What does a managed care director do?
A managed care director is responsible for providing quality care services for the patients by supervising clinical operations and managing medical staff. Managed care directors review all the medical activities in the institution and disseminate communications across the organization. They coordinate with health care providers, negotiate contracts with suppliers and medical organizations, verify insurance details, analyze financial transactions, and implement policies for strict compliance. A managed care director must have excellent communication and organizational skills, especially in handling the department's performance and strategizing to improve services.
Managed care director responsibilities
Here are examples of responsibilities from real managed care director resumes:
- Manage FTE and MH per stat numbers compare to budget.
- Manage dialysis, rehabilitation contact, nursing agency contracts and staff competencies.
- Lead business unit through successful JCAHO accreditation survey process with unprecedent results.
- Provide technical assistance and testimony for development and passage of legislation enabling implementation of Medicaid manage care.
- Provide patients with Thai yoga massage and energetic healing.
- Show compassion and empathy for families, residents and staff.
- Assist the mentally disable in performing their everyday tasks with kindness and compassion.
- Assist residents with activities of daily living and invite, encourage residents to activities as indicated on ISP.
- Provide assistants with ADL s on a personal level by learning the preferences and personalities of the individual residents.
- Assist with ADL such as dressing, bathing and helping residents to the bathroom (transferring to and from commodes).
- Supervise staff including: assistant director, activity director, group fitness instructors, massage therapists, yoga instructors and interns.
- Assess potential and establish clients for in home aide assistance eligibility base on Medicaid guidelines.
- Integrate case management functions to encompass both medical, surgical, and rehabilitation patient populations.
- Provide particularize care to patients with specific needs, supplement medical interventions with spiritual care; assess age-relate needs.
- Work with insurance companies to ensure compliance with numerous contractual obligations around utilization and case management for all patients admit.
Managed care director skills and personality traits
We calculated that 12% of Managed Care Directors are proficient in Patients, Patient Care, and Social Work. They’re also known for soft skills such as Analytical skills, Communication skills, and Detail oriented.
We break down the percentage of Managed Care Directors that have these skills listed on their resume here:
- Patients, 12%
Work with insurance companies to ensure compliance with numerous contractual obligations around utilization and case management for all patients admitted.
- Patient Care, 8%
Established systematic protocols and processes for agency compliance in documentation, facilitation of patient care, and proper administrative practices.
- Social Work, 7%
Supervised case managers and social workers in Integrated Care Management operations department.
- Quality Care, 6%
Provide a positive influence on staff regarding personal and professional development and promote an interdisciplinary team approach for high quality care.
- Oversight, 5%
Chaired Critical Care Committee directing oversight of medical center-wide clinical research activities and hospital-wide clinical emergency response team.
- Care Management, 4%
Care management included medication adjustment, ECT referrals, scheduling family conferences, and participation in interdisciplinary rounds.
Most managed care directors use their skills in "patients," "patient care," and "social work" to do their jobs. You can find more detail on essential managed care director responsibilities here:
Analytical skills. The most essential soft skill for a managed care director to carry out their responsibilities is analytical skills. This skill is important for the role because "medical and health services managers review and evaluate healthcare metrics for ways to improve efficiency and meet goals." Additionally, a managed care director resume shows how their duties depend on analytical skills: "documented data related to patient care including assessment results, interventions, medications, patient responses, or treatment changes. "
Communication skills. Another soft skill that's essential for fulfilling managed care director duties is communication skills. The role rewards competence in this skill because "medical and health services managers must convey information to their staff, other healthcare workers, and, sometimes, patients and insurance agents." According to a managed care director resume, here's how managed care directors can utilize communication skills in their job responsibilities: "led system concept of web-marketing and digital communication in the home health, extended care, post-acute, and acute sectors. "
Detail oriented. This is an important skill for managed care directors to perform their duties. For an example of how managed care director responsibilities depend on this skill, consider that "medical and health services managers must pay attention to detail." This excerpt from a resume also shows how vital it is to everyday roles and responsibilities of a managed care director: "hired, oriented, and scheduled all nursing staff for a 60 bed facility. ".
Leadership skills. A commonly-found skill in managed care director job descriptions, "leadership skills" is essential to what managed care directors do. Managed care director responsibilities rely on this skill because "medical and health services managers hire, train, and direct staff." You can also see how managed care director duties rely on leadership skills in this resume example: "participated in a yearlong leadership development program where i developed a manual for new directors of patient care services. "
Technical skills. Lastly, "technical skills" is an important element of what a managed care director does. Managed care director responsibilities require this skill because "medical and health services managers must stay up to date with advances in healthcare technology, such as the coding and electronic health record (ehr) systems their facility adopts." This resume example highlights how managed care director duties rely on this skill: "train the trainer for patient care documentation, meditech, computer software system technical/computer:. "
The three companies that hire the most managed care directors are:
- Cano Health29 managed care directors jobs
- Sanford Health23 managed care directors jobs
- Atria Senior Living14 managed care directors jobs
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Compare different managed care directors
Managed care director vs. Chief nursing officer
A Chief Nursing Officer supervises nurses and nurse managers, recommends strategies to improve services, and establishes goals for a healthcare facility. They ensure that operations comply with established standards and regulations, as well as prepare and supervise business reports, including annual budgets.
There are some key differences in the responsibilities of each position. For example, managed care director responsibilities require skills like "social work," "care management," "resident care," and "state regulations." Meanwhile a typical chief nursing officer has skills in areas such as "cno," "patient safety," "employee engagement," and "executive leadership." This difference in skills reveals the differences in what each career does.
Chief nursing officers tend to make the most money working in the health care industry, where they earn an average salary of $97,019. In contrast, managed care directors make the biggest average salary, $68,515, in the health care industry.chief nursing officers tend to reach similar levels of education than managed care directors. In fact, chief nursing officers are 3.1% more likely to graduate with a Master's Degree and 0.2% less likely to have a Doctoral Degree.Managed care director vs. Director of health services
A Director Of Health Services is responsible for evaluating and supervising the overall activities for health maintenance and promotion of a health department. They are also responsible for budgeting, procurement, and requisition of biological supplies and equipment.
Each career also uses different skills, according to real managed care director resumes. While managed care director responsibilities can utilize skills like "care management," "customer service," "acute care," and "health system," directors of health services use skills like "public health," "cpr," "behavioral health," and "mental health."
Directors of health services earn a lower average salary than managed care directors. But directors of health services earn the highest pay in the non profits industry, with an average salary of $85,179. Additionally, managed care directors earn the highest salaries in the health care with average pay of $68,515 annually.Average education levels between the two professions vary. Directors of health services tend to reach similar levels of education than managed care directors. In fact, they're 2.6% more likely to graduate with a Master's Degree and 0.2% more likely to earn a Doctoral Degree.Managed care director vs. Patient care manager
Patient care managers are executives who are in charge of supervising a clinical team. The managers take responsibility for directing patient care within an organization. Also called health care managers, they protect every patient's safety and health in a clinical setting. They interact with the healthcare team members to maintain open communication. It is also part of their duties to supervise the daily operations in the clinical care units. Managing clinical budgets and maintaining quality health services are also their responsibilities.
There are many key differences between these two careers, including some of the skills required to perform responsibilities within each role. For example, a managed care director is likely to be skilled in "patient care," "oversight," "state regulations," and "acute care," while a typical patient care manager is skilled in "community resources," "substance abuse," "medication administration," and "direct patient care."
Patient care managers make a very good living in the health care industry with an average annual salary of $54,278. On the other hand, managed care directors are paid the highest salary in the health care industry, with average annual pay of $68,515.Most patient care managers achieve a lower degree level compared to managed care directors. For example, they're 5.7% less likely to graduate with a Master's Degree, and 1.9% less likely to earn a Doctoral Degree.Managed care director vs. Clinical manager
A clinical manager is responsible for monitoring medical procedures and administrative duties to ensure the smooth flow of operations in a healthcare facility. Clinical managers manage the facility's staffing needs, evaluate budget reports, assist healthcare professionals on administering medical duties, and develop strategic procedures to optimize treatments and maximize productivity. A clinical manager enforces strict sanitary and safety regulations for everyone's strict compliance. They also need to have excellent knowledge of the medical industry to promote medical processes and provide the highest quality care.
Even though a few skill sets overlap between managed care directors and clinical managers, there are some differences that are important to note. For one, a managed care director might have more use for skills like "patient care," "quality care," "care management," and "resident care." Meanwhile, some responsibilities of clinical managers require skills like "direct patient care," "quality patient care," "patient education," and "process improvement. "
In general, clinical managers earn the most working in the health care industry, with an average salary of $72,510. The highest-paying industry for a managed care director is the health care industry.The average resume of clinical managers showed that they earn similar levels of education compared to managed care directors. So much so that theyacirc;euro;trade;re 3.2% less likely to earn a Master's Degree and more likely to earn a Doctoral Degree by 0.0%.Types of managed care director
Updated January 8, 2025
