Duties and Responsibilities
Like every business, healthcare needs top-notch management to keep the operation running smoothly. Health care executives, also known as health services and medical services managers, are responsible for coordinating, planning, directing and supervising the delivery of health care.

Many of these professionals are specialists responsible for a specific clinical department or they have broad responsibilities through managing an entire health care facility.

Because of the rapidly changing structural and financial changes taking place in health care, future health and medical services professionals must prepare to deal with an ever increasing complicated regulatory environment, health care delivery systems integration, work restructuring and more attention on preventive care.

In addition, they will be asked to improve the quality of care and the efficiency of their health care facilities.

Many large facilities use assistant administrators as aids to the top administrator. They are responsible for handling daily decisions and directing the daily clinical activities like medical records, surgery, nursing, health information or surgery.

On the other hand, in the smaller facilities, the top administrators are responsible for handling more of the daily operational details like managing personnel, facility operations, finances and admissions in addition to providing resident care.

As a general rule, clinical managers have experience and have been trained in a specific clinical specialty and therefore have more responsibilities specific to that area than do generalists.

For example, it's likely that a director of physical therapy is an experienced physical therapist and a high number of health information and medical record administrators have their bachelor's degree in medical record administration or health information.

When it comes to department policies, procedures, processes and objectives the clinical managers are responsible, for the most part, for overseeing and ensuring their implementation. They are also accountable for developing budgets and reports, coordination of activities with other managers and personnel reviews.

When it comes to the security, accuracy and maintenance of patient records, that responsibility normally falls on the back of the health information manager. The Federal Government recently enacted legislation requiring all health care providers maintain patient records in an electronic format and that those records be secure.

Therefore, it's essential that health information managers keep current with both legislative requirements and software and computer technology. Health information managers must also ensure that as patient data becomes more prominent in quality management and research that those databases that contain patient information are secure and accurate.

Managers work hand-in-hand with doctors in group medical practices but their role is a bit different depending on the size of the practice.

In small medical groups, they may handle business issues and leave policy decisions to the doctors but larger medical groups often hire an administrator to oversee business strategies and the day-to-day operation of the office.

A relatively small group of doctors, less than 15 may employ an administrator to oversee activities like personnel matters, planning and budgeting, equipment purchases, collections and perhaps patient flow. On the other hand, a group of 50 doctors might have a top administrator with a number of assistants, with each assistant responsible for a different area.

Those health and medical services managers working in a managed care facility are responsible for similar duties to their counterparts in large group practices, with the exception of possibly having to manage a large staff.

In addition, a percentage of health and medical services managers are responsible for managing numerous facilities within a health care system. These systems may contain both in and outpatient facilities and normally offer a diverse range of patient services.

Work Atmosphere
A high percentage of health and medical services managers work extended hours and while some are fortunate enough to have a nice, comfortable, private office; others are expected to share office space with other staff members.

Because around the clock operations is the norm for hospitals and nursing care facilities managers and administrators can be called in at any hour of the day to deal with a problems. Many are also expected to travel to check out satellite facilities or attend meetings.

Education and Training
The most common degree for most generalist positions as a health or medical care manager is a master's degree while for some entry-level positions, a bachelor's degree in some of the smaller facilities is considered sufficient.

On the job experience is still given weight in physicians' offices and a few other similar type facilities and may be an adequate substitution for formal education.

According to the Commission on Accreditation of Healthcare Management Education, in 2007, 70 plus schools had accredited programs leading to a master's degree in health services administration.

Health administration doctoral, master's and bachelor's degree programs are offered by a wide range of institutions from schools of public health, allied health and public administration to colleges and universities.

For interested parties wishing to become clinical department heads, a bachelor's degree in the proper field, coupled with work experience may be adequate early in their career.

However, in many facilities, advancement may hinge on earning a master's degree in health services administration or similar health related field.

As a general rule, most institutions require a bachelor's degree from an accredited program in order to qualify for a Health information managers' position. According to the Commission on Accreditation of Healthcare Management Education, in 2007, there were 42 accredited bachelor's degree programs and 3 master's degree programs in health information management.

While some graduate programs pursue those students with undergraduate degrees in health or business administration, many others seek those students with a health or liberal arts background.

Because competition is keen to be accepted into these programs by many colleges, students having previous health care work experience; in many instances, may have a slight advantage. However, an applicant also needs above-average grades.

Normally, a graduate program lasts between 2 or 3 years. In some instances, this time may include up to 1 year of supervised administrative experience and accompanying coursework in facilities like human resources administration, marketing, hospital management and organization and health information systems. Some graduate programs may even allow students to specialize in a particular type of facility like - mental health or nursing care facilities, medical groups or hospitals, while other graduate programs encourage a generalist approach to health administration training.

Licensure
Unlike other areas of health and medical services management, a bachelor's degree is required to work as a nursing care facility administrator in all 50 states, including the District of Columbia. In addition, one must successfully complete both a state-approved training program, pass a licensing examination and pursue ongoing continuing education.

Certification
Health and medical services managers are often responsible for large numbers (often hundreds, sometimes many of hundreds) of employees and expensive high-tech equipment often worth many millions of dollars.

As a result, they must not only have fantastic communication skills but tact, diplomacy, effective decision making skills, be able to handle and moderate conflicts and last but not least understand and have the ability to interpret financial data.

For health information managers with a post baccalaureate or bachelor's degree that pass an examination from the American Health Information Management Association, they can earn certification as a Registered Health Information Administrator.

Advancement
Advancement for medical and health services managers is normally through moving into higher paying positions with more responsibility like: department head, chief executive officer, assistant or associate administrator or by moving to a bigger facility.

In addition, experienced managers may become professors of health care management or consultants.

Recent master's degree grads in health services administration occasionally start in supervisory or managerial positions. The level of the starting position, for the most part is dependent upon the applicants experience and the size of the organization. Hospitals and other health care facilities offer postgraduate residencies and fellowships as staff positions.

Other locations of master's degree program grads include the larger medical group practices, nursing care corporations, consulting firms, clinics and mental health care facilities.

Graduates from master's degree programs also take jobs in large medical group practices, clinics, mental health facilities, nursing care corporations and consulting firms.

Graduates from bachelor's degree programs in health administration, normally begin as administrative assistants or assistant department heads in larger hospitals. Another common alternative is department head or assistant administrator in a small hospital or nursing care facility.

Employment
In 2006 about 262,000 medical and health services managers were employed. Of that total about 21 percent worked in residential care and nursing facilities and another 38 percent were working in hospitals. Of the approximate 40 percent remaining, most were working in either Federal Government health care facilities, home health care services, outpatient care centers, community care facilities for the elderly or insurance carriers.

Projected Employment
An above average growth rate is expected for health and medical services managers with good job opportunities for those applicants with work experience in the health field and seasoned business management skills.

From 2007 to 2016 employment is expected to growth about 15 percent a year. Because the health care industry is expected to continue to grow and diversify, strong managers will be in demand to help ensure the business side of the facilities run smoothly.

As both Medicare and the insurance companies demand a higher level of accountability, medical and health services managers will need to focus on ways to improve the efficiency and quality of health care, while balancing costs.

In addition, managers will be responsible for overseeing the new push in patient record computerization and to ensure those records are secure as the law requires.

Other demands will result from the need to implement the latest technologies, comply with ever changing and increasingly complex regulations, recruit high quality workers and increase employee retention and improve community health through preventive care.

Over the next decade, hospitals will continue to be the leader in medical and health services management employment but the number of new jobs in hospitals is expected to increase more slowly than in other industries due to faster growth of clinics and other outpatient care facilities.

Employment is expected to grow the quickest in home health care facilities and in practitioners' offices because many services previously provided in hospitals will continue to be shifted to them.

Health and Medical services managers will also be employed by health management companies that provide management services to hospitals and to specific departments such as information management systems, emergency, physician recruiting and managed care contract negotiations.

Employment Prospects
For applicants with experience in the health care field and who possess solid business management skills, job opportunities should be good. In addition, because hospitals are expected to become larger and more complex, those medical and health services managers with experience in large hospitals will enjoy an advantage.

Of course, competition for jobs at the highest management levels will be fierce because of the strong pay and high prestige.

Earnings
In May 2006 median yearly earnings of salaried health and medical services managers was about $73,500 with the middle 50 percent earning between $57,000 and $94,750, the lowest 10 percent earning less than $45,000 and the highest 10 percent earning more than $127,000. Median yearly earnings for the industries employing the largest number of medical and health services managers in May 2006 are listed below.