{ "source": "Cooked Index — occupational AI risk register", "page": "https://cookedindex.com/jobs/medical-and-health-services-managers/", "methodology": "https://cookedindex.com/methodology", "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.", "scored_at": "2026-08-11", "model": "claude-opus-5", "occupation": { "title": "Medical and Health Services Managers", "soc_code": "11-9111", "category": "Management", "us_employment": 597080, "median_annual_wage": 123860 }, "verdict": "EXPOSED", "risk_resistance": 55, "contested": false, "near_boundary": false, "dimensions": { "task_resistance": 11, "embodiment": 8, "liability_shield": 8, "trust_premium": 12, "judgment_accountability": 16 }, "reasoning": { "task_resistance": "Census forecasting, productivity dashboards, RVU and variance reports, and prior-auth denial tracking are already vendor software rather than management judgment, but the 7am charge-nurse escalation, the physician who refuses the new documentation workflow, and the corrective action plan you personally negotiate after a survey deficiency keep this at 11 instead of down near 6.", "embodiment": "You are on-site because the unit is: rounding the floor, walking a surveyor through the med room, checking OR turnover in person, sitting in the credentialing and safety committee rooms — but none of it is your hands on a patient or a piece of equipment, which caps it at 8 rather than the 13+ of the clinicians you manage.", "liability_shield": "Nursing home administrators hold a state NHA licence with personal sanction exposure under 42 CFR 483, and some states licence assisted-living administrators, but the clinic and hospital-department managers who make up most of this SOC need only a master's and maybe FACHE or CPC — voluntary credentials that no regulator can pull — so the shield averages to 8.", "trust_premium": "Your leverage comes from named relationships you cannot delegate: the medical director who will take your call about a difficult partner, the DON who tells you about a staffing problem before it becomes an incident report, the payer contract rep who knows your volumes — but the health system can and does replace you in that seat, which is why this sits at 12 rather than a physician's 17.", "judgment_accountability": "You own the calls no procedure covers: closing beds versus mandating overtime when four nurses call out, whether an incident becomes a root cause analysis or a peer review referral, whether to self-disclose a coding pattern to the payer, which service line absorbs the budget cut — decisions signed in your name with patient-safety and CMS-survey consequences and no manual to point at." }, "rationale": "The modal worker here is a clinic, department, or practice manager whose week mixes staffing and scheduling, budget variance review, billing and coding oversight, regulatory reporting, and policy documentation — the reporting and documentation half is squarely in AI's wheelhouse. What survives is walking the unit, handling a physician or nurse conflict at 7am, owning a Joint Commission survey finding, and making resource calls when census spikes and staff call out. Nursing home administrators carry real state licensure and personal accountability; most hospital and physician-practice managers do not, so the legal shield is partial.", "outlook": "Headcount holds or grows with healthcare demand, but the reporting-and-scheduling layer thins as AI absorbs it, concentrating value in managers who own regulatory accountability and staff relationships.", "what_would_raise_it": { "levers": [ { "dimension": "liability_shield", "change": "Extension of nursing-home-style administrator licensure (state NAB/NHA licensure, personal accountability for facility deficiencies) to other settings — e.g. state licensure of ambulatory surgery center administrators, or CMS conditions of participation naming a specifically credentialed, personally accountable administrator for hospital outpatient departments and dialysis facilities. Also plausible: state health-AI bills (following Texas HB 1709-style and California AB 3030 lines) requiring a named human administrator to attest that clinical AI tools used in the facility have been reviewed, with personal sign-off on the attestation.", "plausibility": "plausible", "would_add": 5 }, { "dimension": "liability_shield", "change": "Accreditation-driven sign-off: a Joint Commission or NCQA standard requiring a named human leader to personally certify corrective action plans and AI-generated quality reports, rather than allowing system-generated submission. Joint Commission's 2025 responsible-AI-use guidance with CHAI is the visible seed.", "plausibility": "already happening", "would_add": 3 }, { "dimension": "judgment_accountability", "change": "Formal designation as the accountable executive for AI governance — hospital AI committees (as at Mayo, Kaiser, Duke) increasingly name a specific operational leader who owns model deployment, drift monitoring, and shutdown decisions. If CMS or state law makes that designation mandatory and non-delegable, the role gains an explicitly consequential, ambiguous-call portfolio.", "plausibility": "already happening", "would_add": 3 }, { "dimension": "task_resistance", "change": "Genuine two-tier structure: if reporting, budget variance narrative, coding audit prep, and scheduling optimization are absorbed by software, the residual week is labor conflict, survey defense, physician relations, and surge resource allocation — all of which are resistant. Watch for span-of-control widening (fewer managers, each with more human-conflict load) rather than headcount stability.", "plausibility": "already happening", "would_add": 3 } ], "ceiling_note": "Trust premium has no realistic route — patients and payers do not select or pay for a facility because a human manages the back office, and no purchasing decision surfaces this role. Any resilience gain must come from licensure and named accountability, and the largest single lever (licensure spread beyond long-term care) has been static for decades." }, "adjudication": null, "employment_history": { "points": [ { "y": 2017, "emp": 346980, "wage": 98350 }, { "y": 2018, "emp": 372670, "wage": 99730 }, { "y": 2019, "emp": 394910, "wage": 100980 }, { "y": 2020, "emp": 402540, "wage": 104280 }, { "y": 2021, "emp": 436770, "wage": 101340 }, { "y": 2022, "emp": 476750, "wage": 104830 }, { "y": 2023, "emp": 515100, "wage": 110680 }, { "y": 2024, "emp": 565840, "wage": 117960 }, { "y": 2025, "emp": 597080, "wage": 123860 } ], "from": 2017, "to": 2025, "change_pct": 72.1, "comparable_from": 2019, "spans_soc_revision": true }, "pivots": [], "license": "https://cookedindex.com/terms" }