Medical and Health Services Manager

Education and Training: College plus graduate degree

Salary: Median—$67,430 per year

Employment Outlook: Good

Definition and Nature of the Work

Health care is one of the largest sectors of the American economy, and it is undergoing radical changes in order to meet the needs of a growing and aging population. Like other complicated businesses, health care institutions require skilled managers.

Currently, more than one-half of medical and health services managers (health care administrators) are employed by hospitals. Other medical and health services managers work for health maintenance organizations (HMOs), nursing homes, mental health institutions, outpatient facilities, home health care agencies, and independent group practices. As health care trends such as preventive medicine and managed care become more common, relatively fewer administrators will be employed by hospitals. (Managed care is a system that delivers health care services to covered individuals by arrangements with selected providers.) Other trends affecting health care administration include integrating various types of health care delivery systems, continual changes in technology, and the rapidly aging American population.

There are many different types of medical and health services managers. Generalists set the overall direction of the health care facility that they manage and do not specialize in any one facet of health care. Top managers or chief executive officers and assistant managers without specific titles are usually generalists. They must combine a basic understanding of clinical issues with business management expertise. Top managers are also often called on to represent their health care facilities to the general public and/or investors.

Specialist managers generally fall into one of two categories: clinical and non-clinical. Nonclinical managers are responsible for such nonhealth functions as finance, housekeeping, and human resources. Clinical managers specialize in functions unique to the health care industry, such as nursing, surgery, therapy, medical records, and outpatient services. Clinical managers usually have more narrowly defined responsibilities than generalists or nonclinical managers.

In addition to being employed at health care facilities, medical and health services managers are also employed by governments and insurance companies. Those employing managers include public health departments, health planning agencies, and the Veterans Administration (VA) health care system. Insurance companies need managers to help manage medical records and claims.

Certain tasks are common to most medical and health services managers regardless of their specialty or employer. Most managers evaluate personnel and their job performance; develop budgets; and implement policies, objectives, and procedures established for their various departments. All managers must also be able to coordinate their efforts with those of other managers and administrators in the best interests of their health care facility and its doctors, nurses, and patients.

The number of administrators employed by a given health care facility is determined by the size of the facility. A large hospital or HMO may employ dozens of managers, whereas a small group of physicians in a group practice may hire a single administrator to handle billing and other administrative duties.

Medical and health services managers often face difficult decisions and complex situations on a daily basis. The job requires good leadership and management skills, excellent problem-solving abilities, and the capacity to work long hours under stress.

Education and Training Requirements

A bachelor's degree from an accredited program and a Registered Health Information Administrator (RHIA) certification from the American Health Information Management Association is almost always a prerequisite for finding employment as a medical and health services manager. Candidates with bachelor's degrees can expect to compete for jobs as administrative assistants or assistant department heads. Becoming a health information manager requires a bachelor's degree. In 2005 there were forty-five accredited bachelor's programs in health information management, according to the Commission on Accreditation for Health Informatics and Information Management Education.

Department managers usually must have at least a master's degree. In addition, many clinical managers also have practical experience in their fields (for example as nurses or therapists) in addition to management training and experience. In 2005 seventy schools had accredited programs leading to the master's degree in health services administration, according to the Commission on Accreditation of Healthcare Management Education. Competition for entry in these programs is keen. Typically, the programs last two to three years and provide course work in hospital organization and management, marketing, accounting, budgeting, and human resources. Some programs offer students the chance to specialize in one type of health care facility or one aspect of health care management, while others offer a general education in health care administration.

Top managers, independent health care management consultants, and researchers have often earned doctoral degrees en route to achieving their positions.

Getting the Job

High school students interested in preparing for a career in medical and health services management should study sciences related to health care, such as biology, chemistry, and physics. In addition, they should take available courses in business management, accounting, and marketing. Volunteering at hospitals, nursing homes, and other health care facilities also provides important exposure to the field.

Upon earning a college degree and certification in medical and health services management, candidates can apply directly to health care facilities for entry-level positions. As mentioned previously, graduate degrees are almost always a prerequisite for top management jobs, so many low-level health care managers participate in continuing education programs in order to advance to the next level.

Advancement Possibilities and Employment Outlook

Medical and health services managers advance by moving into more responsible and higher-paying positions. They may advance within their places of employment or by moving on to larger facilities.

Employment of medical and health services managers is expected to grow faster than the average for all occupations through 2014 due to expansion and diversification in the health services industry. Expect to find relatively fewer positions in hospitals, and more positions in HMOs, home health care agencies, group practices, and long-term facilities.

Working Conditions

Medical and health services managers work long hours in modern facilities. Hospitals, nursing homes, and other health care facilities never "close," and managers are needed at all times to solve problems and handle day-to-day operations. Health care management is a high-stress occupation because managers must make decisions balancing the health of patients with the fiscal health of their facilities.

Where to Go for More Information

American College of Healthcare Executives
One N. Franklin St., Ste. 1700
Chicago, IL 60606-4425
(312) 424-2800
http://www.ache.org
http://www.ache.orghttp://www.healthmanagementcareers.org

American College of Health Care Administrators
300 N. Lee St., Ste. 301
Alexandria, VA 22314
(888) 882-2422
http://www.achca.org

Earnings and Benefits

The median annual income of medical and health services managers were $67,430 in 2004. According to a survey by Modern Healthcare magazine, the median annual compensation in 2004 for hospital administrators of selected clinical departments was $76,800 in respiratory care, $81,100 in physical therapy, $87,700 in home health care, $88,800 in laboratory services, $90,200 in long-term care, $93,500 in medical imaging/diagnostic radiology, $94,400 in rehabilitation services, $95,200 in cancer treatment facilities, $96,200 in cardiology, $102,800 in nursing services, and $113,200 in pharmacies.