The short version. Medical & Health Services Manager pay in the United States runs from about $67,900 to $216,750 with a national median of $117,960 (U.S. Bureau of Labor Statistics, May 2024). Hospital, government, and pharmaceutical-services settings pay materially more than outpatient centers, physician offices, and long-term care. The top-paying states are New York, California, Delaware, Washington, and D.C. (metros above $150K median), and the four levers that move an offer are level (supervisor to director to VP), setting (hospital > ambulatory > LTC), certification (FACHE), and metro. Analyze your offer.
The national picture
Medical & Health Services Managers earn a national median of $117,960, with the 10th percentile at $67,900 (typical for an entry-level practice supervisor) and the 90th percentile at $216,750 (typical for a director or executive at a large health system). Median hourly is $56.71.
The occupation covers a broad range - the front-line practice supervisor at a two-physician office, the operations manager at a 300-bed hospital, the director of ambulatory services at an academic medical center, the compliance officer at a managed-care organization. Reading the OES median without adjusting for setting and level will miss the range dramatically. The rest of this page unpacks the levers that move the number.
Highest-paying states and metros
The five highest-paying states, per BLS OES annual mean wages (May 2024), are New York, California, Delaware, Washington, and Massachusetts - each above $150K annual mean. Top-paying metropolitan areas follow the same map: San Jose-Sunnyvale-Santa Clara, San Francisco-Oakland, New York-Newark-Jersey City, Salinas, Vallejo, and Bridgeport (per BLS). These metros clear $150K-$180K+ median with 90th percentiles into the mid $200Ks.
| State | Annual mean (approx) |
|---|---|
| New York | $164,340 |
| California | $161,940 |
| Delaware | $153,860 |
| Washington | $152,830 |
| Massachusetts | $151,180 |
| District of Columbia | $150,000+ |
Cost of living matters. A $150K NYC offer, after taxes and living costs, is close to a $115K Nashville offer in real disposable income. Do not chase the headline number without running your own cost-of-living math.
By setting - hospital vs ambulatory vs long-term care
Setting is one of the biggest differentiators inside SOC 11-9111. The BLS OES industry tables reveal a clear ladder.
| Setting | Annual mean (approx) | Notes |
|---|---|---|
| Pharmaceutical & medicine manufacturing | $196,940 | Compliance, regulatory affairs, medical affairs leadership. |
| Scientific research & development services | $182,970 | Site director, clinical operations lead at CROs and biotech. |
| Insurance carriers | $150,570 | Managed-care, quality operations at payers. |
| General medical & surgical hospitals | $135,690 | Largest employer. Operations, service-line management. |
| Offices of physicians | $113,800 | Practice management, physician-group operations. |
| Outpatient care centers | $122,120 | Ambulatory, dialysis, surgery centers. |
| Nursing care facilities | $107,020 | SNF administrator, LTC. |
| Community & vocational rehab services | $100,720 | Case-management admin, program leadership. |
Move-worthy differentials: a director-level move from a physician office to a hospital or health-system role typically adds 15-25%; a move from LTC to hospital operations often adds 20-30%; a move into pharma or CRO compliance leadership can add 30-50% at similar level (with higher variability quarter to quarter).
By level - supervisor to VP
Level is the other big lever. Levels here map onto the AHA-defined ladder used at most large health systems.
| Level | Typical base range | Scope |
|---|---|---|
| Supervisor / Coordinator | $60K - $85K | Front-line clinic supervisor, unit coordinator, small-practice office manager. |
| Manager | $80K - $120K | Practice manager, department manager (billing, HIM, clinic ops). |
| Senior Manager / Assistant Director | $100K - $140K | Multi-clinic, multi-site, or larger department. |
| Director | $130K - $200K | Service line, hospital department (perioperative, ambulatory, revenue cycle). |
| Senior Director | $170K - $250K | System-level director, multi-hospital. |
| VP / Chief (department) | $220K - $400K | VP Perioperative, VP Ambulatory, Chief Nursing Officer, CIO. |
| Hospital CEO / System CFO | $400K - $1.5M+ | Executive leadership; heavily bonus-and-equity weighted. |
Base, bonus, and total comp
Below the director level, base is 90%+ of total comp. At director, expect 10-20% bonus tied to quality (HCAHPS, readmission), operating margin, and cost-per-case. At VP and above, bonus grows to 20-40% and long-term incentive plans (LTIPs) begin to appear at large systems - either cash-based LTIPs at nonprofits or stock-based at investor-owned. In pharma and CRO settings, RSU vesting can be a meaningful component from senior manager up.
Executive comp is highly benchmarked. Boards use Sullivan Cotter, IntelliDyne, and Mercer benchmark data to set VP-and-up ranges. Individual negotiation happens inside those bands.
The four levers that move an offer
- Setting. The biggest one for lateral moves. Move from LTC to hospital service-line operations at the same title and pay usually jumps 20-30%.
- Level. Every step (manager -> senior manager -> director -> VP) is roughly a 25-40% base step, sometimes larger.
- Certification. FACHE credentials pass a screen at almost every director+ role. MHA or MBA is essentially expected for VP+.
- Metro. Big coastal metros pay 30-40% above the US mean; adjust for cost of living before you compare.
How to negotiate
Three moves that work well in healthcare administration offers. First, negotiate on the total package - base, bonus target, PTO, CME allowance, relocation, sign-on. Bonus target is usually the easiest lever above manager level (move from 10% to 15%). Second, use benchmark data - Sullivan Cotter and IntelliDyne benchmark reports are widely used by boards; naming the median and 75th percentile of your peer group gives an anchor. Third, at director level and above, negotiate scope alongside comp - service-line ownership, direct reports, board reporting - because scope drives the next promotion.
Analyze your offer.
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Frequently asked questions
What is the national median salary for a medical and health services manager?
Per the U.S. Bureau of Labor Statistics (May 2024, latest OES release), the national annual median wage for medical and health services managers (SOC 11-9111) is $117,960, with a 10th percentile of $67,900 and a 90th percentile of $216,750. Median hourly wage is $56.71. That covers everyone from an outpatient practice manager to a service-line director at a large health system.
Which states pay the highest?
The five highest-paying states are New York, California, Delaware, Washington, and Massachusetts, with annual mean wages above $150,000. The lowest-paying states are typically in the Southeast and Plains (Mississippi, Arkansas, Oklahoma, Kentucky) with means in the $95K-$110K range. Cost of living moves those numbers meaningfully - a $150K New York offer and a $115K Nashville offer can be comparable real income.
Do you make more in a hospital than an outpatient center?
Yes, generally. Hospitals of state, local, and private ownership pay above the national mean; general medical and surgical hospitals are the largest employer. Outpatient care centers, physician offices, and home-health services pay closer to or slightly below the median. Nursing care facilities and residential mental-health facilities pay at the lower end. That said, top-of-market outpatient specialty groups (oncology, ortho, cardiology) can rival hospitals.
What does a hospital CEO or system executive earn?
That is above SOC 11-9111 for most reporting. Hospital CEOs of mid-sized systems typically earn $500K-$1.5M in total comp; large integrated-delivery-network CEOs earn $2M-$5M+. Departmental service-line vice presidents at large systems (VP of Perioperative Services, VP of Ambulatory Care) typically clear $250K-$400K base with meaningful bonus.
Does an MHA or MBA increase pay?
Yes, at the director-and-up level. An MHA (Master of Health Administration) or an MBA is essentially expected for VP and C-suite roles at hospitals and health systems. At the manager and mid-manager level the credential differential is smaller. FACHE (Fellow of the American College of Healthcare Executives) is a meaningful signal at the director+ level - budget-owning roles favor FACHE candidates.
How much does the bonus typically add?
At the manager level, bonus is often 5-10% of base. Directors run 10-20%. VPs and above run 20-40%, sometimes higher on quality-and-cost metric attainment. In physician-owned or PE-backed practices, comp can include profit-sharing and equity that dwarfs base.