How to Become a Healthcare Administrator

Medical and health services managers plan, direct, and coordinate medical and health services. BLS says they may manage an entire facility, a specific clinical area or department, or a medical practice for a group of physicians, and that they must adapt to changes in healthcare laws, regulations, and technology.^[5]

The Handbook lists typical duties: setting goals and objectives for the efficiency and quality of services, making sure the facility complies with laws and regulations, preparing and monitoring budgets and managing finances including patient fees and billing, recruiting, training, and supervising staff, creating work schedules, representing the facility at investor meetings or governing boards, and keeping records of facility services such as the number of inpatient beds in use.^[5] O*NET ranks the tasks by importance. Directing, supervising, and evaluating the work of medical, nursing, technical, clerical, service, and maintenance staff scores 86, developing and maintaining computerized record systems 83, and planning and administering programs and services in the facility 80. Fiscal operations such as budgets, rates for services, and financial reporting, and staying aware of advances in medicine, equipment, regulations, and health insurance, each score 79.^[6]

The Handbook names three common types. Nursing home administrators manage all aspects of a facility, from admissions and building maintenance to the care of residents. Clinical managers oversee a department such as intensive care or physical therapy, with responsibilities based on that specialty. Health information managers make sure databases of patient records are complete, accurate, and accessible only to authorized personnel.^[5] The titles in O*NET's reported list fit the same pattern: cancer center director, clinical director, nurse manager, nursing director, health information management director, mental health program manager, and healthcare system director.^[6]

The common thread is that you are responsible for an operation whose product is care you do not deliver yourself. A nurse treats the patient; the administrator makes sure there is a nurse on the schedule, a budget for the unit, a compliant record, and a bill that gets paid.

O*NET's work-context survey describes an indoor job built on constant contact. Every respondent reported using email every day, and 93 percent reported daily phone conversations. Eighty-two percent said the job requires constant contact with others, and 75 percent said it requires face-to-face discussions with individuals and teams every day.^[6] Teamwork is close to universal: 86 percent rated working with a group as extremely important and the other 14 percent as very important.^[6]

The work carries heavy accountability. Eighty-two percent of respondents described the responsibility for the work outcomes and results of other workers as high or very high, and 43 percent said dealing with the public or external customers is extremely important. Decisions that affect other people, money, or the organization's reputation come up every day for 48 percent. Conflict situations are part of the job, daily for 29 percent and weekly for another 25 percent. On autonomy, the answers are split: 39 percent reported a lot of freedom to set their own tasks and priorities, 39 percent some, and 14 percent limited freedom.^[6] That split is believable for a job that includes both the executive who sets direction and the department head who works inside a hospital's structure.

The activities O*NET rates highest tell you where the hours go: communicating with supervisors, peers, and subordinates (91), evaluating information to determine compliance with laws and standards (89), working with computers (89), and coaching and developing others (88).^[6] In practice the day alternates between people (staff, physicians, boards, insurers), compliance and records, and numbers.

BLS adds that evening or weekend work may be required in healthcare settings that operate around the clock, such as hospitals and nursing homes, and that managers may need to be on call in case of emergencies.^[5]

Hospitals are the largest employer. In the federal wage survey, general medical and surgical hospitals employ 158,730 healthcare administrators, more than any other industry, at a median of $134,050.^[1] The Handbook's broader grouping puts all hospitals at 28 percent of the occupation, offices of physicians at 13 percent, nursing and residential care facilities at 9 percent, and outpatient care centers and government at 7 percent each.^[5]

The setting changes the job. A hospital manager typically runs a department inside a large structure, a practice manager works closely with physicians in a small group, and a nursing home administrator runs a whole facility and needs a license.^[5] The pay follows the setting. The federal executive branch pays a median of $154,380, hospitals $134,050, outpatient care centers $116,060, nursing care facilities $105,550, and physicians' offices $105,770.^[1] The industry table in our salary guide lists each of the largest employers.

Geographically, the jobs concentrate in large states. California (75,090), Texas (58,420), Florida (42,700), New York (33,200), and Pennsylvania (30,480) hold 40.2 percent of the 597,080 jobs in the wage survey.^[1] The state table shows the job count and median for every state, which matters here because a nursing home license is issued by the state and does not travel automatically.

The biggest markets are not automatically the best paid once prices are counted. Using the Bureau of Economic Analysis's state price parities, New York still comes out on top, but California falls out of the top five, and lower-cost states such as South Dakota and Georgia move into it.^[7] The cost-of-living section of our salary guide shows the adjusted figures.

1. Earn a bachelor's degree (about four years). BLS says managers typically need a bachelor's degree, with common majors in healthcare and related fields such as health administration or nursing, or in other relevant fields such as business. A degree that combines management with healthcare may include courses in health services management, accounting and budgeting, and health informatics.^[5]

2. Get into a healthcare setting. Employers may require work experience in either an administrative or a clinical role in a hospital or other healthcare facility.^[5] This is the step that decides the timeline, covered in the next section.

3. Build management experience (typically less than five years). BLS lists less than 5 years of related experience as typical for entry.^[2] The way to shorten it is to take the supervisory piece of a clinical or administrative job: a charge role, a schedule, a budget line, a quality project.

4. Add a license if your target job requires one. All states require licensure for nursing home administrators, with requirements that vary by state.^[5] Some positions may also require candidates to be licensed as a registered nurse or social worker.^[5]

5. Consider a master's degree and a professional credential later. BLS says some employers prefer a master's and that advancement to top executive positions may require one.^[5] Both options are covered below.

Put together, the federal requirements describe a path of about four years of school plus the time it takes to land and grow in a healthcare job. Work experience sometimes may substitute for education, according to the Handbook, so the route is not identical for everyone.^[5]

Because the manager title follows time inside a facility, the first decision is which starting job to take. BLS names two routes. Clinical: nursing home administrators may have years of experience working as a registered nurse. Administrative: other managers begin as medical records specialists, administrative assistants, or financial clerks in a healthcare office.^[5]

Medical records specialists are the most visible entry point in the data: 194,720 wage-and-salary jobs, a median of $51,140, and about 14,000 openings a year projected from 2025 to 2035, with BLS listing a postsecondary nondegree award and no prior work experience as typical for entry.^[1][2] Coding and electronic health record systems are the technical skills the Handbook says managers must keep current, and a records job works with them daily.^[5] Health information technologists and medical registrars are the step up on the records side, a median of $68,020 with an associate's degree typical for entry and 3,000 openings a year.^[1][2]

The clinical route fits a registered nurse who wants to leave the bedside. Nurse manager and nursing director are among the titles O*NET lists for this occupation, so the move is a recognized one.^[6] The tradeoff is that the move leads away from direct patient care.

Whichever you choose, the deciding factor for promotion is not the starting title but what you own while in it. An employee who has run a schedule, a unit budget, or a compliance project has done part of the manager's job, and that is the record a hiring manager looks for when a department head position opens.

BLS names five qualities as important: analytical skills to review healthcare metrics and improve efficiency, communication skills to convey information to staff, other healthcare workers, and sometimes patients and insurance agents, attention to detail for scheduling and billing at very large facilities, leadership skills to hire, train, and direct staff, and technical skills to keep up with coding and electronic health record systems.^[5]

O*NET's work-style ratings add a personality profile. Dependability scores highest at 98, followed by leadership orientation (91), attention to detail (87), integrity (85), cooperation (81), adaptability (77), cautiousness (76), and stress tolerance (75).^[6] The mix is telling: the job rewards people who are careful and reliable first and decisive second, which suits a field where an error in a record or a missed compliance step has consequences.

On tools, O*NET lists electronic health record systems including Epic Systems, MEDITECH, and eClinicalWorks, business intelligence software such as Tableau, database query with SQL, spreadsheet and project software including Microsoft Excel and Microsoft Project, process mapping in Microsoft Visio, and compliance software such as HIPAA checkup tools.^[6] The fastest way to build these is on the job in a records, scheduling, or billing role. In school, a business analytics course load or a health informatics elective covers the data side.

Associate degree. BLS says some employers hire candidates with an associate's degree, and work experience sometimes may substitute for education.^[5] It is the lowest-cost way in and fits someone already working in a facility. Our associate in healthcare administration ranking analyzed 95 programs.

Bachelor's degree. This is the typical entry credential. Our ranking of bachelor's in healthcare administration programs analyzed 432 accredited programs on graduation rate, cost, selectivity, and outcomes. BLS lists health administration, nursing, and business among the common majors,^[5] so a nursing or business degree is a legitimate route in as well.

Master's degree. BLS says some employers prefer a master's and that top executive positions may require one.^[5] A master's in healthcare administration (MHA) is the specialized option; our master's in healthcare administration ranking analyzed 367 programs, and the online master's ranking narrows it to remote options. An MBA is the broader management degree; our MBA ranking analyzed 978 programs. We compare the two in our MHA vs MBA guide.

BLS does not publish healthcare administrator pay by degree level, so no federal figure shows what a graduate degree adds. Because the job typically asks for experience as well, a master's is easiest to justify once you know whether you want to run departments, a facility, or a system, and it is required for the FACHE credential described below.^[4]

Most healthcare administrator jobs have no license. The Handbook says some managers need a state-issued license and gives one case: all states require licensure for nursing home administrators, with requirements that vary by state, so the licensing board in your state is the authority.^[5]

NAB, the National Association of Long Term Care Administrator Boards, runs the national exams used in the licensing process. Its steps are: review your state's license types and requirements, contact the state board to see whether you qualify, study, then apply for the exam through NAB once the board has approved you, and schedule it through Pearson within your eligibility window.^[8] NAB says directly that candidates must be approved to test by their state board and that NAB cannot approve any NHA exam applications.^[3] It also says each state sets its own requirements for the license, for becoming an administrator-in-training, and for continuing education.^[9]

The exams are two: the Core of Knowledge exam, with 125 questions (100 scored and 25 pretest) and 150 minutes of seat time, and the NHA line-of-service exam, with 75 questions (60 scored and 15 pretest) and 90 minutes. NAB lists the combined CORE plus NHA application at $480 effective February 1, 2026, and since January 1, 2026 it limits each exam to 4 attempts per examination cycle, which runs July 1 to June 30.^[3]

The fees and format come from NAB's own page and can change, and NAB's page does not cover any application or licensing fees your state board sets. If your target is a nursing home, call the board before you plan the timeline. BLS names nursing home administrators as its example of a license requirement and adds that some positions may require a registered nurse or social worker license, so read the posting for any other role.^[5]

Certification is not required for this occupation, though some managers choose to earn a professional credential.^[5] The main executive-level credential in the field is Fellow of the American College of Healthcare Executives (FACHE).

ACHE sets a high bar for entry. Applicants need one year of ACHE membership, a master's or other post-baccalaureate degree, a current healthcare management position with five years of healthcare management experience, at least 36 continuing education credits in the past three years, four volunteer activities (two civic and two in healthcare) in the past three years, and two references, one an interview with a current Fellow. The application fee is $250 and nonrefundable, and after approval the Board of Governors Exam in Healthcare Management costs $225. The application stays valid for two years after approval, during which the exam must be passed.^[4]

That list makes FACHE a mid-career credential, not a way in. BLS does not publish pay by credential, so do not assume it comes with a raise. If you are still in school, it is something to plan for, not something to chase.

Most medical and health services managers work in healthcare facilities, including hospitals, nursing homes, and group medical practices. Most work full time, and some work more than 40 hours per week.^[5] Evening or weekend work may be required where the facility never closes, and managers may need to be on call in case of emergencies.^[5]

The Handbook also flags a physical risk many people do not expect from a management job. Medical and health services managers have one of the highest rates of injuries and illnesses of all occupations, from slips, falls, and overexertion, and BLS recommends safety procedures such as slip-resistant shoes and proper lifting technique.^[5]

O*NET's picture of the day is mostly indoors and in contact with others: 96 percent said the job is in an environmentally controlled indoor space every day, and half reported sitting continually or almost continually.^[6] Being exact matters: 50 percent called it extremely important and another 39 percent very important.^[6]

The Handbook describes two paths up. Some health information managers advance by taking on additional responsibilities, such as for an entire hospital's information systems. Other managers advance to top executive positions within an organization, and advancement to the top level may require a master's degree.^[5]

The steps before the title are jobs like medical records specialist, at a median of $51,140, and health information technologist or medical registrar, at $68,020, so the move into management is the main pay jump in the field.^[1] The percentile ladder is the best federal guide to how far the job goes, because BLS does not publish pay by years of experience: $94,700 at the 25th percentile, $123,860 at the median, and $224,340 at the 90th.^[1]

Lateral moves exist in both directions. Social and community service management, at a median of $80,390, is a mission-driven neighbor with less than 5 years of experience typical for entry. General and operations management, at $105,770 across 3,503,020 jobs, is the broad version of the same skills, and human resources management, at $149,280, is the higher-paying move but asks for 5 years or more of related experience.^[1][2] Our HR manager and operations manager guides cover those paths.

Five occupations sit closest, and their outlooks diverge. Over 2025 to 2035, BLS projects employment growth of 24.2 percent for healthcare administrators, 15.9 percent for health information technologists and medical registrars, 7.8 percent for medical records specialists, 7.2 percent for social and community service managers, 5.5 percent for human resources managers, and 5 percent for general and operations managers, against 3.5 percent for all occupations.^[2]

Healthcare administration stands out for the combination of growth and entry: it is projected to grow faster than every comparison role, and BLS lists less than 5 years of experience as typical, against 5 years or more for HR managers and for general and operations managers.^[2] The pay trails HR management, which earns $25,420 more at the median, but HR's growth is slower, with about 16,800 openings a year to 62,300 for healthcare administration.^[1][2]

The records roles are the safer on-ramp and the lower ceiling. Medical records specialists earn $72,720 less at the median than healthcare administrators. For someone who wants to work with data and systems rather than people and budgets, health information technology is the closer fit; for someone who wants to lead, the manager track is the point.

BLS does not address artificial intelligence in this occupation's profile, so this section sticks to what the sources say. The Handbook says advancements in technology, shifting policies and regulations, and evolving models of care are making healthcare delivery more complex, and that this complexity is part of why more managers will be needed to organize workflows and staff.^[5] It also lists technical skills as a core quality, because managers must stay current on coding and electronic health record systems.^[5]

O*NET shows how much of the day already runs on software. Working with computers is among the highest-rated activities at 89, developing and maintaining computerized record systems is a core task at 83, and the software list includes electronic health record and analytics tools.^[6] The practical reading is that data literacy will keep mattering: a manager who can read a utilization report, question what an EHR dashboard is counting, and explain it to a board is doing the part of the job that does not go away. No source here supports a claim that automation will remove or add jobs, and this guide does not make one.

The median annual wage was $123,860 in May 2025, with the middle half earning between $94,700 and $166,100.^[1] Employment is projected to grow from 640,400 to 795,500 jobs between 2025 and 2035, about 62,300 openings a year including replacements.^[2] BLS attributes the growth to an aging population and a more complex healthcare system.^[5]

The spread is wide. The lowest-paid 10 percent earn less than $73,390 and the highest-paid 10 percent more than $224,340.^[1] Even the bottom of that range sits above the $50,980 median for all occupations.^[2] The salary guide breaks the pay down by state, industry, and cost of living.

The case for it. The median wage is $72,880 above the median for all occupations, growth is far faster than the workforce, and a bachelor's degree is the typical entry credential.^[1][2] The skills transfer across hospitals, practices, nursing homes, and outpatient centers, and O*NET flags the occupation as a bright outlook.^[6]

The case against. The job carries responsibility for other people's work outcomes, conflict situations that come up daily for some respondents, and, where the facility never closes, evening, weekend, and on-call hours.^[6][5] Nursing home administrators carry a state license requirement. The injury rate is high.^[5] And BLS says top executive positions may require a master's degree.^[5]

O*NET's interest profile is a useful self-check. On its 100-point scale, the occupation rates 83 for Enterprising interests (leading, managing, persuading), 70 for Conventional (organizing data and following procedures), 57 for Social, 46 for Investigative, 18 for Realistic, and 8 for Artistic.^[6] Despite the care setting, the job is above all about management and procedure rather than hands-on service.

It suits people who want to improve how a care operation runs without delivering the care themselves: a nurse tired of the bedside, a records specialist who wants more say, a business graduate drawn to a field with growth. The enterprising and conventional profile on O*NET is the mix of leading and following procedure that fits.^[6]

It does not suit someone who wants to stay clinical, because the job moves you away from patients. It does not suit someone who wants a quiet, low-conflict desk job, given the conflict and accountability responses above.^[6] It does not suit someone who wants to start as a manager straight out of school at a large hospital, since employers look for administrative or clinical experience first.^[5] And if you want the data and systems side without managing people, the business analyst path or health information technology is a better match.