Knowledge and skills for healthcare management careers
At the manager and executive level, healthcare management careers usually require either a master’s degree or a doctorate. Professionals at this level are responsible for managing people and operations, and will be tasked with innovating and setting strategy according to an organization’s goals.
Effective management in any industry requires a wide range of experience, both technical and interpersonal. In the healthcare industry, managers and administrators must not only have experience in healthcare — whether that comes from a clinical, research, insurance, or related background — they must also have a solid foundation in business concepts, such as accounting, marketing, operations, or human resources. In addition, they need the interpersonal skills that enable them to be effective administrators or managers.
The skills and experience required for an effective career in healthcare management include:
Healthcare industry knowledge
Healthcare is a highly complex, heavily regulated industry. To be an effective leader, healthcare management professionals must have a solid understanding of healthcare concepts. Depending on what career field they choose, they should know how their department impacts the organization’s bottom line. Areas that healthcare managers must have knowledge of include:
Patient care
Patient care is the focus of every healthcare provider, whether they are a single-physician office or a national hospital system. Even departments that don’t directly interact with patients, such as accounting, must understand the patient workflow, from scheduling to billing to reimbursements. Patient privacy, safety, and quality of care are often part of every department’s metrics.
Healthcare technology
Healthcare technology has expanded far beyond state-of-the-art medical devices. Technology such as artificial intelligence (AI) and patient electronic health records (EHRs) are now an everyday part of healthcare. AI is used in patient scheduling and diagnosing. EHRs are used across most of the industry. The data produced by healthcare technology is used to analyze operations and performance.
Healthcare regulations
The Health Information Portability and Accountability Act (HIPAA) governs patient health records and privacy. Medicare regulations govern how providers get reimbursed for care. According to the American Hospital Association, hospitals must comply with more than 600 separate regulations, and new rules are frequently adopted.
Healthcare revenue cycles
Understanding the revenue cycle of a hospital, physician’s office, nursing home, or other provider is essential to an effective healthcare finance career. All the steps of the revenue cycle must be integrated into the administrative operations of the healthcare provider. Data captured from the revenue cycle can help a facility better understand its operations. For example, too many billings that go to collections could indicate a problem at the patient registration step.
Physician practice management
Good financial management is essential to a thriving physician practice. A well-trained healthcare financial administrator will be knowledgeable about compliance with the Stark Law (an anti-kickback statute), financial reporting, and contract evaluation, among other best practices.
Managed care
Understanding managed care means understanding how healthcare insurance intersects with healthcare. It is crucial to how providers get paid. Effective healthcare finance managers will have a strong background in managed care and health insurance.
Financing and capital
Healthcare is a capital-intensive industry. Financial administrators must understand capital, debt, bond issues, and other financing issues to ensure their organization’s financial well-being. They may also be involved in making decisions regarding debt, capital projects, and other strategic initiatives.
Healthcare policy, strategy, and innovation
Healthcare is a dynamic industry, and healthcare policy is ever-changing. Effective management requires a mindset that is innovative and forward thinking. Examples of innovation in healthcare strategy and policy include:
The impact of COVID-19
The pandemic changed the way hospitals and doctors treat patients. Now, policies such as telemedicine have become part of the day-to-day operations of some providers. The pandemic also spurred innovations that were adopted almost immediately, rather than taking years to filter through the industry. The rapid development and deployment of the coronavirus vaccine is a case in point.
Price transparency and surprise billing
Hospital charges have typically been a source of great anxiety and confusion to most patients. Surprise billing, by which a patient finds out they’re responsible for thousands of dollars in hospital bills after a surgery or emergency room visit, has earned the hospital industry some black marks. Recent legislation is designed to foster price transparency and eliminate surprise billing.
Value-based care vs. fee-for-service
U.S. hospitals and other providers traditionally have been paid under a fee-for-service model. However, the industry is moving toward value-based care, which stresses preventive healthcare to improve patient outcomes and reduce costs. This move has changed the way providers are reimbursed for care. Understanding the new model is essential to making sure that providers get paid for their services.
Human resources
As the COVID-19 pandemic has shown, doctors and nurses are vulnerable to fatigue and stress due to overwork, which can lead to many bad outcomes, including a burned-out workforce. Properly managing staffing is essential to providing quality care to patients and maintaining a safe and rewarding workplace for employees. Human resources issues significant to the healthcare industry include:
Shortage of qualified health professionals
In the U.S. alone, employment in healthcare is expected to grow 15% from 2019 to 2029, according to the U.S. Bureau of Labor Statistics. Demand is rising due to an aging population, and because many healthcare professionals are retiring. A significant shortage of nurses is projected nationwide, for example, and many rural areas are experiencing physician shortages.
Scheduling
Scheduling nursing and other clinical staff is an art form. Administrators responsible for shift scheduling in physician practices, nursing homes, hospitals, and other facilities have a variety of software options to make the process more efficient.
Certification and training
Ensuring staff are trained and that all of their certifications and licensures are up-to-date is another essential administrative task. Expired certifications and licenses pose legal, regulatory, and quality risks. Other training, such as cybersecurity training, is increasingly the responsibility of healthcare administrators.
Creative thinking, communication, and problem-solving
High-level healthcare management careers place a premium on creative thinking and problem-solving. Many of the issues that face healthcare providers require innovation and creative strategies. Skills for a successful manager include:
Value creation
Preventive medicine, telemedicine, data analytics, and the use of AI and other technologies are changing the way healthcare is delivered. Managers and executives who understand these concepts are positioned to create new business models that meet the healthcare challenges of the future.
Communication
Negotiation and persuasive communication are an important part of a healthcare professional’s arsenal of tools. Managers and administrators must be able to present their ideas to the leadership team. Effective communication with patients and community outreach are essential to building trust and getting buy-in when introducing new care models, for example.
Data analytics and decision-making
Data analytics, blockchain, big data, and other digital concepts are expanding in influence in the healthcare sector. Managers and administrators must understand how data can be used to support decision-making and strategy.
Healthcare marketing
To be competitive, healthcare providers must market their services to patients, to their local communities, and even nationally or internationally. Healthcare marketers must create and deploy marketing campaigns that support their organization’s brand and mission while also building name recognition and trust in patients and potential patients. Healthcare marketing activities include:
Digital marketing
Digital marketing, including email, social media, and video, are ways to raise a provider’s profile. Digital marketing can be an effective part of an overall marketing strategy.
Thought leadership development
Highlighting physicians, nurses, and other providers as thought leaders can boost patient and community trust. For example, some hospitals make their healthcare experts available for news articles or features on current events in healthcare.
Medical services advertising
With a marketing strategy in place, healthcare marketers can use their channels — social media, video, newsletters, and other tools — to promote their medical services to potential patients.
