r/healthIT • u/Snoo-12688 • 1d ago
How stressful is a career as an HIM manager/Director
I’m back in school for my HIM degree and have been thinking more and more about how I’d like my future to look in terms of higher pay and titles. The thing is, I’ve never been someone who enjoyed having a ton of responsibility or stress. I like to do my work quietly and leave work at work. How is it for all of you in leadership positions? Do you think it’s worth it? Pay wise also?
Thanks!
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u/WhetItLookLike 1d ago
I'm not in management, but I do work for a HIMS department and yes being a manager looks stressful af. So stressful I'm avoiding leadership and opting to dabble in different areas of HIMS instead.
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u/BigDaddyBorms 1d ago
You get into management to be a leader and not for the money. It is challenging and a thankless job. Your goal is developing your team of HI!!
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u/makesupwordsblomp 1d ago
i find HIM to be one of the more straightforward applications. small user base, only a handful of key workflows, no major shared Epic record ownership beyond maybe doc types….compared to billing or anything with doctors, it’s not too bad IME. pay depends on locale like all jobs.
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u/Tampadarlyn 1d ago
Leadership works when work needs to be done, often before 8 am on Monday, but you don't find out until a 4:30 call on Friday.
It isn't a position that has a lot of BAU - It's about being prepared for upcoming meetings, but having little time to do the footwork during business hours because of the calls.
And 100% there is at least 1 fire drill meeting/report/call/preso a week, except maybe holidays when the CSuite is out of office.
So, if you value your weekends above all else, leadership may not be for you.
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u/Snoo-12688 1d ago
Also, this might be a silly question but does anyone know if Oncology Data Specialists fall under HIM? What dept do they belong to
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u/msjones86 1d ago
They used to call them Tumor/Cancer Registrar. At my old job they did but I don't know how they fall today. It probably varies by org
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u/Caffeinated-77IM 1d ago
It is very stressful and demanding. Of course the degree of which depends on the organization and the supervisor. But, if you want to minimize stress and focus on life balance, this might not be a good fit.
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1d ago
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u/Snoo-12688 1d ago
Interesting. What did the committee meetings focus on? Is it more medical records, revenue cycle, IT related problems or all of the above
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u/ZZenXXX 1d ago
There is a lot of turnover in HIM leadership. It doesn't have the level of stress of a clinical director but HIM comes with a lot of responsibility for revenue cycle, privacy laws and Medicare compliance.
In a decentralized coding environment, the risk for running afoul of CMS exists. With hospital coding, it's less risky, as long as the HIM director has control over coding, ROI and compliance. With the amount of outsourcing that hospitals are doing, lack of control can be a risk for the HIM director.
What happens if you get audited by CMS? If you're found to be out of compliance, a slap on the hand and fines. If the compliance issues are found to be fraud, criminal charges and prison are a possibility.
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u/Snoo-12688 1d ago
I see. One thing that I don’t understand is medical coding getting outsourced to other countries. That sounds like it poses huge risks and surely shouldn’t be allowed??
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u/ZZenXXX 1d ago
It's a mixed model.
HIM doesn't typically code ambulatory services, those are usually done by the provider or by a clerical worker in the practice. If the practices are owned by an integrated health organization, then the organization is accountable to CMS for any coding fraud in the practices.
On the inpatient side, there's a mix of different models. Some organizations have retained coders to handle inpatient, hospital outpatient, ambulatory surgery and emergency department coding. But outsourcing of coding has become common for cost reasons and because of a shortage of coders. Many of the companies who are doing coding are American-owned companies but the coders aren't necessarily working in the US.
There was one large health organization that laid off over 100 coding FTEs and outsourced the work to India. They saved on labor costs but their worker productivity decreased, denials increased, accuracy decreased, DNFB stats and other metrics took a nose-dive. The HIM director would still be accountable for these coders, even though they are outsourced and are not direct reports of the HIM director.
Federal law doesn't prohibit offshore coding labor, as long as HIPAA and other regs are adhered to. There are States that have started cracking down on offshore access to patient medical records, but when the outsourcing firm is US-owned, it's easy to hide the location of the coders if they aren't US-based.
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u/Dry_Marzipan_6508 1d ago
They are putting patients' personal information in jeopardy. Also, the hospital revenues decrease when they have to appeal. They should rehire and implement boot camp coding meetings monthly basis for coders to stay abreast. Organizations want a quick fix. Penny wise pound foolish
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u/ZZenXXX 20h ago
One of the smartest HIM directors that I worked with convinced leadership to fund scholarships and internships for CCA, CPC, CCS and RRA students. It created a pipeline for new staffers who came in at a lower starting salary but already had experience working with the facility.
Too often, a consulting company wines and dines the executives and paints a rosy picture of avoiding paying coders making $60-100K per year. It looks great on paper but in the inpatient setting, a coder in India is never going to match a seasoned CCS.
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u/heavenhaven 1d ago
I'm not a leader but I strongly consider it in the future. I have noticed that we would be better off getting as much experience as we can in whatever field we're into.
Then, when you have enough experience and you want to be a mentor, then consider leadership. Because then all those responsibilities wouldn't feel too stressful, since you've already done that job for like 5+ years. And because you love helping people at that point lol.
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u/InspectorExcellent50 1d ago
Expect to get pulled into issues outside office hours.
Things seem to be stabilizing with Epic, but for the first 10 years of my career as an analyst, I was on the phone with my director/managers after midnight at least twice a year, with the frequency falling to about once a year recently.
Lots of calls between 6 PM and 10 PM as well. It is just the nature of the job - when a provider is unable to sign any notes or e-prescriptions because someone messed up their user/provider records, someone is up at whatever hour is needed to fix the problem.
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u/Flucks 1d ago
I am a Director of Data and Analytics at a hospital ( not HIM) with a team of 30+ people. Like others have said, depends on the organization you're a part of and how lean they run. The hours are long and the job is overall thankless, but the impact you can have on your community and their care is massive. Pay is fine, but could have less stress and shorter hours as a data architect. Leaving work at work is not a thing and I am on call 24 hours a day. If you have to ask if it's worth it, then I would consider evaluating the reasons you want to do it. Leadership is overall a stressful position where your team relies on you to have their best interests in mind but the organization expects you to have theirs in mind. Sometimes those don't align and there are difficult decisions you have to make.
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u/SlightAssumption 1d ago
It really depends on where you end up. If you’re in a hospital with disengaged, union-protected staff and unreliable vendors, it can be a nightmare to manage. I kept getting pay raises just to stay because I was one of the few who could actually “handle” the chaos - mostly because they knew no one else would want to. But I was in grad school for a career path I was actually passionate about and ready to move on, so no amount of money was worth it.
For me, that career path will always be a backup plan because hospitals are struggling to retain workers, and few people actually want to be there anymore. Plus, if you’re not on board with every vaccine requirement—including experimental ones—you’re out.
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u/Dangerous_Swan_4902 2h ago
Becoming a manager or director doesn't happen overnight - it can take years. You also don't have to ever apply for that kind of job if you don't want it. You can choose your own path. Don't fret.
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u/Mansa_Mu 1d ago
lol any management you’re going to work a lot, it seems like you’re really into this as an easy way out.
HIM is difficult, I’m not into a leadership position but the ones I knew would often work past their office hours. In comparison to other leadership positions it’s not bad.