How to Become a Health Care Administrator

By: Kelli Hansen, RN

Last Updated: Jun 29, 2021

Health care administrators manage health care facilities, which gives them wide-ranging influence within the world of medicine. The leadership that they provide sets the future course not only for the facilities they manage but also for the health care system as a whole. Managing a health care facility today is the close equivalent to managing an entire city. It’s a dynamic environment of specialized groups that have both direct and indirect relationships with one another, and at times, competing interests.

To lead a health care facility requires careful budgeting, tough decision-making, and above all else, the ability to maintain the respect and cooperation of diverse interest groups that are sometimes adversely affected by an administrator’s decisions. Within this environment, a health care administrator is responsible for establishing health care standards, making strategic policy decisions, and implementing the personnel management procedures necessary to support his vision. In addition to the internal leadership they provide, health care administrators are leaders within the greater community as well. They partner with other health care organizations, comply with government regulations, advocate and testify on behalf of health care policies, and maintain campuses that are significant to communities.

Although the professional titles of health care administrators vary according to their place of employment, the significance of the work they accomplish – and the interdisciplinary skill set required to do so – is universal. Healthcare administrators have the challenge and opportunity to deliver high-quality health care within an appealing work environment while contributing positively to the greater community at large. There are few positions within the health care arena as exciting, versatile and rewarding as that of the health care administrator – who has the opportunity to lead, inspire and enact policies of far-reaching consequence.

Workplace Details

About 33% of health care administrators work within hospitals. Other employment settings include physicians’ offices, small or large group medical practices, long-term nursing care facilities, home health care agencies, and outpatient clinics or centers. Within these settings, they manage whole facilities or a specific department. Most health care administrators work full-time business hours, but those responsible for 24-hour facilities should expect to work on an urgent or emergent basis during off-hours including weekends, nights or holidays.

Hover over any state to explore local income and job growth data.

When calculating salaries, the U.S. Bureau of Labor Statistics reports that the median annual wage for all health care administrators is $104,280. For the bottom 10% of earners, the median salary is $59,980, while the median income of the top 10% is $195,630.

Higher salaries are usually awarded to professionals with the most responsibility and those who oversee larger practices or facilities. For example, according to the BLS May 2020 Occupational Outlook Handbook, administrators overseeing smaller facilities with fewer than six physicians could expect a median compensation closer to $94,240. Those overseeing larger facilities could see a median salary of $112,870.

More employment opportunities are expected in the area of medical practice management than in other areas of health care administration because of the trends toward outpatient care and an overall increased demand for health care services. There is also expected to be an increase in the need for long-term care administrators because of aging baby boomers. The U.S. Bureau of Labor Statistics reports job growth for all health care administrators to be 32% from 2019 to 2029, which is much faster than average for all occupations.

A bachelor’s degree (usually requiring four years) is the typical entry-level preparation needed for health care administration jobs. Some employers, however, will promote from within or hire other professionals with related experience (such as nurses) who are ideal for an administrative role because of their direct health care knowledge. Subspecialties are sometimes available within undergraduate programs, though this is more common in grad school.

Prospective health care administrators should look for educational programs accredited by the Commission on Accreditation of Healthcare Management Education. An accredited program has successfully gone through a process that ensures accountability and a commitment to quality improvement.

For high-level executive positions, a graduate education (two to three years) is usually the starting point, and in other cases it will be preferable. This means attaining an MBA, or a different type of master’s degree, or a doctorate in health administration. Subspecialties are often available in graduate programs. These include long-term care administration, health care services, or health information management.

Some graduate programs in health care administration have real-world internships as part of the curriculum. Students often spend time in an ancillary or assistant role under the mentorship of a health administrator or participate in a special project designed to benefit a facility or health care practice.

In most areas of health care administration, a license is not needed. One notable exception is for administrators of long-term care nursing facilities and some assisted living facilities. State license requirements vary from state to state, but a licensing examination and proof of successful completion of an educational program are typical elements of the licensing process.

Certification is mostly an optional process, depending on a health care administrator’s role and professional goals. Certification is offered by professional associations such as the American College of Health Care Administrators (for long-term care/assisted living professionals) and the Professional Association of Health Care Office Management (for medical practice managers).

Healthcare administrators usually choose to move up the executive ladder. For instance, a manager of a department may become an executive in charge of multiple departments or an entire facility. If a health care administrator doesn’t already have it, a graduate education is sometimes necessary for this kind of advancement. Experienced health care administrative professionals are also ideal for taking on consultant roles, becoming educators, or becoming policymakers in a public service or government capacity.

Most entry-level healthcare administrator jobs require a bachelor’s degree. These include middle-management positions in hospitals, physician practices, insurance organizations, nursing facilities, and government agencies.

Employers hiring healthcare administrators will typically accept a wide range of college majors, especially if the candidate has some healthcare experience. If you’re new to the field, consider majoring in:

• Healthcare administration
• Public health administration
• Business administration
• Health information management

Another option is a health professions degree like nursing - especially if you plan to work clinically for a few years before moving into administration.

Many universities and online schools offer health administration bachelor’s degrees. If you choose the online option, it’s best to find a program that offers some face-to-face instruction in the form of classes, seminars, or an internship.

A word of caution: with the exception of CAHIIM, which accredits health information management programs, there’s no accreditor specializing in healthcare administration bachelor’s degrees. This sometimes makes it difficult to judge a program’s quality. Public and private non-profit colleges generally offer the best educational value. You can also check with employers or working healthcare administrators in your area to learn which schools are most respected.

Healthcare administration students at the bachelor’s level often study:

The American College of Healthcare Executives (ACHE) recommends that healthcare administrators hold a master’s degree at minimum. Many employers prefer candidates with graduate degrees, especially large organizations that are hiring for executive positions.

Healthcare administration master’s candidates typically major in:

• Health administration (MS, MHA)
• Public health (MPH)
• Health services administration (MHSA)
• Business administration (MBA) with a healthcare concentration

It’s also possible to combine a clinical degree with an administrative one (for example, medicine or nursing with an MBA).

The Commission on Accreditation of Healthcare Management Education (CAHME) accredits graduate programs in healthcare administration. Many employers and fellowship administrators prefer candidates from accredited programs.

ACHE emphasizes the importance of face-to-face instruction in health administration education. However, many schools offer an executive option to meet the needs of working professionals. This track typically combines blocks of face-to-face instruction with online learning.

At the master’s level, healthcare administration students can expect to study:

Most master’s-level programs also include field experience in the form of clinical rotations or an administrative residency. Many healthcare administration master’s students complete an optional one-year fellowship after graduation.

The following organizations offer voluntary certification for healthcare administrators. Candidates must meet eligibility requirements (usually a combination of educational and work experience) and pass an exam.

American College of Healthcare Executives (ACHE)

• Fellow of the American College of Healthcare Executives (FACHE) – Requires a master’s degree or higher and 5 years of work experience at the executive level

Professional Association of Health Care Office Management (PAHCOM) certifies managers of physician office practices. Candidates must have two years of relevant experience and 12 college credit hours in healthcare and business.

• Certified Medical Manager (CMM)
• Health Information Technology Certified Manager (HITCM-PP)

American College of Health Care Administrators (ACHCA) offers credentials for nursing home and assisted living administrators. Certification requires two years of licensure (where required by the state) and 40 hours of continuing education.

• Certified Nursing Home Administrator (CNHA)
• Certified Assisted Living Administrator (CALA)

American Health Information Management Association (AHIMA) has a certification program for administrators of health information technology programs. Candidates must hold a four-year degree or higher from an AHIMA-approved program.

• Registered Health Information Administrator (RHIA)