ridge Obstetrics and Gynecology, a University of Rochester affiliate, is looking to recruit a board certified/board eligible Ob/Gyn physician. Come join our large family! We have 12 physicians and 4 nurse practitioners, many of whom have been with the group for years, reflecting our strong, collaborative culture and commitment to long-term, high-quality patient care. We have 2 offices, one in Webster, NY and one in Greece, NY. Deliveries are at Strong Memorial Hospital. Our surgeries are done both at the hospital and the outpatient surgery center, and there are robotics available at both. 

**Job Description**

- 2 outpatient offices located in Greece and Webster
- Large group of physicians (12) and 4 Nurse Practitioners
- 4 day work week
- Call 1:11
- Locally competitive salary
- 6 weeks vacation/CME time
- CME stipend
- Epic EMR
- Malpractice coverage
- Medical, vision, and dental plans offered
- Retirement Benefits 401K

**Requirements**

- New York State Medical License eligible
- Board Certified or Board Eligible in Obstetrics and Gynecology

**Benefits**

- Competitive local salary ($250,000.00 - $350,000.00 annually)
- 6 weeks vacation/CME time
- Malpractice coverage
- Medical, vision, and dental plans offered
- Retirement plan

**Community Overview**

Rochester, NY is a great place to raise a family and has an affordable cost of living. There are many summer festivals, numerous beautiful lakes to visit, and great schools.

Ob/Gyn Physician

Upstate New York Family Medicine/Internal Medicine Opportunity$325k+ Starting Salary- $75k Signing Bonus4 Day Work Week- Outpatient Only Exciting opportunity to practice the region's leading not for profit health system. This position will offer a high earning potential, work life balance, and extensive support from colleagues and staff. <ul><li>Employed Family Practice/Internal Medicine physician opportunity- 4 day work week outpatient only adult primary care practice</li><li>Work in state of the art clinic with a large, supportive team of Family Practice and Internal Medicine providers</li><li>$325,000+ starting salary (negotiable based on training and experience), plus RVU based and quality based incentives.</li><li>$75,000 Sign-on bonus and relocation allowance with student loan assistance/repayment available and reimbursement for relocation and student loans (if applicable), full benefits</li><li>Full-time and part-time openings. 2026 graduating Internal Medicine and Family Medicine residents are welcome to apply! The position is J1 and H1b visa eligible</li></ul> Clifton Springs offers it all- small town suburban living with immediate access to Finger Lakes and Rochester<ul><li>Live in the scenic Finger Lakes Region, the jewel of Upstate New York and enjoy all four seasons with year-round outdoor recreation that includes boating, hiking, skiing, and more</li><li>Safe neighborhoods, family friendly amenities, and excellent public and private school systems, with advanced curriculum options</li><li>Close proximity to Rochester, Syracuse, and Buffalo for city amenities, dining, and travel</li></ul>Job ID- JN -1<img src="https://www.jobg8.com/Tracking.aspx?9NRMGh5nV%2b5FfJL9aT3czgj" width="0" height="0" />

**Upstate New York Family Medicine/Internal Medicine Opportunity**

Exciting opportunity to practice in the region's leading not-for-profit health system. This position will offer a high earning potential, work-life balance, and extensive support from colleagues and staff.

**Job Description**

- Employed Family Practice/Internal Medicine physician opportunity - 4 day work week outpatient only adult primary care practice
- Work in a state-of-the-art clinic with a large, supportive team of Family Practice and Internal Medicine providers
- $325,000+ starting salary (negotiable based on training and experience), plus RVU-based and quality-based incentives
- $75,000 sign-on bonus and relocation allowance with student loan assistance/repayment available and reimbursement for relocation and student loans (if applicable), full benefits
- Full-time and part-time openings. 2026 graduating Internal Medicine and Family Medicine residents are welcome to apply! The position is J1 and H1B visa eligible

**Community Overview**

Clifton Springs offers it all - small town suburban living with immediate access to Finger Lakes and Rochester.

- Live in the scenic Finger Lakes Region, the jewel of Upstate New York, and enjoy all four seasons with year-round outdoor recreation that includes boating, hiking, skiing, and more
- Safe neighborhoods, family-friendly amenities, and excellent public and private school systems, with advanced curriculum options
- Close proximity to Rochester, Syracuse, and Buffalo for city amenities, dining, and travel

Family Practice - Without OB Physician

Certified Registered Nurse Anesthetist (CRNA) Full-Time, Direct Hire We are seeking an experienced Certified Registered Nurse Anesthetist (CRNA) to join a dynamic healthcare team in a full-time, direct-hire position . This role offers competitive compensation, excellent benefits, and opportunities to work in a collaborative environment with a diverse patient population. Why You ll Love This Role: Work with a supportive anesthesia and surgical team Administer anesthesia in a variety of settings, including OR, outpatient procedures, and specialty cases Competitive salary with potential sign-on, retention, and relocation bonuses Standard or flexible schedules depending on facility Responsibilities: Provide anesthesia care for surgical, obstetric, and procedural patients Perform pre-anesthesia assessments and develop individualized anesthesia plans Monitor patient vital signs and adjust anesthesia as needed during procedures Collaborate with surgeons, anesthesiologists, and other healthcare providers to ensure optimal patient outcomes Maintain accurate documentation and comply with all regulatory and quality standards Qualifications: Active CRNA license in the state of practice Current BLS, ACLS, and PALS certifications Strong clinical judgment, attention to detail, and communication skills Previous anesthesia experience preferred; new grads may be considered at select facilities Benefits: Comprehensive medical, dental, and vision coverage Retirement plan with employer contributions Paid time off and continuing education support Professional growth opportunities in a collaborative environment For more information or to apply: Send your resume to or call/text .<img src="https://www.jobg8.com/Tracking.aspx?aPoBvXocclNbdWUqVvnz%2fAo" width="0" height="0" />

CRNA / Anesthesiology / New York / Locum or Permanent / Certified Registered Nurse Anesthetist - CRNA Job

Medical Technologist/MLS or Medical Laboratory Technician Opening at one of New York's Top Healthcare Providers! This organization is looking to add a permanent and full time Medical Technologist/ Medical Laboratory Technician to their team on either evening or night shift! They also have department specific openings in blood bank, microbiology, core laboratory or special chemistry! This facility is offering a highly competitive hourly rate and a top notch benefits package! Benefits include: Medical Dental and Vision, Retirement Benefits, Generous PTO, Recognition and Reward Programs and ample opportunity for Career Development! Sign on bonus and/or Relocation Assistance is also available! Interested in learning more? Contact Marina at or call/text !<img src="https://www.jobg8.com/Tracking.aspx?WlNMCJ%2b8Bw1NY%2flQxbMXMAq" width="0" height="0" />

**Medical Technologist/MLS or Medical Laboratory Technician**

Opening at one of New York's top healthcare providers! This organization is looking to add a permanent and full-time Medical Technologist/Medical Laboratory Technician to their team on either evening or night shift. They also have department-specific openings in blood bank, microbiology, core laboratory, or special chemistry. This facility is offering a highly competitive hourly rate and a top-notch benefits package!

**Job Description**

- Join a dynamic team as a Medical Technologist/Medical Laboratory Technician.
- Work in various departments including blood bank, microbiology, core laboratory, or special chemistry.

**Benefits**

- Medical, dental, and vision insurance.
- Retirement benefits.
- Generous PTO.
- Recognition and reward programs.
- Ample opportunity for career development.
- Sign-on bonus and/or relocation assistance available.

Physician / New York / Locum or Permanent / MT/MLT (evening/night) Job

A wellrespected integrated health services organization is seeking to employ a BE/BC ENTJoin a high volume, wellestablished hospital employed ENT team while contributing to the growth of the practice. Call 1:3 with full support personnelPAY RANGE $400,000.00 $500,000.00 The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.Incredible city with every amenity. Have access to major entertainment, sports, culture and the arts, top universities and colleges, excellent restaurants, shops, wineries, and quaint villages too. One of the most affordable housing markets in the country<img src="https://www.jobg8.com/Tracking.aspx?aPoBvXocclPAy3Kl%2b1n5Hgo" width="0" height="0" />

**ENT Physician**

A well-respected integrated health services organization is seeking to employ a board-eligible/board-certified ENT. Join a high-volume, well-established hospital-employed ENT team while contributing to the growth of the practice. Call is 1:3 with full support personnel.

**Job Description**

- Contribute to the growth of a high-volume, well-established hospital-employed ENT team
- Participate in a call schedule of 1:3 with full support personnel

**Compensation**

- Pay range of $400,000.00 to $500,000.00. The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

**Community Overview**

Incredible city with every amenity. Have access to major entertainment, sports, culture and the arts, top universities and colleges, excellent restaurants, shops, wineries, and quaint villages too. One of the most affordable housing markets in the country.

Otolaryngology Physician

Excellent opportunity to be employed by one of the most successful healthcare systems in NY state!Work with an experienced OB/GYN group including 4 Ob/Gyns and 1 laborist with midwifery and APP Support. Community Hospital features Stateoftheart Labor and Delivery Unit, PostPartum Suites, and newly renovated outpatient office.PAY RANGE $250,000.00 $300,000.00 plus with robust benefits package The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.Incredible city in the area has every amenity. Have access to major entertainment, sports, culture and the arts, top universities and colleges, excellent restaurants, shops, wineries, quaint villages, and beautiful scenery too. Have a world class quality of life at an affordable cost of living! One of the most affordable housing markets in the country!<img src="https://www.jobg8.com/Tracking.aspx?CUsWLd82v%2f%2bCgpL%2byQfDOga" width="0" height="0" />

**OB/GYN**

Excellent opportunity to be employed by one of the most successful healthcare systems in New York state! Work with an experienced OB/GYN group including 4 OB/GYNs and 1 laborist with midwifery and APP support. The community hospital features a state-of-the-art labor and delivery unit, postpartum suites, and a newly renovated outpatient office.

**Job Description**

- Work with an experienced OB/GYN group including 4 OB/GYNs and 1 laborist with midwifery and APP support
- Community hospital features a state-of-the-art labor and delivery unit, postpartum suites, and a newly renovated outpatient office

**Compensation**

- Pay range: $250,000.00 - $300,000.00 plus a robust benefits package
- The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

**Community Overview**

Incredible city in the area has every amenity. Have access to major entertainment, sports, culture and the arts, top universities and colleges, excellent restaurants, shops, wineries, quaint villages, and beautiful scenery too. Enjoy a world-class quality of life at an affordable cost of living! One of the most affordable housing markets in the country!

Obstetrics & Gynecology Physician

Some locum assignments can be as short as a day, others, years. Some are far from home, others are local. Whatever it is you're looking for, we offer true opportunities, not just postings. CompHealth goes far beyond a job board, providing you with expert guidance tailored to your specific needs and phase of your career.<ul><li>Monday - Friday 8am - 4:30pm with occasional weekend coverage</li><li>Home health setting providing direct patient care</li><li>Team-based environment with comprehensive case management</li><li>Collaborates with physicians and family members</li><li>One year minimum home care experience required</li><li>We provide complimentary housing and travel</li><li>We arrange and cover costs for licensing and malpractice</li><li>We simplify the credentialing and privileging process</li><li>We provide first-day medical insurance and 401(K)</li><li>Your personal recruiter handles every detail, 24/7</li></ul>From $1820.00 to $3000.00 weekly Per week (based on a 40-hour work week). Includes estimated taxable wages of $23.00 - $40.00 per hour and estimated tax-free reimbursements for meals, incidentals, and housing of $900 - $1,400 per week based on GSA guidelines (subject to eligibility, location, and seasonal adjustment).<img src="https://www.jobg8.com/Tracking.aspx?dl8zXVO9naeqnmyigstihAx" width="0" height="0" />

**Locum Tenens Opportunity**

Some locum assignments can be as short as a day, others, years. Some are far from home, others are local. Whatever it is you're looking for, we offer true opportunities, not just postings. CompHealth goes far beyond a job board, providing you with expert guidance tailored to your specific needs and phase of your career.

**Job Description**

- Monday - Friday 8am - 4:30pm with occasional weekend coverage
- Home health setting providing direct patient care
- Team-based environment with comprehensive case management
- Collaborates with physicians and family members
- One year minimum home care experience required
- We provide complimentary housing and travel
- We arrange and cover costs for licensing and malpractice
- We simplify the credentialing and privileging process
- We provide first-day medical insurance and 401(K)
- Your personal recruiter handles every detail, 24/7

**Compensation**

From $1820.00 to $3000.00 weekly per week (based on a 40-hour work week). Includes estimated taxable wages of $23.00 - $40.00 per hour and estimated tax-free reimbursements for meals, incidentals, and housing of $900 - $1,400 per week based on GSA guidelines (subject to eligibility, location, and seasonal adjustment).