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Become A Managed Care Director

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Working As A Managed Care Director

  • Communicating with Supervisors, Peers, or Subordinates
  • Making Decisions and Solving Problems
  • Establishing and Maintaining Interpersonal Relationships
  • Evaluating Information to Determine Compliance with Standards
  • Developing and Building Teams
  • Deal with People

  • Unpleasant/Angry People

  • Mostly Sitting

  • Make Decisions

  • $129,388

    Average Salary

What Does A Managed Care Director Do

Medical and health services managers, also called healthcare executives or healthcare administrators, plan, direct, and coordinate medical and health services. They may manage an entire facility, a specific clinical area or department, or a medical practice for a group of physicians. Medical and health services managers must adapt to changes in healthcare laws, regulations, and technology.

Duties

Medical and health services managers typically do the following:

  • Work to improve efficiency and quality in delivering healthcare services
  • Develop departmental goals and objectives
  • Ensure that the facility in which they work is up to date on and compliant with new laws and regulations
  • Recruit, train, and supervise staff
  • Manage the finances of the facility, such as patient fees and billing
  • Create work schedules
  • Prepare and monitor budgets and spending to ensure departments operate within allocated funds
  • Represent the facility at investor meetings or on governing boards
  • Keep and organize records of the facility’s services, such as the number of inpatient beds used
  • Communicate with members of the medical staff and department heads

Medical and health services managers work closely with physicians and surgeons, registered nurses, medical and clinical laboratory technologists and technicians, and other healthcare workers. Others may interact with patients or insurance agents.

Medical and health services managers’ titles depend on the facility or area of expertise in which they work. The following are examples of types of medical and health services managers:

Nursing home administrators manage staff, admissions, finances, and care of the building, as well as care of the residents in nursing homes. All states require licensure for nursing home administrators; licensing requirements vary by state.

Clinical managers oversee a specific department, such as nursing, surgery, or physical therapy, and have responsibilities based on that specialty. Clinical managers set and carry out policies, goals, and procedures for their departments; evaluate the quality of the staff’s work; and develop reports and budgets.

Health information managers are responsible for the maintenance and security of all patient records and data. They must stay up to date with evolving information technology, current or proposed laws about health information systems, and trends in managing large amounts of complex data. Health information managers must ensure that databases are complete, accurate, and accessible only to authorized personnel. They also may supervise the work of medical records and health information technicians.

Assistant administrators work under the top administrator in larger facilities and often handle daily decisions. Assistants might direct activities in clinical areas, such as nursing, surgery, therapy, medical records, or health information. They also handle administrative tasks, such as ensuring that their department has the necessary supplies and that equipment is operational and up to date.

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How To Become A Managed Care Director

Most medical and health services managers have at least a bachelor’s degree before entering the field. However, master’s degrees are common and sometimes preferred by employers. Educational requirements vary by facility.

Education

Medical and health services managers typically need at least a bachelor’s degree to enter the occupation. However, master’s degrees are common and sometimes preferred by employers. Graduate programs often last between 2 and 3 years and may include up to 1 year of supervised administrative experience in a hospital or healthcare consulting setting.

Prospective medical and health services managers typically have a degree in health administration, health management, nursing, public health administration, or business administration. Degrees that focus on both management and healthcare combine business-related courses with courses in medical terminology, hospital organization, and health information systems. For example, a degree in health administration or health information management often includes courses in health services management, accounting and budgeting, human resources administration, strategic planning, law and ethics, health economics, and health information systems.

Work Experience in a Related Occupation

Many employers require prospective medical and health services managers to have some work experience in either an administrative or a clinical role in a hospital or other healthcare facility. For example, nursing home administrators usually have years of experience working as a registered nurse.

Others may begin their careers as medical records and health information technicians, administrative assistants, or financial clerks within a healthcare office.

Important Qualities

Analytical skills. Medical and health services managers must understand and follow current regulations and adapt to new laws.

Communication skills. These managers must effectively communicate policies and procedures with other health professionals and ensure their staff’s compliance with new laws and regulations.

Detail oriented. Medical and health services managers must pay attention to detail. They might be required to organize and maintain scheduling and billing information for very large facilities, such as hospitals.

Interpersonal skills. Medical and health services managers discuss staffing problems and patient information with other professionals, such as physicians and health insurance representatives.

Leadership skills. These managers are often responsible for finding creative solutions to staffing or other administrative problems. They must hire, train, motivate, and lead staff.

Technical skills. Medical and health services managers must stay up to date with advances in healthcare technology and data analytics. For example, they may need to use coding and classification software and electronic health record (EHR) systems as their facility adopts these technologies.

Licenses, Certifications, and Registrations

All states require licensure for nursing home administrators; requirements vary by state. In most states, these administrators must have a bachelor’s degree, complete a state-approved training program, and pass a national licensing exam. Some states also require applicants to pass a state-specific exam; others may require applicants to have previous work experience in a healthcare facility. Some states also require licensure for administrators in assisted-living facilities. For information on specific state-by-state licensure requirements, visit the National Association of Long Term Care Administrator Boards.

A license is typically not required in other areas of medical and health services management. However, some positions may require applicants to have a registered nurse or social worker license.

Although certification is not required, some managers choose to become certified. Certification is available in many areas of practice. For example, the Professional Association of Health Care Office Management offers certification in medical management, the American Health Information Management Association offers health information management certification, and the American College of Health Care Administrators offers the Certified Nursing Home Administrator and Certified Assisted Living Administrator distinctions.

Advancement

Medical and health services managers advance by moving into higher paying positions with more responsibility. Some health information managers, for example, can advance to become responsible for the entire hospital’s information systems. Other managers may advance to top executive positions within the organization.

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Managed Care Director Jobs

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Managed Care Director Demographics

Gender

Female

69.9%

Male

28.6%

Unknown

1.6%
Ethnicity

White

63.5%

Hispanic or Latino

14.3%

Black or African American

11.3%

Asian

7.2%

Unknown

3.7%
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Foreign Languages Spoken

Spanish

45.2%

French

9.5%

Mandarin

4.8%

Russian

4.8%

Polish

4.8%

Italian

4.8%

Portuguese

2.4%

Hawaiian

2.4%

Ukrainian

2.4%

Cantonese

2.4%

Greek

2.4%

Persian

2.4%

Hindi

2.4%

Korean

2.4%

Chinese

2.4%

Carrier

2.4%

Yiddish

2.4%
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Managed Care Director Education

Schools

University of Phoenix

25.4%

Walden University

9.0%

Capella University

6.6%

Indiana Wesleyan University

4.9%

University of Alabama

4.1%

Ohio State University

4.1%

University of Kentucky

4.1%

New York University

3.7%

Michigan State University

3.7%

Liberty University

3.7%

Central Michigan University

3.7%

Loyola University of Chicago

3.3%

University of Memphis

3.3%

Grand Canyon University

3.3%

University of South Florida

2.9%

University of Saint Francis

2.9%

Ashford University

2.9%

University of Texas at Arlington

2.9%

University of Pennsylvania

2.9%

Temple University

2.9%
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Majors

Nursing

36.4%

Business

18.8%

Health Care Administration

7.4%

Social Work

6.7%

Management

3.7%

Psychology

3.3%

Theology

3.1%

Mental Health Counseling

2.4%

Public Health

2.1%

Education

2.1%

Marketing

2.0%

Public Administration

1.7%

Communication

1.6%

Elementary Education

1.3%

Criminal Justice

1.3%

General Studies

1.3%

Medical Assisting Services

1.3%

Human Services

1.3%

Biology

1.2%

Health Sciences And Services

1.2%
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Degrees

Masters

39.2%

Bachelors

26.6%

Other

14.0%

Associate

9.7%

Doctorate

4.2%

Certificate

4.1%

License

1.4%

Diploma

0.7%
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Full Time
Part Time
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Temporary

Real Managed Care Director Salaries

Job Title Company Location Start Date Salary
Director of Neurocritical Care Children's Hospital Neurology Foundation, Inc. Boston, MA Feb 01, 2013 $326,400
Director of Neurocritical Care Ch Neurology Foundation Boston, MA Feb 01, 2010 $320,000
Director, Vision Care Luxottica Retail North America Inc. Mason, OH Jan 02, 2016 $185,000
Patient Care Managing Director Allcare Dental and Dentures Inc. of Il-Bates Dds Rockford, IL Jun 25, 2010 $136,000
Patient Care Managing Director/Dentist Allcare Dental & Dentures of Ma, PC Chicopee, MA Sep 28, 2009 $136,000
Director, Managed Care Payment Reform NYU Langone Health System New York, NY Oct 01, 2016 $135,200
Director, Medicaid Accountable Care Children's Hospital Corporation Boston, MA Apr 04, 2016 $130,000
Director, Managed Care Payment Reform New York University Hospitals Center New York, NY Jan 12, 2015 $130,000
Director, Acute Care Flow Saint Joseph Mercy Health System Ann Arbor, MI Jun 10, 2013 $129,000
Patient Care Managing Director/Dentist Allcare Dental & Dentures of Ia, PC Des Moines, IA Oct 01, 2009 $115,274
Director, Managed Care Tenet Health System Medical, Inc. ('THM') Atlanta, GA Oct 01, 2012 $110,000
Patient Care Managing Director/Dentist Allcare Dental & Dentures, Inc. of Ohio-Bates Cuyahoga Falls, OH Oct 01, 2009 $108,800
Director of Heatlh Care Services Sunrise Community, Inc. Miami, FL Jan 10, 2015 $96,000
Director of Patient Care Services Aston Home Health Inc. Wilmington, DE Aug 02, 2012 $84,000
Director of Patient Care Services Golden Hills Healthcare Services, Inc. Burbank, CA Oct 01, 2012 $83,480
Director of Patient Care Services Jubilee Home Health Services, Inc. Lakewood, CA Dec 30, 2010 $78,499
Ass't. Director of Nursing-Long Term Care and Reha Spectrum Health Continuing Care Grand Rapids, MI Mar 11, 2013 $76,752
Director of Patient Care Services Bakersfield Community Hospice, Inc. Bakersfield, CA Aug 15, 2015 $76,045
Director of Patient Care Services Hillcrest Hospice Inc. Burbank, CA Aug 15, 2015 $72,000
Director of Patient Care Services Care First Hospice, Inc. Burbank, CA Aug 15, 2015 $72,000
Director of Patient Care Services Mar Vista Hospice, Inc. Burbank, CA Aug 15, 2015 $72,000
Director of Patient Care Services Hillcrest Hospice Inc. Burbank, CA Sep 01, 2014 $72,000

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Top Skills for A Managed Care Director

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  1. Compliance
  2. Procedures
  3. Patient Care
You can check out examples of real life uses of top skills on resumes here:
  • Implemented and maintained a consistent utilization management process that assured compliance with federal/state regulatory agencies and payers.
  • Identified and successfully negotiated clinical procedures and surgical supply carve outs of managed care contracts thus increasing reimbursement revenue.
  • Established systematic protocols and processes for agency compliance in documentation, facilitation of patient care, and proper administrative practices.
  • Developed managed care reporting templates and framework for evaluation of capitation contract financial performance.
  • Directed oversight of staff physician practice management issues, including revenue enhancement, billing and credentialing.

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Top 10 Best States for Managed Care Directors

  1. New York
  2. Nevada
  3. Rhode Island
  4. Massachusetts
  5. District of Columbia
  6. Delaware
  7. New Mexico
  8. Connecticut
  9. California
  10. Oregon
  • (917 jobs)
  • (133 jobs)
  • (71 jobs)
  • (777 jobs)
  • (121 jobs)
  • (46 jobs)
  • (137 jobs)
  • (200 jobs)
  • (2,135 jobs)
  • (235 jobs)

Top Managed Care Director Employers

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