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 representing typical tasks they are likely to perform in their roles.

  • 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 list "patients," "patient care," and "social work" as skills on their resumes. We go into more details on the most important managed care director responsibilities here:

  • The most important skills for a managed care director to have in this position are analytical skills. In this excerpt that we gathered from a managed care director resume, you'll understand why: "medical and health services managers must understand and follow current regulations and adapt to new laws." According to resumes we found, analytical skills can be used by a managed care director in order to "documented data related to patient care including assessment results, interventions, medications, patient responses, or treatment changes. "
  • Another trait important for fulfilling managed care director duties is communication skills. According to a managed care director resume, "these managers must effectively communicate policies and procedures to other health professionals and ensure their staff’s compliance with new laws and regulations." Here's an example of how managed care directors are able to utilize communication skills: "led system concept of web-marketing and digital communication in the home health, extended care, post-acute, and acute sectors. "
  • Detail oriented is also an important skill for managed care directors to have. This example of how managed care directors use this skill comes from a managed care director resume, "medical and health services managers must pay attention to detail" Read this excerpt from a resume to understand how vital it is to their everyday roles and responsibilities, "hired, oriented, and scheduled all nursing staff for a 60 bed facility. "
  • A managed care director responsibilities sometimes require "interpersonal skills." The responsibilities that rely on this skills are shown by this resume excerpt: "medical and health services managers discuss staffing problems and patient information with other professionals, such as physicians and health insurance representatives." This resume example shows how this skill is used by managed care directors: "provide customer service skills, interpersonal skills,good communication skills,leadership skills,telephone skills. "
  • Yet another important skill that a managed care director must demonstrate is "leadership skills." These managers are often responsible for finding creative solutions to staffing or other administrative problems This is clearly demonstrated in this example from a managed care director who stated: "participated in a yearlong leadership development program where i developed a manual for new directors of patient care services. "
  • Another skill commonly found on managed care director resumes is "technical skills." This description of the skill was found on several managed care director resumes: "medical and health services managers must stay up to date with advances in healthcare technology and data analytics" Here's an example from a resume of how this skill could fit into the day-to-day managed care director responsibilities: "train the trainer for patient care documentation, meditech, computer software system technical/computer:. "
  • See the full list of managed care director skills.

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    What Chief Nursing Officers Do

    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.

    We looked at the average managed care director annual salary and compared it with the average of a chief nursing officer. Generally speaking, chief nursing officers receive $19,649 higher pay than managed care directors per year.

    Even though managed care directors and chief nursing officers have vast differences in their careers, a few of the skills required to do both jobs are similar. For example, both careers require patients, patient care, and quality care in the day-to-day roles.

    There are some key differences in responsibilities as well. For example, a 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 how truly different these two careers really are.

    Chief nursing officers tend to make the most money in the health care industry by averaging a salary of $97,019. In contrast, managed care directors make the biggest average salary of $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.

    What Are The Duties Of a 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.

    The next role we're going to look at is the director of health services profession. Typically, this position earns a lower pay. In fact, they earn a $4,519 lower salary than managed care directors per year.

    A similarity between the two careers of managed care directors and directors of health services are a few of the skills associated with both roles. We used resumes from both professions to find that both use skills like "patients," "patient care," and "social work. "

    But both careers also use 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," some directors of health services use skills like "public health," "cpr," "behavioral health," and "mental health."

    It's been discovered that directors of health services earn lower salaries compared to managed care directors, but we wanted to find out where directors of health services earned the most pay. The answer? The non profits industry. The average salary in the industry is $85,179. Additionally, managed care directors earn the highest paychecks in the health care with an average salary of $68,515.

    When it comes to the differences in education between the two professions, 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.

    How a Patient Care Manager Compares

    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.

    The third profession we take a look at is patient care manager. On an average scale, these workers bring in lower salaries than managed care directors. In fact, they make a $19,448 lower salary per year.

    While looking through the resumes of several managed care directors and patient care managers we discovered that both professions have similar skills. These similarities include skills such as "patients," "social work," and "quality care," but they differ when it comes to other required skills.

    There are many key differences between these two careers as shown by resumes from each profession. Some of those differences include the skills required to complete responsibilities within each role. As an example of this, 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. Whereas managed care directors are paid the highest salary in the health care industry with the average being $68,515.

    Patient care managers typically study at lower levels compared with 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.

    Description Of a 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.

    Now, we'll look at clinical managers, who generally average a lower pay when compared to managed care directors annual salary. In fact, the difference is about $751 per year.

    While both managed care directors and clinical managers complete day-to-day tasks using similar skills like patients, social work, and oversight, the two careers also vary in other skills.

    Even though a few skill sets overlap, 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 clinical managers might include skills like "direct patient care," "quality patient care," "patient education," and "process improvement" on their resume.

    In general, clinical managers make a higher salary in the health care industry with an average of $72,510. The highest managed care director annual salary stems from the health care industry.

    The average resume of clinical managers showed that they earn similar levels of education to managed care directors. So much so that the likelihood of them earning a Master's Degree is 3.2% less. Additionally, they're more likely to earn a Doctoral Degree by 0.0%.