How to Become a Managed Care Director

An interesting career option to consider is that of a Managed Care Director. This career is hard to define since it is so varied in what environment they may work. Many in this field consider themselves working for the insurance industry, because of the amount of insurance paperwork and tasks they do.

How to Become a Managed Care Director

The goal of a managed care director is to seek out and obtain the best benefits package for patients in a hospital or managed care facility.

They are not necessarily a licensed insurance agent though. Their job is to facilitate the best use of all of the health care resources available and pool them together in a working unit in order to benefit the most people. You may work in a hospital or care facility or you may work as a representative of any of the managed care organizations, such as HMO’s, or major medical insurance packages. The three most prominent major managed care systems are: HMO, PPO, and POS. Think of them as “delivery models” for health care, because that is really what they are. This area will likely see a huge boom in the near future due to the x-ray focus the political arena has on health insurance issues and the number of people currently not covered by an insurance plan.

Requirements/Qualifications

The requirements for a managed care director are at least a Bachelor’s degree in the health care area, or a Bachelor’s in Business or Business Administration. An insurance background is helpful but not required, as you will be dealing with many different health care insurance companies, government agencies, and other entities during the course of their career. Additionally, you should be skilled in interpersonal skills and communications, and practice a high standard of ethics.

Typical Education

The typical education track for a managed care director would be an M.B.A. in Business. The focus should traditionally be on management skills, public relations, and financial training. It helps to know the ins and outs of several other industries too, such as the insurance field and the health care industry. Even a background in politics would be helpful, since negotiation is at the heart of this process and politicians are skilled in this area.

An Alternate Route

If you do not plan to seek a Master’s degree, it is possible to work in the field on some level with a Bachelor’s degree in Health Care Administration or Business. But a Master’s is usually preferred. If you have career experience in negotiating plans or business proposals, this would be beneficial.

Steps to Becoming a Managed Care Director

To become a managed care director, you need to be a strong manager, as well as have a broad knowledge in both business and health care. Any additional skills you can pick up in the insurance or other industries, such as Ethics and Law would be to your advantage. Additionally, follow these steps to pursue a career as a managed care director:

1) Get a Master’s or Bachelor’s degree. An M.B.A. is ideal, but a Bachelor’s may suffice in some arenas to be a managed care director. Study public relations skills, Psychology, Law, and Business, as well as the health care industry for the best experience background.

2) Get experience in the health care industry. Get an entry level job in a hospital or care facility and learn the business. The more you know about how to help patients get the best deal for their managed health care, the better you will be at your job later as a managed care director.

3) Learn to negotiate well. At the heart of the managed care director’s job is negotiating skills. Learn to negotiate with companies and agencies to get patients the best deal for their managed care packages. This is what you will be doing everyday for people, so the better you get at this, the better your chances will be for success in this position.

4) Keep up with the insurance industry. There are so many changes going on right now in the insurance and managed care industries. It is important that you keep up with the changes, so that you can better advise people of their options, and negotiate the best deals for them.

5) Work on interpersonal and communications skills. Much of what you will do in this role is communications. Get good at communications skills. You will be doing a lot of this on a daily basis as a managed care director.

The goal of a managed care director is to seek out and obtain the best benefits package for patients in a hospital or managed care facility. Nursing homes, hospitals, and other health care agencies rely on this position to find care packages for patients that will solve both patients’ needs in health care, and the problems of hospitals who cannot serve patients with no insurance. This is a touchy subject politically right now, but it is likely to grow by leaps and bounds soon, as people and the government scramble for alternative means to reduce the overall costs of health care, and serve people in a way that benefits the majority. If you think this is a career you would enjoy, start your education journey today!

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