Many people are attracted to the health care industry for its prominent humanitarian and service-oriented aspects. However, the harsh reality is that regardless of the details of any particular job description, the industry as a whole is all business these days. The health care industry provides diagnostic, healing, rehabilitation, and preventive services for the injured, ailing, incapacitated, disabled, and the healthy. However, it is the health care organization itself-that is, the hospital or heath management organization (HMO)-that finances much of the industry today; it represents the preponderance of the physician's revenues. The lion's share of these revenues, in turn, comes from employee health insurance plans, Medicare (health insurance for Americans over the age of 65), and Medicaid (health insurance for low income Americans). In addition to managed care providers like HMOs and health insurance plans, the health care industry includes establishments ranging from small-town private practices of physicians who employ only one medical assistant to busy hospitals that provide thousands of diverse jobs. These entities provide an enormous range of job opportunities within business-oriented occupations.
Back to topHospital Administration Hospital administration is the discipline of managing hospitals, outpatient clinics, hospices, and drug-abuse treatment centers. Hospital administrators ensure hospitals operate efficiently and provide adequate medical care to patients.
Examples of Hospital Administrators include:
In addition to these examples, there are also a number of hospitals operated by research universities. Examples include:
Back to top
Managed Care / Health Insurance A Managed Care Organization, often referred to as a heath insurance carrier, provides health care services to members through contract agreements with doctors, hospitals and other health care providers. The Managed Care Organization is ultimately responsible for managing the health care costs of the provider by facilitating the management of medical services. They ensure that health care services provided to members are in accordance with contract agreements established by the entity that provides the heath benefits (eg. Employers, Colleges, Governments).
Examples of Managed Care / Health Insurance Organizations include:
Back to topPublic Health Public Health is the discipline of protecting and improving the health of a community, as by preventive medicine, health education, control of communicable diseases, application of sanitary measures, and monitoring of environmental hazards. Organizations involved in promoting and managing public health help improve the health and well being of people in local communities and across the nation. With recent threats of bio-terrorism and the spread of diseases career opportunities are growing, but are typically targeted at individuals with Master of Science Degrees in Public Health. For more information on pursuing opportunities in Public Heath, please visit the American Public Health Association website.
Examples of public health organizations include:
Government Health Care Programs Governments at all levels play a significant role in the financing, delivery, and overall stewardship of their health systems. Government Health Care Programs provide health benefits for low income citizens, senior citizens, and veterans. In addition, local, state, and federal agencies are responsible for facilitating government operated health systems that administer health benefits, process health insurance claims, and manage eligibility verification for prescription drug coverage.
Examples of government health care programs and agencies include:
Department of Veterans Affairs - Veterans Health Administration
- Department of Health and Human Services - Medicaid
Back to topCorporate Health Care Companies of all sizes and scope provide health benefits to their employees. Be it a company with 100,000 employees or a university with 2,000 employees, the organization must dedicate staff to the administration and facilitation of complex health benefits programs. Some organizations confront the responsibility in-house, while others opt to outsource (see Benefits Administration Outsourcing) this responsibility to a third-party specialty consultant. Corporate Health Care is the internal management of health care benefits for employees of a company.
Back to topBenefits Administration Consulting / Outsourcing Today's competitive business environment demands that companies find better, more efficient ways to manage their significant employee benefits investment. Many choose to outsource the administration of health care benefits to a single provider—reducing administration costs, improving efficiencies, and focusing more intently on core business. Benefits Adminstration Consultants assume the responsibilty for managing the complexities of health care beneifts so companies can concentrate on the core issues of their business.
Example benefit administration outsourcing consultants Include:
What type of entry level jobs exist in Health Care?
Benefits Outsourcing: Benefits Analyst
Back to topDescription: College graduates often start as Benefits Analysts. The Benefits Analyst (BA) is responsible for ensuring the benefits adminstrator is delivering timely and accurate information to each and every participant within the health plan.
Skill Requirements: Benefits Analyst positions are typically open to all majors. These positions are a great way to learn the intricacies of health plans and a excellent stepping stone into the field. Entry-level analysts should demonstrate:
- Effective interpersonal and written communication skills
- An aptitude for technology
- An ability to work well in team environments
- Problem solving and decision making skills
Tasks: Much of benefits adminstration is technology oriented, so individuals should be comfortable spending their first 1-2 years learning the technology that facilitates the business. Individuals that spend adequate time learning the systems will be rewarded with a deeper knowledge of the business processes and regulations that govern health care. Benefits Analysts will spend time:
Identifing process improvement opportunities.
Creating and executing test plans.
Overseeing data file processing and job scheduling/monitoring
Performing acceptance testing of ongoing processes
Developing and maintaining Standard Operating Procedures (SOPs) documentation
- Studying Health Plan Documents (materials that cover the rules and regulations for the benefit plans)
Education: BA, BS, BBA
Hours: 50 hrs per week
Salary: $42,000 - $45,000
Managed Care: Claims / Eligibility Analyst
Back to topDescription: Entry-level hires often start as Claims or Eligibility Analysts. Analysts in these positions are responsible for appropriate handling of the health insurance claims, as well as ensuring compliance with regulatory standards.
Skill Requirements: Undergraduates from all academic majors are actively recruited. Candidates should demonstrate:
Attention for detail
Effective interpersonal and written communication skills
Demonstrated time management and organizational skills
Ability to work independently
Demonstrated ability to use PC and software applications including Microsoft Word and Excel.
Tasks: Tasks can seem rather tedious and adminstrative, but they provide valuable knowledge of managed care processes and procedures. Tasks often include:
- Determining whether to return, pend, deny or pay claims within policies.
- Settling claims with claimants in accordance with policy provisions
- Interacting with agents and claimants by mail or phone to correct claim form errors or omissions and to investigate questionable entries.
- Researching medical claims and appeals
- Maintaining medical records
- Studying (Health Insurance Portability and Accountibility Act) HIPAA regulations and guidelines
Education: BA, BS, BBA
Hours: 40
Salary: $26,000 - $30,000
Managed Care: Underwriting Analyst
Back to topDescription: Leading health insurance carriers offer entry-level positions in underwriting leadership training programs. These programs are designed to develop leaders in underwriting and risk assessment.
Skill Requirements: Underwriting Analyst positions are highly analytical and candidates should demonstrate:
- Effective oral and written communication skills
- Strong analytical skills with demonstrated ability to identify problems and respond appropriately
- Demonstrated application of mathematical skills
- Basic knowledge of Microsoft Word and Excel
Tasks: During a developmental training program, new hires will typically receive extensive on-the-job and classroom training, coaching and mentoring from a manager. Job tasks will include:
- Reviewing health plan design information to ensure compliance with product and service offerings, adherence to underwriting guidelines and consistency with market and segment strategy.
- Providing prompt, constructive and creative support of sales partners.
- Processing and mapping data in Excel and database applications..
- Updating tracking forms and software to ensure effective workload management and reporting.
Education: BA, BS, BBA
Hours: 40
Salary: $35,000 - $40,000
Hospital Administration: Information Analyst
Back to topDescription: Hospital Information Analysts, often referred to as Business Analysts or Data Analysts, are one of the few entry-level opportunities available to undergraduates in hospital administration. Information Analysts are responsible for assisting in effectively and efficiently retrieving and analyzing information from various sources within hospital data systems.
Skill Requirements: Information Analyst positions are highly analytical and candidates should demonstrate:
- Effective oral and written communication skills
- Strong analytical skills and critical thinking skills
- Demonstrated knowledge of statistical principles
- Proficiency in spreadsheet software (Excel)
Ability to work independently
Tasks: Much of the time spent by Information Analysts is heads-down analysis. Tasks often include:
Screening inpatient and identified outpatient discharges to identify cases that require medical peer review based on established indicators
Collecting and aggregating medical staff volume and performance statistics accurately for use in Medical Staff performance profiles
Compiling reports and graphs
Assisting in identification and development of effective outcome indicators and measures
Assisting with Core Measures data analysis
Education: BA, BS, BBA
Hours: 40
Salary: $35,000 - $40,000
Benefits Administration Outsourcing: Career Path
Back to topBenefits Operations Manager: After 2-3 years, a Benefits Analyst can be promoted to Benefits Operations Manager (BOM). The Operations Manager is the subject matter expert for their clients' ongoing processes. They are responsible for making sure that all the portions of ongoing service delivery work smoothly and result in high-quality service for health plan sponsors and participants. This includes project scheduling, process scheduling, process flow, delegating work to meet deliverables, tracking status of outstanding issues, and process improvement. (Salary range: $45-55,000)
Benefits Service Manager: After 3-4 years, Operations Managers can be promoted to Service Manager. The Benefits Service Manager (BSM) is responsible for the overall quality of health benefits delivery. The BSM is the main client contact for service specific topics and is directly accountable, for client satisfaction for benefits delivery. A proficient BSM demonstrates strong client consulting skills, deep plan knowledge (including compliance), and a high degree of focus on operational effectiveness. The BSM is the main contact point for the client with respect to ongoing health plan requirements. (Salary range: $60 - 75,000+bonuses) Benefits Delivery Manager: A Benefits Delivery Manager (BDM) is accountable for the overall management of benefits client services and associates within a delivery group. A delivery group can consist of one large client or a group of clients (groups of clients being the norm) and includes all Benefits services delivered (multi-service). The BDM is accountable for meeting or exceeding client's benefits delivery expectations to ensure satisfaction, and the retention and future expansion of business. BDMs are also responsible for leading business development efforts into new clients. (Salary range: $80,000 - $120,000 + bonuses)
Managed Care: Operations Career Path
Back to topEligibility Specialist: After serving 1-2 years an Eligibility Analyst can be promoted to Eligibility Specialist. They manage the daily activities of an analyst team that is responsible for the research/processing of medical claims, as well as overpayment recoveries. Eligibility Specialists provide direction and guidance regarding policies, procedure, and workflows. They are responsible for monitoring and maintaing service standards. (Salary Range: $35-$45,000)
Business Process Manager or Operations Manager: After 2-3 years, Sr. Business Process Analysts can be promoted to Business Process Manager or Operations Manager (in some cases Eligibility Specialists are promoted directly to Business Process Manager). operations of benefit processing. They also maitain close contact with Account Managers to ensure business requirements are in accordance with negotiated contracts. (Salary Range: $60-80,000)
Managed Care: Sales Career Path
Back to topSenior Sales Representative: Business Process Managers, Sales Representatives, and Underwriting Analysts tend to leverage their product knowledge to become Senior Sales Representatives. They develop and implemens sales strategies for targeted key accounts in a plan, a territory, or a specified geographic area. Very knowledgeable of complete line of products/services and clients' issues and needs. Primarily focuses on seeking out new clients and responding to Request for Proposals (RFPs). (Salary Range: $60-$120,000)
Account Manager: Primary responsibility includes strategic account management for large and/or complex national accounts. Also, responsible for the sales of additional products/services to existing accounts. Account Managers are the main point of contact into a client, as well as the health plan administrator. They are typically responsible for interfacing with project managers that oversee the technical and process oriented aspects of the health plan relationship. (Salary Range: $65,000-$90,000) Account Execuitve: The Health Care Hiring Process
Back to top
If the health care company you are interested in recruits on campus, please post your resume directly through the William & Mary Career Center e-Recruiting website.
You will be evaluated on the basis of your resume - doors will be opened or closed. Quick decisions are made by people who read resumes, in just a matter of seconds. Since your resume will normally be reviewed by people you do not know, and when you are not present, you may not be given any opportunity to explain, strengthen, or correct the facts given on your resume. Decision-makers may simply discard or set aside your resume if it lacks the impact or clarity necessary to the decision-maker. Remember, the goal of a resume is not a job offer. The goal of your resume is to get a job interview. Therefore, it is crucial that your resume embody certain attributes.
What constitutes a good health care resume:
Back to top
- Demonstrated quantitative and analytical skills
- Results orientation
- Written and verbal communication skills
- Team player mentality
- Reflect on industry exposure and/or experience, leadership skills, experience in customer service, knowledge of financial operations, multi-tasking skill.
- Use Times New Roman font in point size 10-12.
- Use bullet points to accentuate appropriate elements and make your resume easier to read overall.
- Use a basic, conservative format – avoid “flash.”
- Keep your resume to ONE PAGE. Multi-page resumes are often discarded.
- Print your resume and cover letter on matching white or off-white paper.
The Health Care Interview Process
Health care interviews typically include 2 rounds of interviews that are behavioral in nature. If the company is recruiting at William & Mary, then the first will be on-campus and the second is on-site.
Back to topPreparing for a Structured Behavioral Interview:
You will be asked questions that focus on situations you’ve encountered in the past. When you answer, there are three pieces of information the interviewer will collect for each behavioral example:
- The Situation or Task that you faced
- The Actions that you took
- The Results or changes caused by the action
General answers about behavior are not what the employer is looking for. You must describe in detail a particular event, project, or experience and how you dealt with the situation, and what the outcome was. The premise behind behavioral interviewing is that the most accurate predictor of future performance is past performance in similar situations.
Although it will be more difficult to prepare concrete answers in advance to these interviews (as opposed to traditional ones), you can and should take some time to review your understanding of yourself, your past successes and concrete examples of your accomplishments. Work on honesty, sincerity and candidness. When you start to tell a behavioral story, the interviewer may try to sort out the details by understanding your behaviors.
The interviewer will probe for more depth, detail or understanding with questions like: “What were you thinking at that point?” or “Tell me more about what you discussed with that person.” If you’ve told a story that’s anything but totally honest, your response will not hold up through these probes.
Listed below are some examples of behavioral questions:
Back to top
- Tell me about a time that you demonstrated initiative?
- Describe a situation when have you motivated yourself to complete an assignment or task that you did not want to do?
- Think about a difficult boss, professor or other person. What made him or her difficult? How did you successfully interact with this person?
- Think about a complex project or assignment that you have been assigned. What approach did you take to complete it?
- Tell me about the riskiest decision that you have made. What were your considerations in making that particular decision.
- Can you tell me about an occasion where you needed to work with a group to get a job done? What were the challenges and difficulties and how did you face these?
Here are 10 ways to improve your success in interviews:
- Show interest by preparing for the interview—research the health care company and industry, prepare a list of questions, and know your skills, talents, and accomplishments, etc.
- Dress to reflect the image of a business professional.
- Express sincere interest in both the company and position.
- Extend a firm, friendly handshake and maintain good eye contact.
- De-emphasize money and fringe benefits. (Simply do not bring this subject up during your interview!)
- Exhibit confidence and poise (at ease, calm, relaxed).
- Express a career purpose and interest in long-term opportunities (goals).
- Indicate participation in group activities (team player).
- Express appreciation for the interviewer's time.
- Follow up appropriately after each interview (phone call, thank you email, etc.).
Useful Links
Interview with a Medical and Health Services Manager
Glossary of Managed Care Terms
Department of Labor - Health Services Managers
American Journal of Managed Care / AJMC
Links to Professional Associations
Back to topAmerican Public Health Association
Managed Care Organizations
Aetna
Cigna
Group Health Cooperative of Puget Sound
HealthLink, Inc.
Health Net
HealthPartners
Health Insurance Plan of New York
Humana, Inc.
IHC Health Plans, Inc.
Kaiser Permanente
MVP Health Plan
PacifiCare Health Systems
PreferredOne
Private Healthcare Systems
Rockford Health PlansHealth Care Provider Companies
Beverly Enterprises Inc.
Cancer Treatment Centers of America
Community Health Systems
Genesis HealthCare
Health Management Associates
HCA, Hospital Corporation of America
HCR Manor Care
Kindred Healthcare
Life Point Hospitals
Magellan Healthcare Corporation
Quorum Health Resources
Select Medical Corporation
Sun Healthcare Group
SunLink Health Systems
Tenet Healthcare Corporation
Universal Health Services
William & Mary e-Recruiting - Health Care Job Search - You will need your William & Mary login and password to access the job opportunities within e-recruiting.
University of California Berkeley (Graduate Program in Health Management)
Georgetown University (Graduate Program in Health Systems Administration)
Johns Hopkins (Graduate Program in Health Finance and Management)
Association of University Programs in Health Administration (AUPHA) (List of Programs)