Management roles will vary from organization to organization and in different practice settings. In ambulatory physician practices, there is typically a practice manager, supervisor, and possibly leadership positions within medical records and/or the billing office. In a nursing home, the administrator is typically the highest-ranking position. Multiple department directors—business office, nursing, activities, environmental services, and admissions—often report directly to the administrator. Conversely, in a hospital, the highest-ranking position is often a chief executive officer, who may or may not be a physician. There is often a chief operating officer, chief financial officer, and chief nursing officer to round out the executive team. From there, there are a multitude of director positions for each main department. On a patient care unit, it is common to have a director of nursing, nurse manager, clinical supervisor, and charge nurses comprising the leadership team.
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